Urogynaecology
Urogynaecology is the branch of women's health medicine concerning both problems of bladder function and of pelvic organ prolapse. A prolapse means that the organs above and around the vagina have lost their support and can bulge downwards into the vagina.
Bladder problems are quite common and include: leaking or loss of control; increasing frequency or urgency of toileting; difficulty emptying the bladder. Women often have symptoms for some time before seeking help.
Pelvic organ prolapse can be more subtle and may present symptoms such as: feeling or seeing a lump within the vagina; a dragging feeling in the vagina or lower back; problems emptying the bladder, passing a bowel movement or with intercourse. For some women, a prolapse will be noticed when they are having a routine smear examination.
In most cases women with such problems will see their family doctor, who may then recommend and organise a specialist referral. There may be other situations where she wishes to come directly to a specialist. We are happy to accommodate this and can usually arrange an appointment at a time that is convenient.
Specialist consultation
The initial appointment will usually take between thirty and forty minutes. This will involve a thorough discussion of the presenting issues and in most cases a physical examination including a vaginal/ pelvic examination will be necessary.
Depending on what the problem is there may be investigations or tests and a follow-up appointment before decisions on appropriate treatment can be made. For most women, there will be no problem with driving oneself to and from the clinic appointment.
Urodynamic study
For some women with urogynaecological problems, it will be necessary to carry out a test of bladder function known as a urodynamic study. At Auckland Urogynaecology this study is performed by the specialist gynaecologist and our nurse.
The test takes around thirty minutes to complete and involves the placement of catheters to fill the bladder and to measure pressures within the bladder and the abdomen. While an unusual process to undertake, the urodynamic study is not painful and should not normally result in any side-effects.
Colposcopy
A colposcopy is a specialist procedure involving a magnified examination of the uterine cervix (neck of the womb).
A colposcopy will be used to clarify the situation when a woman has an abnormal result on her cervical smear test, or if she has had some unusual vaginal bleeding. A microscope-like instrument is used to perform the examination while the woman lies on a couch with her legs supported to either side. A colposcopy is not usually a painful procedure and one would expect to be able to drive home afterwards.
Physiotherapy
The consultants at Auckland Urogynaecology work in close association with specialist pelvic floor physiotherapists, Vicki Holmes, Christine Hannigan and Jill Wood. They exclusively treat female bladder and bowel problems, pelvic floor dysfunction, pelvic organ prolapse, maternity musculoskeletal problems, pelvic pain and the sensitive issues of sexual pain as well as providing pre and post-operative advice.
In many cases a referral to physiotherapy will come from a gynaecologist or a woman's general practitioner although you can always call and make an appointment to be seen. The initial consultation will involve a discussion of your symptoms as well as an examination. Treatment recommendations can then be made and follow-up organised.