Urogynaecology is a subspecialty of gynaecology that focuses on conditions affecting the pelvic floor, bladder, and bowel in women. These problems are very common, particularly after childbirth and with increasing age, and they can have a significant impact on quality of life.
Our subspecialist urogynaecologists in Manchester and across the North-West have extensive experience in managing both straightforward and complex pelvic floor conditions, offering personalised, evidence-based care.
Conditions commonly managed in Urogynaecology include:
- Urinary incontinence – leakage of urine with coughing, laughing, exercise, or urgency
- Pelvic organ prolapse – a bulge or dragging sensation caused by the womb, bladder, or bowel dropping into the vagina
- Overactive bladder – urgency, frequency, or needing to pass urine at night
- Problems following childbirth – including injuries to the pelvic floor or perineum
- Mesh complications – including pain, erosion, or exposure following previous surgery
- Pelvic fistulae – abnormal connections between the bladder, bowel, or vagina
- Complex pelvic floor problems – involving both bladder and bowel function
Treatment options
Subspecialist urogynaecologists are trained to offer the full range of treatment approaches, from conservative management through to advanced surgical procedures. Treatment is always tailored to your symptoms, needs, and preferences.
Options may include:
- Conservative measures – pelvic floor physiotherapy, lifestyle advice, and bladder training
- Medical treatments – tablets or topical therapies where appropriate
- Pessary support – devices used to support prolapse without surgery
- Surgical options – including minimally invasive (laparoscopic and robotic) techniques when suitable
Mesh and the High Vigilance Restriction Period (HVR)
In the UK, the use of surgical mesh for stress urinary incontinence and vaginally inserted mesh for prolapse is currently subject to a national pause following safety reviews.
Some types of mesh procedures for prolapse, such as those used for uterine or vaginal vault prolapse, may still be appropriate in carefully selected circumstances. These procedures can only be carried out under High Vigilance Restriction (HVR) governance, which requires strict oversight, specialist expertise, and robust follow-up.
There is always a choice of treatments. Your urogynaecologist will take time to discuss the benefits and risks of each option, supporting you to make a decision that feels right for you.
NWG doctors providing Urogynaecology services
- Dr David Iles
Locations
- The Alexandra Hospital