Urologist or Gynecologist? Here is What They Treat
The female body is a miracle of physiological engineering. It is expressly designed to conceive, nourish, and deliver other humans while at the same time perform all the essential functions to keep the woman healthy.
Take the complexities that occur among all the organs and muscles nestled just beneath the waist: The kidneys, bladder, urethra, uterus, vagina, and pelvic floor. Many disorders can arise here, and due to their proximity, it’s easy to think of the urological and reproductive systems as interconnected and needing just one specialist.
But that’s like thinking one doctor can treat both your teeth and your eyes. The female urology and reproductive systems are separate and require different experts for their care: urologists, gynecologists, or – in certain conditions – urogynecologists.
Here, we will explore the difference.
Clearing Confusion About Urologists and Gynecologists
Confusion about seeing a urologist or gynecologist (or both) is likely rooted in misconceptions that urologists treat only men and gynecologists care for women. This thinking may be reinforced by the fact that so many women begin seeing gynecologists at young age and/or for family planning.
As a result, women might neglect certain urinary symptoms or seek the wrong specialist.
The Urologist’s Specialties: Urinary Organs and Conditions
Urologists are trained to treat urinary disorders of the kidneys, bladder, urethra, pelvis, and ureters (the tubes running from the kidneys the bladder). Common urinary disorders and symptoms include:
- Overactive bladder (OAB) – OAB causes the recurrent and instant urge to urinate that can be hard to hold, sometimes resulting in leaks. OAB occurs because the bladder muscles squeeze involuntarily and without warning before the bladder is full. A spectrum of conditions can make this happen, including bladder obstructions, a urinary tract infection, age-related hormonal changes, a communication error from the nerves that control bladder function, certain neurologic diseases, and weak pelvic floor muscles. Other symptoms include urinating sooner than every two hours and having to get up to go more than twice at night (nocturia). Read more about OAB.
- Incontinence – Easily confused with OAB, incontinence also is marked by lost bladder control and urinary leakage. However, the causes differ. Incontinence comes in two forms: stress incontinence, when sudden movements such as coughing, laughing, or jumping cause leakage due to weak pelvic floor muscles; and urge incontinence, marked by a miscommunication from the nerves that control the bladder. Incontinence is twice as common among women than men due to its causes, which include childbirth and menopause. Other symptoms include more frequent urination and the uncontrollable need to urinate, paired with pelvic pressure or spasms. Learn more about female incontinence and treatments.
- Urinary tract infections (UTIs) – UTIs occur in at least half of all women at some point due to bacteria creeping into the urinary tract, which is more easily accessibly in women than men. This typically results in a painful infection in the urethra and bladder but can spread to the ureters and kidneys. Sometimes, frequent UTIs are an indication of abnormalities such as kidney stones or the bladder’s inability to completely empty. Other symptoms include burning urination, an increased need to urinate but producing little volume, cloudy and/or strong-smelling urine, and pelvic pain. Read up on UTI causes and care.
- Kidney stones – Comprised of minerals and salts that bind in the kidneys, stones are actually small crystals that can become lodged in the kidneys or ureter, triggering severe pain. If stones obstruct the ureter, they can block urine flow and cause a backup into the kidney; also painful. A key culprit of stones is dehydration, because it deprives the kidneys of sufficient fluid to pass the salts and minerals they excrete. Recurrent UTIs and diet also raise the risk. Other symptoms include blood in the urine (hematuria), pain in the back, sides, or stomach, vomiting (from pain), and more frequent urination. Learn how kidney stones are diagnosed and treated.
- Interstitial cystitis – Also known as painful bladder syndrome, this chronic condition is diagnosed 10 times more often in women than in men. The cause is unknown, but researchers believe contributing factors include a breakdown in the bladder lining that can expose the organ to irritants from urine, an autoimmune reaction in the urinary tract, or an infection. Other symptoms include bladder pressure, persistent pelvic pain, frequent and urgent urination, and pain during intercourse. Our interstitial cystitis web page explains more.
- Bladder-related neurologic diseases – Often, nerve damage disrupts the body’s ability to communicate internally, hindering organ, muscle, and tissue function. In the urinary system, this condition is referred to as neurogenic bladder. It occurs between the nerves and the muscles that control the bladder and can prevent the bladder from filling or emptying correctly (OAB). Millions of people suffer this condition, including patients with multiple sclerosis, Parkinson’s disease, a spinal cord injury, or stroke. Other symptoms include leaking or dribbling urine, urine retention, and UTIs (from retention). Read our blog, “What Causes Neurogenic Bladder and How Is It Managed?”
- Blood in urine (hematuria) – Urine that is tinged the color pink, red, maroon, or brown might be passing blood from the kidneys, ureters, bladder, or urethra. The cause of the bleeding might not be serious, but should be addressed as hematuria could signal stones, a UTI, inflammation, bladder cancer, or kidney cancer. Other symptoms include (depending on the cause) burning urination, increased urination, and low abdominal, pelvic, and back discomfort. Learn how to recognize hematuria.
Gynecologists Largely Treat Reproductive Organs
Gynecologists are physicians who specialize in conditions specific to women, including reproduction, that involve the vagina, uterus, and ovaries. Common gynecological disorders and symptoms include:
- Menstrual issues – Periods that are irregular due to unusually heavy bleeding, acute menstrual pain, skipped periods, or bleeding in between periods indicate your reproductive system is not working normally. Depending on the symptoms, menstrual problems can suggest thyroid disorders, stress, ovarian cysts, or hormonal changes. Other symptoms includepain during your period and ovulation.
- Endometriosis – This occurs when tissue similar to the uterine lining grows elsewhere, such as the ovaries, fallopian tubes, or bladder, causing chronic pain. Researchers don’t fully understand the cause, but theorize endometriosis can be brought about by early menstruation, immune system disorders, or menstrual blood flowing backward into the pelvis rather than out of the body (retrograde menstruation). Other symptoms include heavy or irregular periods, painful sex, infertility, and gastrointestinal issues. Read how endometriosis interferes with sex drive.
- Yeast infections – All bodies naturally contain a small amount of yeast (fungus) that coexists with your body’s natural bacteria. Normally, healthy bacteria keep the yeast levels in check, but if something disrupts the bacterial balance, the yeast cells can overmultiply and induce an uncomfortable infection. In the vaginal tract, this imbalance can lead to a vaginal yeast infection. Other symptoms include intense itching, irritation, and swelling.
- Gynecologic cancers – When cells grow abnormally and out of control, they can form into cancerous tumors. When cancer develops in the ovaries, cervix, or uterus, the symptoms can differ among patient, but abnormal bleeding and discharge are common. Other symptoms include abdominal, back, and/or pelvic pain and a more frequent and urgent need to urinate.
Conditions that Both a Urologist or Gynecologist Can Treat
Certain female disorders present a grey area that can be treated by a urologist, gynecologist, or urogynecologist (which focus on pelvic floor and bladder control issues). Many of these conditions are treated by the specialists at Advanced Urology Institute, and include:
- Vaginal prolapse (pelvic floor weakness)
- Vaginal pain
- Vaginal dryness
- Hormone imbalance
Depending on the condition, choose a specialist you trust. Because like the female body, the knowledge and treatments to which you have access are a kind of a miracle – of innovation, tenacity, and dedication.
Advanced Urology Institute’s urologists and urogynecologists are expertly trained to diagnose and provide treatment for women’s urinary and sexual health issues. You can find a specialist near you on our AUI Providers page.
About the Author: Rolando Rivera, MD, FACS is a longtime provider at Advanced Urology Institute. He specializes in female urology, having completed a fellowship in Female Pelvic Medicine, Reconstructive Surgery, and Urodynamics at the University of Miami. He sees patients in our Naples office, and is always welcoming new patients.