"In female pelvic medicine and reconstructive surgery, now an accredited subspecialty, working together is incredibly crucial. If we are going to further this field, we need to pool our resources and talents, which are similar, but slightly different, to provide the best patient care. The pool of patients with these problems is getting bigger as the American population ages.
Overall, urology and gynecology work well together on many levels, particularly at an academic medical center. In our infertility center, urology male infertility specialists work closely with female infertility specialists; clearly, one can’t exist without the other. Another area of overlap is oncology. Gynecologic oncologic problems often affect urologic organs.
One reason we have subspecialty training for people from both backgrounds is that we can’t completely exist without each other. Since the subspecialty fellowship began, training is much more standardized. Historically, it was more of an apprenticeship. You got experience in whatever the person you were working with did. Accreditation led to standardization of training.
The two specialties need to work together. People with complex problems such as urinary incontinence, combined with prolapse of the vaginal walls and rectal prolapse, are sent to see colorectal surgeons, GI specialists, then maybe urogynecologists who can handle one part, but not incontinence, so then it’s the urologist. Patients shouldn’t have to maneuver themselves through the waters of the complex pelvic floor disorders. This multidisciplinary collaborative approach allows us to develop a care plan involving input from all of these people.”
Sarah E. McAchran, MD / Madison, WI
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