What Is a Urogynecologist and How Can They Help?
If you're experiencing urinary incontinence, pelvic pressure, pain with sex, or postpartum changes that just don't feel quite right, you may benefit from seeing a urogynecologist. But what exactly do they do, and when should you reach out for help?
Dr. Maria Canter, a double board-certified expert in Female Pelvic Medicine and Reconstructive Surgery as well as Obstetrics and Gynecology, joined the podcast to explain what urogynecology is, how these specialists support women's pelvic health, and why early intervention matters.
What Is a Urogynecologist?
A urogynecologist is a medical specialist who focuses on pelvic floor dysfunction in women. While gynecologists address general reproductive health and urologists treat the urinary tract, urogynecologists bridge both worlds with additional training to manage complex pelvic floor conditions.
They treat:
Urinary incontinence (involuntary loss of urine)
Fecal incontinence (loss of stool)
Pelvic organ prolapse (when pelvic organs descend into or outside the vaginal canal)
Sexual dysfunction (such as pain with intercourse, low libido, and lubrication issues)
Unlike general OB-GYNs, they don't typically handle routine screenings like pap smears or mammograms, and they don’t treat bladder or kidney cancers.
Common Postpartum Symptoms That May Need a Specialist
You might benefit from seeing a urogynecologist if you notice:
A feeling of vaginal heaviness or like a tampon is out of place
Urinary leakage with laughing, coughing, or exercise
Difficulty holding urine when you feel an urge
Incontinence without realizing it's happening
Difficulty emptying your bladder or bowels
Pain or pressure in the pelvic region
Even more complex issues like fecal incontinence can arise after a severe vaginal tear (such as a fourth-degree laceration), and pelvic floor specialists are uniquely equipped to help with recovery.
According to Dr. Canter, the best time to address these issues is right away. "Day one of incontinence is day one you should report it," she says. Early intervention can lead to better recovery outcomes.
Even if symptoms seem mild, they can signal underlying dysfunction. For example, numbness in the pelvic floor could indicate nerve damage, which physical therapy and stimulation tools like TENS units can help rehabilitate.
What Is Pelvic Organ Prolapse?
One common condition urogynecologists treat is pelvic organ prolapse. This occurs when the muscles and tissues supporting the pelvic organs weaken, causing the bladder, rectum, uterus, or vaginal walls to shift out of place.
You might feel a bulge or pressure in your vagina, notice difficulty with bowel movements, or experience discomfort during daily activities. A prolapse isn’t dangerous, but it can seriously affect your quality of life.
Mild cases can be treated with pessaries and physical therapy; more severe cases may eventually require surgery.
First-Line Treatments: Physical Therapy & Beyond
Don’t worry—seeing a urogynecologist doesn't mean you'll be sent straight to surgery. In fact, surgery is usually not the first recommendation.
Most patients begin with:
Pelvic floor physical therapy (not just Kegels—think core and Pilates-style movement)
Pelvic floor exercises tailored to your condition
Estrogen creams for tissue healing and dryness
Supportive devices like pessaries (silicone rings fitted to support the vagina or bladder)
You Don't Have to Just Live With It
Many people delay treatment for pelvic floor symptoms due to embarrassment, misinformation, or fear. But these conditions are common, treatable, and nothing to be ashamed of. Take your time and look for the provider that fits your needs – namely, someone who will listen, explain the various options, and help you figure out how they fit in your life. (For one patient’s experience with seeking help for serious vaginal and rectal prolapse, listen to Episode 6 of Perinatal and Reproductive Wellness, with Colleen Avis.)
If something feels off postpartum or beyond, trust yourself. There are compassionate providers and effective treatments available. You deserve to feel good in your body.
Need Help?
Ask your OB-GYN about a referral to a urogynecologist, or search for pelvic floor specialists in your area. The sooner you seek care, the sooner you can begin to feel better.