Who Treats Pelvic Floor Disorders?

Pelvic floor disorders fall into a category that can span across different medical specialties. If you see your primary care physician regularly, it is likely that they will be your initial point of contact regarding your pelvic floor symptoms. In most cases, though, your primary care physician should refer you to a specialist if they believe you need treatment. The type of specialist that your doctor refers you to will depend on the specific symptoms you have.

Research aimed at understanding how primary care physicians deal with pelvic disorders in their patients has shown that in the case of symptoms associated with physical anatomy – such as prolapse, doctors are more likely to refer patients to gynecologists than to urologists.¹

On the other hand, when symptoms have more to do with urinary issues, primary care physicians seem more likely to refer to urologists than to gynecologists. When patients have urinary incontinence – involuntary urine leakage – primary care physicians have been shown to refer patients to:

• urologists 38% of the time
• urogynecologists 42% of the time

For overactive bladder symptoms, the same study showed that doctors refer to:

• urologists 54% of the time
• urogynecologists 31% of the time
• gynecologists only 13% of the time

Primary care physicians play a major role in the everyday health of their patients, but they may be unfamiliar with the management of female pelvic floor disorders. If you understand the different types of specialists who can help with your pelvic floor symptoms, you will be better equipped to advocate for yourself when you need help.

So who are the different specialists, and what do they do for pelvic floor disorders? We will discuss the differences between Urologist, Gynecologists, Urogynecologists, and MIGS.

Urologists

Urologists spend at least 5 years being trained in the urogenital system, which focuses on urinary tract systems and male reproductive organs. Many people think of urologists as doctors who treat men, but they treat both men and women. While they treat bladder problems and UTIs, some – but not all – urologists are trained in how to deal with pelvic organ prolapse.² Other specialists may be more specifically trained in how to deal with pelvic floor disorders, but experts have suggested that people with urology training may bring a unique perspective that could help with approaches to certain types of pelvic challenges.³

Gynecologists

Like urologists, gynecologists are trained in pelvic and reproductive medicine, but unlike urologists, gynecologists treat only women. Some gynecologists are trained in both gynecology and obstetrics – and are referred to as OB/GYNs – meaning that they are also trained in the processes of pregnancy and childbirth. Gynecologists, like urologists, can evaluate patients with pelvic floor disorders and determine a treatment plan. While they are more specialized in treating pelvic floor disorders than primary care physicians, gynecologist will refer you to another specialty with better training if necessary.

Urogynecologists

People are recognizing more and more the need to help people with pelvic floor disorders, and because both urology and gynecology training offer value for patients with pelvic floor symptoms, a subspecialty called urogynecology was developed less than a decade ago that offers the most specialized care for these patients. Urogynecologists are OB/GYNs or urologists with extra training.⁴ Doctors who are board-certified in urogynecology hold, in addition to their MD (Medical Degree), the additional designation of FPMRS, which stands for Female Pelvic Medicine and Reconstructive Surgery. The FPMRS initials following a doctor’s name indicate that the doctor has the highest level of expertise for treating pelvic floor disorders, such as incontinence, prolapse, OAB, etc.

Minimally Invasive Gynecologic Surgery

Some specialist train in MIGS, known as Minimally Invasive Gynecologic Surgery, a technique with smaller incisions, faster procedure & recovery time and known to reduce the pain to patients. These procedures can be used to treat conditions such as endometriosis, fibroids, ovarian cysts, abnormal bleeding, etc.

Why it’s better to see a specialist instead of a primary care physician

Pelvic floor disorders are not only common but can also be complex. Managing them is known to be difficult. As a result, experts have suggested that a multidisciplinary approach may be the most effective way to help patients with pelvic floor disorders, and policies are even being established to encourage interdisciplinary collaboration to treat pelvic floor disorders.⁷

The relatively new certification of urogynecology represents a need for more specialized training to help adequately address the challenges that women with pelvic floor disorders face. The demand for these specialists is also growing quickly as other doctors learn that they can refer their patients to people who are specially trained to help these women.⁸

When to see a specialist

When you are experiencing symptoms. Your primary care physician is likely the best person to see first to tell you if you could benefit from seeing a specialist for your pelvic floor symptoms. So far, research on the success of treatments that are provided by FPMRS doctors has produced promising results.¹ At the same time, urogynecology continues to advance as a specialty, and so doctors training in this field are becoming better equipped to help women with pelvic floor disorders.⁹

Takeaway

If you suffer from pelvic floor symptoms, there are several resources available to you. Because more and more people in the medical community are recognizing how common pelvic floor disorders are, they are allotting more effort to both understanding these disorders and treating them more effectively. Your Primary Care Physician can help you determine if you can benefit from seeing a specialist – and if so – which type of specialist is right for you. But it is important for you to know your options so that you can advocate what you believe is best for yourself.