Female urology at Parkside Hospital

What is female urology?

Female urology is a branch of medicine focused on urinary and pelvic floor problems that affect women. It covers conditions linked to the bladder, urethra and the muscles and tissues that support your pelvic organs.

What conditions does female urology treat?

Conditions commonly seen within female urology include:

• urinary incontinence, including stress, urge and mixed incontinence
• overactive bladder
• pelvic organ prolapse, where the bladder, bowel or womb drops from its usual position
• recurrent urinary tract infections
• bladder pain conditions, such as interstitial cystitis
• kidney stones, and cancers affecting the kidney or bladder.

A number of things can weaken the pelvic floor over time: carrying and delivering a baby, the hormonal shifts that come with ageing and menopause, ongoing strain from constipation or lifting heavy items, earlier operations in this area, carrying extra weight, and inherited factors can all play a part.

What are the benefits of seeing a female urology specialist?

Most people notice a real difference once they get the right kind of expert input. It's common to struggle on for years assuming nothing can be done, that this is simply what getting older or having children involves, but that's rarely true, and getting help sooner rather than later tends to pay off.

Are there different types of treatment within female urology?

Treatment is tailored to your specific condition, and may include:

• starting with the least invasive options, such as pelvic floor exercises, adjustments to daily habits, or physiotherapy from someone who specialises in this area
• medication, for example antibiotics for recurrent infections, or drugs to settle an overactive bladder
• a vaginal pessary, a removable device that supports organs affected by prolapse
• minimally invasive procedures, such as nerve stimulation to improve bladder symptoms
• surgery, including procedures for prolapse or for stress incontinence, chosen to suit your particular diagnosis.

What happens before an appointment?

You'll often be asked to keep a short record beforehand, sometimes for up to a week, tracking what and when you drink, how often you use the toilet, and noting any leaks along with what was happening at the time.

• pull together your obstetric history, any earlier surgery in this area, what medicines you're currently taking, and whether similar issues run in the family
• make a note of how your symptoms present, roughly when they began, what seems to help or worsen them, and anything you've already tried
• list out whatever you'd like answered while you're there
• choose clothing that's simple to remove, given an internal check is often part of the visit, and pack a pad in case of a little bleeding once it's done.

That opening appointment tends to combine a thorough conversation about your background, some structured questions about your symptoms, a look back over any diary you've kept, a physical check, and testing a sample of urine.

What happens during an assessment?

Depending on your symptoms, you may be offered one or more specific tests:

• a test tracking how your bladder fills and empties, using a fine tube passed into the urethra; this runs for somewhere between half an hour and an hour, done in the consultation room
• a flexible look inside the bladder itself, where a slim, camera-tipped scope travels up through the urethra, over within about 10 to 15 minutes once numbing gel has taken effect
• a simple check that measures the speed and shape of your urine flow as you pass it into a special device
• imaging, such as an ultrasound or MRI scan, brought in where a more detailed look at your pelvic floor structures is needed.

What does recovery look like?

What comes afterwards depends heavily on the treatment involved. Procedures carried out through the vagina, or using less invasive techniques, often have people feeling back to normal within 1 to 4 weeks, whereas anything reaching through the abdomen or done laparoscopically can take 6 weeks or longer to settle.

The pace of improvement varies too. Sticking with pelvic floor exercises can take several weeks before a change is noticeable, with the strongest gains often landing at around 3 to 6 months of regular practice. Medicine or a less invasive procedure tends to work faster, and surgery can bring some relief almost straight away, a prolapse no longer bulging, for instance, though the fuller outcome usually only becomes clear once healing has properly finished, again often 3 to 6 months later.