Urogynecology

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Urogynecologist
Occupation
Names Doctor, Medical Specialist, Surgeon
Occupation type
 Gynecology, Urology, Specialty, Surgery
Activity sectors
 Medicine, Surgery
Description
Competencies Patient Care, Education, Research
Education required
 Doctor of Medicine, Doctor of Osteopathic Medicine
Related jobs
 Gynecologist, Urologist

Urogynecology or urogynaecology is a surgical sub-specialty of urology and gynecology.

History

In 1893, Howard Kelly, a gynecologist and pioneering urogynecologist, invented an air cystoscope which was simply a handheld, hollow tube with a glass partition.[1] When the American Surgical Society, later the American College of Surgeons, met in Baltimore in 1900, a contest was held between Howard Kelly and Hugh Hampton Young, who is often considered the father of modern urology.[2] Using his air cystoscope, Kelly inserted ureteral catheters in a female patient in just 3 minutes. Young equaled this time in a male patient.[3] So began the friendly competitive rivalry between gynecologists and urologists in the area of female urology and urogynecology. This friendly competition continued for decades. In modern times, the mutual interest of obstetricians, gynecologists, and urologists in pelvic floor problems in women has led to a more collaborative effort.

Education and training

For a brief definition/description of what a urogynecologist does, see: .[4] Although there are many similarities in their clinical focus and training, the urologic subspecialty of Female Urology is only accessible to those who have completed urology residency and then undergo 1–2 years of additional training in a Female Urology fellowship. Female urology is not ABMS recognized or board certified separately from general urology.

Urogynecology is now officially known as ″The subspecialty of Female Pelvic Medicine and Reconstructive Surgery″. FPMRS obtained approval for board certification from the American Board of Medical Specialties in 2012, and in June 2013 practitioners began sitting for a mandatory board certification exam in the subspecialty for the first time. Board certified urogynecologists' titles are followed by 'FPMRS' (Female Pelvic Medicine and Reconstructive Surgery) to reflect their status. Even before the current training requirements, many practitioners had completed a board-accredited fellowship in Urogynecology and Reconstructive Pelvic Surgery after completing a residency in Obstetrics and Gynecology or Urology. The first fellowship received accreditation in 1996.[5] As of January 2010, there were 30 fellowship programs approved by both the American Board of Obstetrics and Gynecology[6] and the American Board of Urology.[7][8] Additionally, qualified candidates may seek board certification for Female Pelvic Medicine and Reconstructive Surgery through the American Osteopathic Board of Obstetrics and Gynecology (AOBOG).[9] These fellowships are three-years for obstetrician-gynecologists and two-years for urologists. Thus, the combined duration of training for female pelvic medicine and reconstructive surgery is seven years after medical school for both urologists and gynecologists. The International Urogynecology Journal publishes a listing of world-wide training programs.[10]

Scope of practice

Urogynecology involves the diagnosis and treatment of urinary incontinence and female pelvic floor disorders. Incontinence and pelvic floor problems are remarkably common but many women are reluctant to receive help because of the stigma associated with these conditions. "There is no more distressing lesion than urinary incontinence-A constant dribbling of the repulsive urine soaking the clothes which cling wet and cold to the thighs, making the patient offensive to herself and her family and ostracizing her from society"[11] Although countless women are bothered by a loss of bladder control, bowel symptoms, and pelvic discomfort they are often not aware that these problems have a name much less how common they really are. Pelvic floor conditions are more common than hypertension, depression, or diabetes. One in three adult women have hypertension;[12] one in twenty adult women have depression;[13] one in ten adult women have diabetes;[14] and, more than one in two adult women suffer from pelvic floor dysfunction.[15]

Some conditions treated in urogynecology practice include:[16]

Diagnostic tests and procedures performed include:[16]

Specialty treatments available include:[16]

See also

References

  1. ↑ Kelly HA. Medical Gynecology. New York: Appleton, 1908.
  2. ↑ Hugh H. Young
  3. ↑ Young HH. A Surgeon's Autobiography. New York: Harcourt, 1940.
  4. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  5. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  6. ↑ http://www.abog.org
  7. ↑ http://www.abu.org
  8. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  9. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  10. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  11. ↑ Howard Atwood Kelly, M.D, 1928
  12. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  13. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  14. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  15. ↑ Goldberg et al. Delivery mode is a major environmental determinant of stress urinary incontinence: results of the Evanston-Northwestern Twin Sisters Study. Am J Obstet Gynecol (2005) vol. 193 (6) pp. 2149-53
  16. ↑ 16.0 16.1 16.2 Lua error in package.lua at line 80: module 'strict' not found.

External links

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