Gynaec Urology or Urogynecology is a sub-specialty of Gynecology, and is also known as Female Pelvic Medicine and Reconstructive Surgery. Stress urinary incontinence is a common problem in all age groups. Common pelvic floor disorders include urinary incontinence, pelvic organ prolapse and faecal incontinence. Dr. Sudhir Chawla, Urogynecologist manages clinical problems associated with dysfunction of the pelvic floor and bladder. Pelvic floor disorders affect the bladder, reproductive organs, and bowels.

Infertility is one area where Gynaec Urology treatment is required to work together. Infertility can be a male or female problem, or it can be a combination. The urologist might perform a physical examination of the male partner, analyze the sperm cells or treat any sexually transmitted diseases in either the man or woman. The gynaecologist would assess the woman’s uterus and ovaries, confirm she is ovulating normally or perform a surgery to ensure the lining of the uterus is healthy. Dr. Sudhir Chawla, M.S., DNB (Urology) is an #eminent Surgeon Doctor of Indore who has got expertise and vast experience in Gynaec Urology. Dr. Chawla knows the mystics in the Methodology of treatment of Gynaec Urology. Increasingly, Urogynecologists are also responsible for the care of women who have experienced trauma to the perineum during childbirth. Dr. Sudhir Chawla has done successfully Bladder Neck & Mid Urethral Suspension surgery.

There is some crossover with the Subspecialty of Female Urology – the Doctors are Urologists who undergo additional training to be able to manage female urinary incontinence, pelvic organ prolapse and interstitial cystitis/PBS. In addition, there are Colorectal Surgeons who have a special interest in anal incontinence and pelvic floor dysfunction related to rectal function. The contemporary urogynecological practice encourages multidisciplinary teams working in the care of patients. This is especially important in the care of patients with complex problems, e.g. those who have undergone previous surgery or who have combined incontinence and prolapse or combined urinary and bowel problems.

Dr. Sudhir Chawla, Urogynaecologist manage Patients,i.e., women with urinary incontinence and pelvic floor dysfunction. The clinical conditions that a Urogynecologist may see include stress incontinence, overactive bladder, voiding difficulty, bladder pain, urethral pain, vaginal or uterine prolapse, obstructed defecation, anal incontinence, and perineal injury, also care for women with VesicoVaginal or RectoVaginal fistulae with specialist training, and in conjunction with his Team.

Patients will usually be assessed using a combination of history taking, examination (including pelvic examination and assessment of prolapse using validated systems such as the Pelvic Organ Prolapse Quantification System and assessment of the quality of life impact using validated questionnaires, including the assessment of sexual function, using Pelvic Organ Prolapse/Incontinence Sexual) Questionaire discussion. A bladder diary is often used to quantify an individual’s fluid intake, and the number of voids per day and night, as well as the volume the bladder, can hold on a day-to-day basis. Further investigations might include urodynamics or a cystoscopy. Treatment usually starts with conservative measures such as pelvic floor muscle training, fluid and food modification or bladder training. Drug therapies can be used for overactive bladder, which may include antimuscarinic drugs or beta 3 receptor agonists – both of this help to control the urgency that is the key component of overactive bladder. If medications fail, more invasive options such as injections of botulinum toxin into the bladder muscle, or neuromodulation are other options for symptom relief. Surgical treatments can be offered for stress incontinence and/or uterovaginal prolapse if pelvic floor muscle training is unsuccessful.

Urogynecological problems are seldom life-threatening, but they do have a major impact on the quality of life of affected individuals. Dr.Sudhir Chawla,Urogynecologist usually use quality of life improvement as a treatment goal, and there is a major focus on optimising symptoms using conservative measures before embarking on more invasive treatments.

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