A urogyn has chosen. To pursue 2-3 years of additional medical and surgical training after completing a residency in obgyn or urology (90% are obgyns). The training focuses on the evaluation and management of bladder problems pelvic organ prolapse and interstitial cystitis in women only. Check out www. Augs. Org.
Gyn subspecialist. They are trained as ob/gyns and then subspecialize and are boarded in female pelvic medicine and reconstructive surgery. They handle problems with bladder control and loss of the pelvic supports of the bladder, uterus, and rectum. The most severe, most difficult, and most complicated problems will be referred to them.
Specialist. A urogyn is a physician who specializes in the treatment of female pelvic disorders including urinary incontince & pelvic organ prolapse.
UROGYN Specialist. A urogynecologist is either an obgyn or urologist who specializes in the treatment of pelvic floor disorders, such as pelvic prolapse (cystocele, rectocele, uterine prolapse) aka "vaginal bulge' or urinary or fecal incontinence. Many have completed advanced training in this field.
Complicated problems. Your regular ob/gyn will normally handle the initial evaluation and screening, and depending on their interests and training may also be able to manage the problem. If your problem is particularly severe, does not respond to initial treatments, and especially if you have already had surgery, then a urogynecologist should be consulted. If in doubt, consult.
Two sides. There are two opinions for the most part. Those that dislike mesh & those that like mesh. The mesh group can further be divided by those that place the mesh vaginally & those that place it abdominally (sacrocolpopexy) by open incision, laparoscopy, or robotic assisted. Many consider sacrocolpopexy the gold standard for prolapse repair withe the first one being done in 1957.
Some do and don't. The society as a whole has setup criteria for who should and shouldn't use mesh for reconstruction. It's use for this purpose should be limited. The much smaller piece for incontinence is very safe in trained hands and is the gold standard. Sometimes called tvt- about 40 million worldwide.
Yes and No. With all of the controversy about mesh, it's important to know that there are mesh and non mesh options for any repair that is needed, including incontinence. The fda has published consumer awareness literature that should be shared with patients considering a mesh procedure. It's important to ask your physician about the options and the reasons for recommended procedures.
It depends... Mesh can be a valuable tool for treating pelvic prolapse and urinary incontinence. To be successful it requires an experienced surgeon and appropriate patient selection.
No simple answer. Mesh is a tool that is used in many different ways in uorgynecology. Some uses appear to have low risks of problems (e.g. for urinary incontinence) and have significant advantages, and other uses have high risks of serious complications and no proof of advantages. If your doctor is recommending the use of mesh for your prolapse or incontinence, make sure they do the procedures often.