UROGYNECOLOGICAL SURGERY CURRENT APPROACHES AND TREATMENTS FOR INCONTINENCE

Urogynecological_Surgery_Kapak

UROGYNECOLOGICAL EVALUATION

Alaattin Karabulut

University of Health Sciences; Tepecik Training and Research Hospital, Department of Gynecology and Obstetrics, İzmir, Türkiye

Karabulut A. Urogynecological Evaluation. In: Balsak D, Çim N, Ege S editors. Urogynecological Surgery Current Approaches and Treatments for Incontinence. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.41-50.

ABSTRACT

Urogynecological diseases are conditions that can seriously affect women’s quality of life and require complex and multidisciplinary evaluation. Conditions such as pelvic organ prolapse and urinary incontinence can lead to loss of self-confidence, social isolation and depression in many women. These patients should also be provided with psychological support when necessary. This chapter will primarily focus on urogynecological evaluation approaches related to two main topics in urogynecology: pelvic organ prolapse and urinary incontinence, along with the methods used in their assessment.

In urogynecology, patients are generally embarrassed by their symptoms and often do not want to talk about them. Therefore, the evaluation should basically start with a comprehensive anamnesis and continue with a careful physical examination and auxiliary tests. During the anamnesis and physical examination, the symptoms and findings of the patients are recorded objectively using a bladder diary, various questionnaires (such as the 3 Incontinence Questionnaire) and classification systems (such as the Pelvic Organ Prolapse-Quantification System). It is also of great importance to record the initial evaluation objectively and in detail in order to evaluate the patients’ response to treatment. Pelvic floor function tests and urodynamic tests are auxiliary methods that strengthen the clinician’s hand. Especially in complicated cases, urodynamics provides objective data on the urine storage and voiding process. The data obtained with urodynamic examinations consisting of cystometry, uroflowmetry, pressure-flow studies, urethral pressure profile, leakage point pressure, postvoid residual volume and electrophysiological tests are recorded. Although these data have not yet been fully standardized, they can help identify the underlying pathology in complicated cases. These tests can help identify the underlying pathology in the patient and choose the right treatment. Imaging methods such as ultrasonography and magnetic resonance imaging are also particularly helpful in identifying anatomical disorders.

In conclusion, a complete comprehensive evaluation in urogynecological diseases; provides accurate and objective definition of symptoms, and determination of the most appropriate treatment option with holistic analysis of physiological and anatomical parameters. The diagnosis and treatment process should be planned not only based on pathological symptoms but also considering the impact of these symptoms on the patient’s quality of life. This approach is a fundamental step that directly affects the success of both conservative and surgical treatments.

Keywords: Urogynecological evaluation; Pelvic organ prolapse; Urinary incontinence; Urodynamics; Pelvic floor

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