My Experience with a Urogynecologist

[Mariah114]

My gynecologist diagnosed me with bladder prolapse a few months ago.   Because of this and other forums,
I took the advice that I should be seeing a Urogynecologist.   After doing some research, I learned there were only
two Urogynecologists in my area, one of which was highly recommended, the other not so much.   So, after hearing so many good things about the recommended UroGyn, I was looking forward to seeing her.  When I made my appointment, I was told the first appointment would be with the Nurse Practictioner which was ok but I soon learned that since I wasn't yet opting for surgery, all of my appointments would be with the NP.  The NP is very knowledgeable, but I was disappointed that I wasn't seeing the doctor after waiting so long to get an
appointment.  The doctor has surgery 3 days a week and the other 2 days are spent seeing patients who have had surgery or will be having surgery.  

[kristinah544]

Afetr trying to see a urogynecologist and getting fed up with everything I
checked online and found a brace from a company called FEMBRACE
that has been very beneficial to me. It has alleviated surgery and the
pessarry ring. It really is worth you looking into.

[UKlady1001]

Clearly you wish to see the Urogyne and I understand this as I would feel the same.  I recently had a similar situation and decided to pay privately in order to see the Urogyne instead of the trainee Dr and Registra.  It costs extra, but if you have had your tests already and only wish to get their opinion this could be your best option other than making a special request to your usual surgery to see your Urogyne there.
If you feel uncomfortable with the way things have been it is important to clear this up.  Yes your Urogyne is busy but they do still see patients 2 days a week and you may only need one appt to clarify your condition and their opinion with regards to your options at this time.

I hope you are able to see your Urogyne and wish you luck with this.
Let us know how you get on

[Mariah114]

Thanks for the responses, Summer and JColoPOP.   I guess this isn't an unusual problem and I don't have a lot of alternatives at this time.  I'm told that the urogyn performs surgery three days a week, thus having only two days to see patients.  I'd be willing to wait a while to see her.  My NP also looks to be about 30 years old and she's 8 months pregnant so I am wondering what happens when she goes on maternity leave.
JColo...What are you going to do at this point?   They should at least let us see the urogyn to advise us as to whether surgery is the answer.  I'm not crazy about being told that the decision is entirely up to me.   I realize that it is my decision but it would be nice to get an opinion.

[JColoPOP]

I have cystocele, rectocele and uterine apex prolapse, all either stage 2 or 3.  I had exactly the same problem with my chosen Urogynocologist, only I didn't feel that the Nurse Practitioner was all that knowledgeable... she was relatively new to the practice. Plus she looked to be about 30 years old.  Although she answered most of my questions, I didn't feel comfortable relying on her answers to make the decision about surgery.  And, until you decide about surgery, you can't take up the Doctor's precious appointment time.    I decided to wait for a bit and/or get a second opinion.  The NP's parting comment to me as I left my third appointment (after having a pessary fail to stay in) was "you'll be back"... Really turned me off!  But the other urogyn's in my area (2) are all men and that wouldn't be my first choice.  Quite a conundrum.

[summer59]

It seems like your urogynecologist is so busy that her patients are screened first to weed out the ones not interested in surgery.  I can see why she runs her practice this way as she probably only has time in her schedule to see so many patients thus just the surgical ones.  Even though this might be the most functional way to conduct business for her it might not be the best for you.  I would have preferred to see the doctor in person myself.  I had prolapse surgery with a highly renowned urogyne with the same schedule as your doctor.  Maybe he took fewer patients, I don't know but on every visit I saw him except some post ops with his PA.  Sure, I had a long time to wait for appts but I knew he would take his time with me when I saw him.  If there are no other alternatives that you feel comfortable with this doctor might still be your best bet.  Probably you could continue to be treated by the NP and when you are ready to discuss surgery ask to see the urogyne.  The bottom line is to go where you feel the most comfortable with.  Sounds as if you have done some good reaserch on these doctors, you just have to decide if the recommended urogyne system is one you want to pursue.  Good luck!

[Mariah114]

hi UKLady.   I'm in the U.S.  It wasn't assumed that I didn't want surgery. I made an appointment and was told that it is their policy that the first visit would be with the NP. When I went in to see the NP, she didn't advise whether or not I should have surgery.  She indicated that was entirely up to me.  I decided that I would hold off for the surgery and be fitted for a pessary for now. She couldn't fit me for a pessary at that time because I had some sort of vaginal irritation which she prescribed medication.  It was when I was making the next appointment that I was told I would again see the NP.   I told them I would like to see the urogyn but was advised that  the NP sees patients that are not planning surgery.  If and when I decide to have surgery, only then would the urogyn see me.

I thought this to be odd and I wonder if anyone else has had this problem. If I would have know this when I made my first appointment, I would have stayed with my gyn.  There is only one other urogyn in my area and he was not recommended for various reasons.

[UKlady1001]

What country are you in and have you asked to specifically see the Urogyne?  I cant understand why it has been perhaps assumed you dont want surgery before you have seen a Urogyne as this is something they have yet to talk to you about with them.
It all seems a bit back to front to me.  Do you know why it has been assumed you dont want an operation?  Whether an op is a good idea or not is normally discussed after examination by a Urogyne and sometimes tests are also to be done depending on your symptoms.

Consider asking to see the Urogyne rather than the NP if this is what you would prefer in order to clarify any concerns you have and gain the benefit of their knowledge and opinion about your specific POP condition.  

Let us know how you get on and good luck.