However, these symptoms should not be considered a natural part of aging, and in most cases they can be effectively treated. Urogynecology focuses on the diagnosis and treatment of these sensitive but common conditions, helping women regain their comfort and quality of life.

What is urogynecology?

Urogynecology is a specialized field combining gynecology and urology, focusing on disorders affecting the female pelvic floor, bladder, and surrounding pelvic organs. This includes urinary incontinence, frequent urination, bladder dysfunction, and pelvic organ prolapse.

Several factors may contribute to the development of these conditions. Pregnancy and childbirth can weaken the muscles and connective tissues of the pelvic floor, sometimes leading to symptoms years later. Hormonal changes, especially during menopause, may also reduce tissue strength and elasticity. In addition, genetic predisposition, obesity, heavy physical strain, or previous gynecological surgeries can all play a role.

What is urinary incontinence and what types exist?

Urinary incontinence refers to the involuntary leakage of urine. Symptoms may range from occasional minor leakage to more significant loss of bladder control. Although this condition is extremely common, many women feel uncomfortable discussing it and therefore delay seeking treatment. It is important to know that urinary incontinence is treatable, and appropriate therapy can significantly improve quality of life.

The most common type is stress urinary incontinence. In these cases, urine leakage occurs during coughing, sneezing, laughing, running, or lifting heavy objects. This is usually caused by weakening of the pelvic floor muscles and the structures supporting the urethra.

Urgency incontinence, also called urge incontinence, is characterized by a sudden and intense urge to urinate that is difficult to control. It is often associated with frequent daytime urination and waking at night to urinate. In some women, both forms occur together, which is referred to as mixed incontinence.

When should you consult a urogynecologist?

It is advisable to see a urogynecologist if you experience any of the following symptoms:

• urine leakage during coughing, laughing, or exercise,
• sudden and urgent need to urinate,
• frequent daytime or nighttime urination,
• recurrent urinary tract infections,
• difficulty emptying the bladder,
• pelvic pressure or heaviness,
• sensation of a bulge or foreign body in the vagina,
• intimate discomfort or pelvic pain.

Early evaluation may help prevent symptoms from worsening and can greatly improve quality of life.

What happens during the examination?

A urogynecological consultation begins with a detailed discussion of symptoms, previous illnesses, surgeries, childbirth history, and medications. Understanding the patient’s complaints in detail is essential for establishing an accurate diagnosis and creating the most effective treatment plan.

The examination may include a gynecological evaluation, ultrasound imaging, and, if necessary, specialized bladder function testing. Urine analysis or additional diagnostic procedures may also be recommended in certain cases.

The goal of the evaluation is not only to treat the symptoms, but also to identify the underlying cause and provide a personalized therapeutic approach.

Treatment options

Treatment for urogynecological conditions always depends on the type and severity of the symptoms, as well as the patient’s individual needs and lifestyle. In milder cases, conservative, non-surgical therapies may provide excellent results.

Pelvic floor muscle training and physiotherapy are often highly effective in strengthening the pelvic muscles and reducing symptoms. Lifestyle modifications, bladder training, and medication may also help improve bladder control. In some cases, supportive devices such as pessaries can provide additional relief.

The aim of treatment is to restore comfort, confidence, and quality of life in everyday activities.

Cube pessary treatment

A cube pessary is a non-surgical treatment option commonly used in urogynecology to manage pelvic organ prolapse and certain forms of urinary incontinence. The pessary is a soft silicone device placed into the vagina to provide support for the pelvic organs and help reduce symptoms such as pelvic pressure, vaginal bulging, or urine leakage.

Cube pessaries are particularly useful for women who wish to avoid surgery, are not suitable candidates for an operation, or would like temporary symptom relief before a planned procedure. They may also provide an effective long-term solution for some patients.

The device is individually selected and fitted by a specialist to ensure comfort and effectiveness. After placement, patients receive detailed instructions regarding use, cleaning, and follow-up care. Regular medical check-ups are important to ensure proper fit and maintain vaginal tissue health.

Many women experience significant improvement in daily comfort and quality of life with pessary therapy, allowing them to remain active and confident without surgical intervention.

Possible surgical solutions

If conservative treatment does not provide sufficient improvement, surgical intervention may be recommended. Modern urogynecological procedures are often minimally invasive, allowing for shorter recovery times and reduced postoperative discomfort.

For stress urinary incontinence, sling procedures are commonly used to provide additional support for the urethra. In cases of pelvic organ prolapse, reconstructive or vaginal plastic surgeries may offer effective long-term solutions.

The choice of surgical technique is always personalized and based on a thorough medical evaluation and consultation. The primary goal is not only symptom relief, but also long-term improvement in the patient’s overall quality of life.