A gynecologist treats the female reproductive system. A urogynecologist is a gynecologist or urologist with three extra years of fellowship training and a separate board certification focused on bladder leakage, overactive bladder, pelvic organ prolapse and other pelvic floor problems.
Most women see a gynecologist for years before a bladder or pelvic floor problem appears. When leakage, urgency or a vaginal bulge starts, it is not always clear who to call next: your gynecologist, a urologist, or a urogynecologist. This guide explains how the three specialties differ, what each one treats best, and the signs that it is time to see a pelvic floor specialist.
At a glance: who to see
- Start with your gynecologist for annual exams, periods, contraception, menopause questions and new, mild bladder symptoms.
- See a urologist for kidney stones, blood in the urine, kidney problems or male urologic care.
- See a urogynecologist for leakage, urgency, a vaginal bulge, recurrent UTIs, bladder pain or mesh problems that have not settled.
- Ask for a second opinion from a urogynecologist before pelvic floor surgery, or if symptoms return after a repair.
What Is a Urogynecologist?
A urogynecologist is a physician board-certified in Urogynecology and Reconstructive Pelvic Surgery, formerly called Female Pelvic Medicine and Reconstructive Surgery (FPMRS). After residency in gynecology or urology, they complete a three-year fellowship focused only on the female bladder, pelvic floor and pelvic support.
The specialty sits where gynecology and urology overlap. A urogynecologist looks at the bladder, urethra, vagina, uterus, rectum and pelvic floor muscles as one connected system, because in women these problems rarely happen alone. A weak pelvic floor after childbirth, for example, can cause leakage, prolapse and bowel symptoms at the same time.
Urogynecologists offer the full range of care: behavioral therapy, pelvic floor physical therapy, medication, pessaries, in-office procedures and reconstructive surgery.
Gynecologist vs Urologist vs Urogynecologist: How Do They Compare?
All three can help with some bladder and pelvic symptoms, but their training and focus differ. Gynecologists cover reproductive health broadly, urologists cover the urinary tract in men and women, and urogynecologists focus on female pelvic floor disorders with both medical and surgical options.
| General OB/GYN | General urologist | Urogynecologist | |
|---|---|---|---|
| Training after medical school | 4-year residency | 5 to 6-year residency (often including general surgery) | Residency in OB/GYN or urology, plus a 3-year fellowship |
| Board certification | Obstetrics and Gynecology | Urology | OB/GYN or Urology, plus Urogynecology and Reconstructive Pelvic Surgery |
| Main focus | Reproductive health, pregnancy, menopause, gynecologic surgery | Kidneys, bladder, stones, urologic cancers, men’s health | Female bladder, pelvic floor, prolapse and reconstructive surgery |
| Leakage and overactive bladder | First-line care | Yes | All levels, including Botox and nerve therapy |
| Prolapse | Some treat it | Some treat it | Core expertise: pessaries to complex repair |
| Mesh complications | Usually refer | Some treat them | Evaluation and revision |
| Kidney stones, blood in urine | Refer | Core expertise | Evaluate and refer when needed |
What Conditions Does a Urogynecologist Treat?
Urogynecologists treat problems of the bladder, pelvic floor and pelvic organ support in women. The most common are stress and urge incontinence, overactive bladder, pelvic organ prolapse, recurrent urinary tract infections, bladder pain, bowel control problems and complications from previous pelvic mesh surgery.
- Urinary incontinence, leaking with coughing, exercise or a sudden urge
- Overactive bladder, frequency, urgency and getting up at night
- Pelvic organ prolapse, a vaginal bulge or pressure
- Recurrent urinary tract infections
- Bladder pain and interstitial cystitis
- Fecal incontinence and trouble emptying the bowel
- Vaginal mesh complications
- Pelvic floor problems after childbirth and changes after menopause
Not sure which specialist you need?
Dr. Solafa Elshatanoufy is board-certified in both general obstetrics and gynecology and in urogynecology, so you can be evaluated for gynecologic and pelvic floor concerns in one practice in Katy. New patients are welcome.
When Should You See a Urogynecologist Instead of Your Gynecologist?
See a urogynecologist when bladder, bowel or pelvic support symptoms affect daily life, have not improved with first treatments, or when surgery has been suggested. A specialist evaluation is also wise if symptoms come back after a previous repair or you have pain after mesh surgery.
| Your situation | Reasonable first step | Time to see a urogynecologist |
|---|---|---|
| New, mild leakage with exercise | Pelvic floor exercises, ask your gynecologist | If it persists after 2 to 3 months or bothers you |
| Urgency or frequent trips at night | Limit caffeine and evening fluids, bladder training | If one or two medicines have not helped or caused side effects |
| A vaginal bulge or pressure | Avoid straining, note what makes it worse | Now, for an exam and options |
| Three or more UTIs a year | Urine culture with each episode | Now, to look for an underlying cause |
| Surgery has been recommended | Ask what non-surgical options were tried | Before deciding, for a second opinion |
| Symptoms returned after a repair, or pain after mesh | Gather your operative records | Now |
When to seek immediate medical evaluation
- You cannot urinate, or your bladder is full and painful
- Fever, chills, or back or side pain with urinary symptoms
- Visible blood in your urine
- Heavy vaginal bleeding, or a prolapse that is painful, swollen and will not go back in
Go to an emergency room or call 911 in an emergency.
Why Does Pharmacy Training Matter in Bladder Care?
Many bladder and menopause treatments are medicines, and several common drugs make bladder symptoms worse. A physician who also holds a Doctor of Pharmacy degree can match medicines to your other prescriptions, age and side-effect risks, and recognize when a medicine is part of the problem.
From a pharmacist’s point of view: diuretics, some blood pressure and diabetes medicines, sedatives, caffeine and alcohol can increase urgency or leakage. Older anticholinergic bladder medicines can cause dry mouth, constipation and, in older women, confusion or memory concerns. Dr. Elshatanoufy, who holds a PharmD, reviews your full medication list as part of every bladder evaluation.
What Happens at a First Urogynecology Visit?
A first visit starts with a detailed conversation about your symptoms, deliveries, surgeries and goals, followed by a focused pelvic exam. Simple office tests, such as a urine test and a bladder scan, are often done the same day, and more specialized testing is added only if it will change your treatment.
- History: when symptoms happen, how much they bother you, and what you have already tried. A 2 to 3 day bladder diary is very helpful.
- Exam: a gentle pelvic exam, sometimes with a cough or bearing down, to check support and the pelvic floor muscles.
- Office tests: urinalysis, a post-void residual scan, and when needed urodynamic testing or cystoscopy.
- A plan: you leave with a clear explanation and options, starting with the least invasive.
Your Care Team at Katy Women’s Pelvic Health
Dr. Solafa Elshatanoufy, MD, PharmD
Board-certified in obstetrics and gynecology, urogynecology and reconstructive pelvic surgery, and advanced minimally invasive gynecology. Fellowship at Wayne State University.
Oyindamola Gbadamosi, FNP
Board-certified family nurse practitioner for follow-up visits, medication adjustments and ongoing care.
Sonya Asghari, PT
Licensed pelvic floor physical therapist working within the practice.
Seeing a Urogynecologist in Katy, Texas
Katy Women’s Pelvic Health is at 410 W Grand Pkwy S, Suite 320, Katy, TX 77494, near I-10 and the Grand Parkway (SH 99). Women from Katy, Fulshear, Cypress, Sugar Land, Richmond and Houston are seen here, Monday to Friday, 8:00 AM to 5:00 PM. We accept most major insurance plans and are accepting new patients. You can also read about our gynecology care.
Outside the Houston area, look for a physician who lists board certification in Urogynecology and Reconstructive Pelvic Surgery (or FPMRS). The American Urogynecologic Society offers a public directory.
Key Takeaways
- A urogynecologist has three extra years of training focused on the female bladder and pelvic floor.
- Gynecologists handle reproductive care and first-line bladder care; urologists focus on the whole urinary tract.
- See a urogynecologist when leakage, urgency, prolapse or recurrent UTIs persist or surgery is suggested.
- A second opinion before pelvic floor surgery is always reasonable.
Frequently Asked Questions
What is the difference between a gynecologist and a urogynecologist?
A gynecologist cares for the female reproductive system across a woman's life. A urogynecologist is a gynecologist or urologist with three more years of fellowship training and separate board certification in the bladder, pelvic floor and prolapse.
Should I see a urologist or a urogynecologist for bladder leakage?
Both can treat leakage. A urogynecologist evaluates the bladder, vagina, pelvic floor muscles and prolapse together, which helps when leakage comes with pelvic pressure, a bulge, childbirth injury or menopause changes.
What does FPMRS mean?
FPMRS stands for Female Pelvic Medicine and Reconstructive Surgery, the board-certified subspecialty now called Urogynecology and Reconstructive Pelvic Surgery. It covers incontinence, overactive bladder, prolapse, pelvic floor disorders and mesh complications.
Do I need a referral to see a urogynecologist?
Many insurance plans let you book directly. Some HMO plans require a referral from your primary care doctor or gynecologist, so check your plan or ask the office to help.
Can a urogynecologist be my regular gynecologist?
Some urogynecologists, including Dr. Elshatanoufy, are also board-certified in general obstetrics and gynecology and provide gynecologic care alongside pelvic floor treatment.
When should I switch from my gynecologist to a urogynecologist?
Consider it when bladder, bowel or prolapse symptoms persist after first treatments, when surgery has been suggested, or when symptoms return after a previous repair.
Gynecology and pelvic floor care in one practice
Book a visit with Dr. Solafa Elshatanoufy in Katy and get every option explained, from therapy to surgery.
