Urologists treat women and address conditions involving the urinary tract system. While urology is often associated with the male reproductive system, its core focus is the health and function of the kidneys, ureters, bladder, and urethra in all people. Urologists provide specialized expertise for female patients dealing with common and complex urinary and pelvic health concerns.
The Scope of Female Urological Care
Female urology is a medical subspecialty dedicated to the structure and function of the female urinary tract and the surrounding pelvic support structures. A urologist’s expertise covers all organs responsible for producing, storing, and eliminating urine: the kidneys, ureters, bladder, and urethra. Understanding the close anatomical relationship between the female urinary tract and the reproductive organs is a central part of this specialization.
While male urology includes treatment for reproductive organs, female urology concentrates on disorders of the urinary system and the pelvic floor. Many urologists receive additional training in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). This training focuses on the complex muscle and tissue support system of the pelvis, allowing them to manage conditions where the urinary system is affected by weakened pelvic support.
Specific Conditions Urologists Treat in Women
Urinary incontinence is a common condition urologists manage, involving the involuntary leakage of urine. This includes stress incontinence, caused by increased abdominal pressure (e.g., coughing or exercise), and urge incontinence, often linked to an overactive bladder (OAB). Treatment often begins with behavioral changes and pelvic floor exercises. If necessary, treatment progresses to medications or minor procedures like urethral bulking agents or slings.
Urologists also treat recurrent urinary tract infections (UTIs), diagnosed as two or more UTIs in six months or three or more in a year. While routine UTIs are handled by a primary care provider, a urologist investigates the underlying causes of chronic infections, such as anatomical issues or lifestyle factors. Their approach may include long-term antibiotic strategies, preventative measures, or the use of vaginal estrogen creams in postmenopausal women.
Conditions involving the kidneys, such as kidney and ureteral stones, are also within a urologist’s scope. These stones form when minerals and salts in the urine crystallize. Urologists use procedures like lithotripsy or ureteroscopy to break up and remove them. Urologists also treat Interstitial Cystitis, or painful bladder syndrome, characterized by chronic pressure and discomfort not caused by infection.
Pelvic Organ Prolapse (POP) occurs when weakened pelvic floor muscles allow organs like the bladder or uterus to descend into the vagina. When the bladder drops (cystocele), it can severely impact urinary function. Management ranges from using a supportive device called a vaginal pessary to surgical reconstruction to restore the organs to their correct position.
Urology Versus Gynecology
The distinction between urology and gynecology often creates confusion because the organs they treat are closely located within the pelvis. Gynecology focuses on the female reproductive system, including the uterus, ovaries, and cervix, and reproductive health. In contrast, urology focuses on the urinary system and its function.
The two specialties overlap significantly in a medical field called Urogynecology, or Female Pelvic Medicine and Reconstructive Surgery (FPMRS). Urogynecologists are specialists trained in both disciplines who focus on pelvic floor disorders affecting both the urinary and reproductive organs. A primary care physician typically refers a patient with a problem centered on urination, such as incontinence or an overactive bladder, to a urologist.
A patient experiencing issues related to menstruation, fertility, or uterine health would primarily see a gynecologist. For complex pelvic floor issues like prolapse involving both the bladder and the uterus, either a urologist with FPMRS training or a urogynecologist may be consulted. The choice often depends on the specialist’s specific certification and the patient’s primary symptoms.