What are urogynaecological conditions and pelvic floor problems?

Urogynaecology is a specialist area of medicine that provides care for people with conditions of the female pelvic organs and pelvic floor, as related to urinary/bladder function. The pelvic floor is a collection of muscles and ligaments that support the organs in the pelvis, including the bladder, bowel and uterus (sometimes called the womb).

Urogynaecology is a subspecialty within gynaecology. In some parts of the UK, there are urogynaecology specialist departments. In areas where these are not available, patients may be referred to gynaecology departments (an area of medicine which specialises in women’s health and conditions affecting the reproductive system, such as the uterus, cervix, vagina, ovaries, fallopian tubes and vulva).

This section covers the following urogynaecology conditions:

  • Urinary incontinence
  • Pelvic organ prolapse
  • Urinary tract infections (UTI) and bladder pain

Dr. Matthew Izett-Kay, a consultant urogynaecologist, describes what urogynaecology is and why he finds helping patients in his job rewarding.

Urinary incontinence

Urinary incontinence is the unintentional loss of urine/wee. There are particular types of urinary incontinence, such as stress incontinence (urine leakage when coughing, sneezing, or exercising), overactive bladder, or urgency (urgently needing to go for a wee). Some people with urinary incontinence can also leak urine without recognising that they need to go for a wee. Some people have a ‘mixed’ type of urinary incontinence, meaning they have several types and associated symptoms.

There are many other forms of bladder symptoms that can bother people that do not involve incontinence, such as needing to wee/urinate a lot, getting up to wee at night, or difficulties emptying the bladder.

Dr. Matthew Izett-Kay, a consultant urogynaecologist, describes what urinary incontinence is and some of the different types of urinary incontinence that may affect people.

Pelvic organ prolapse

Prolapse is a condition in which pelvic organs, like the bladder and uterus, fall down or slip out of place into the vagina. There are particular types, such as cystocele (prolapse of the bladder into the vagina), cystourethrocele (combined prolapse of the urethra and bladder into the vagina), rectocele (prolapse of the rectum into the vagina), and/or uterine prolapse (when the uterus slips down into or out of the vagina).

Prolapses can be graded to describe how severe they appear on examination. However, this doesn’t always correspond with the symptoms people may have from them.

Dr. Matthew Izett-Kay, a consultant urogynaecologist, explains what pelvic organ prolapse means and the different types of prolapse people may experience. People may experience more than one of the types of prolapse.

Urinary tract infections (UTI) and bladder pain

Urinary tract infections are when bacteria infects the system that produces and stores urine, such as the bladder. For some people, UTIs are acute, meaning they have one-off episodes that they recover from with a short course of antibiotics. However, some people may go on to have further problems with UTIs, meaning that symptoms don’t go away or keep coming back again. This is sometimes referred to as ‘recurrent UTI’, ‘embedded UTI’, or ‘chronic UTI’. There can be uncertainty surrounding the diagnosis of these conditions and there is no agreement on the exact definition of many of these terms.

Bladder pain syndrome (sometimes called interstitial cystitis) is a condition that is not yet well understood. It causes tummy pain and discomfort when weeing. The symptoms are often very similar to UTIs, making it difficult to distinguish.

Dr. Matthew Izett-Kay, a consultant urogynaecologist, reflects on the challenges with differentiating different lower urinary tract symptoms to try to help them get the best care for patients.

You can read more elsewhere on this website about people’s experiences of topics like urogynaecological symptoms, the emotional impacts of symptomshaving tests and examinationsmaking decisions about treatments for urogynaecological problems, and experiences of information and support.

Signs and symptoms of urogynaecological conditions

There are different symptoms associated with particular urogynaecological conditions. This section covers: Early signs and realising that something is not ‘right’ Pelvic organ prolapse symptoms...