Urogynaecology

At Midlands Women’s Health, we are proud to have Dr. Pallavi Latthe, our Consultant Gynaecologist, who specialises in urogynaecology—a subspecialty dedicated to the care of women with pelvic floor disorders and bladder or bowel control problems.

What is Urogynaecology?

Urogynaecology is a specialist area within gynaecology that focuses on the diagnosis, assessment, and treatment of conditions affecting the female pelvic floor. These include:

• Urinary incontinence – involuntary urine leakage, often triggered by coughing, laughing, or exercise.
• Overactive bladder – urgency, frequency, and sometimes leakage with a strong, sudden urge to urinate.
• Bowel control disorders – including constipation, bowel leakage, and faecal incontinence.
• Pelvic organ prolapse – when the bladder, uterus, or vagina shift downwards due to weakened support structures.
• Recurrent urinary tract infections and bladder pain.

Why See a Urogynaecologist?

A urogynaecologist is a consultant with specialist training in both gynaecology and urology. This dual expertise makes them uniquely qualified to manage complex pelvic health conditions.

With her advanced training and experience, Dr. Pallavi Latthe provides personalised care for women experiencing pelvic floor and continence issues—helping to restore comfort, confidence, and quality of life.

At Midlands Women’s Health, our Consultant Gynaecologist Dr. Pallavi Latthe specialises in urogynaecology. She sees women with:

• Urine leakage (incontinence)
• Overactive bladder symptoms
• Painful bladder syndrome
• Pelvic organ prolapse
• Recurrent urinary tract infections

What is the Pelvic Floor?

The pelvic floor is a group of muscles that support the bladder, bowel, and uterus. These muscles help with bladder and bowel control, prevent prolapse, support the spine, and also play a role in sexual function.

Over time, the pelvic floor can become weaker due to pregnancy, childbirth, menopause, ageing, being overweight, repeated heavy lifting, chronic constipation, or even long-term coughing.

How We Can Help

Our urogynaecology service offers thorough assessment, diagnosis, and treatment for pelvic floor conditions.

Investigations may include:

1. Cystoscopy – looking inside the bladder with a small camera
2. Uroflowmetry – measuring how urine flows
3. Urodynamics – testing how the bladder and urethra are working

Treatment options may include:

• Lifestyle and behavioral therapy – relaxation techniquesfluid advice, and dietary advice
• Pelvic floor muscle training – strengthening exercises guided by experts including biofeedback, electrical stimulation etc
• Vaginal pessaries – soft devices placed in the vagina to support pelvic organs
• Medications – tablets or creams to relieve symptoms, bladder instillations
• Nerve stimulation– percutaneous or transcutaneous tibial nerve stimulation for overactive bladder
• Surgery – from minimally invasive procedures to reconstructive operations, depending on the condition. This may include repairing prolapse, vaginal hysterectomy, sacrospinous fixation, colpocleisis, supporting the bladder with tape or mesh, Botox injections or bladder neck bulking under cystoscopy (telescope in bladder) guidance.

WHY IS UROGYNAECOLOGY IMPORTANT?

Pelvic floor problems are very common, but many women put up with symptoms that can be painful, embarrassing, or limiting in daily life. Too often, these issues are dismissed as just a “normal” part of getting older or something that naturally follows childbirth—but they don’t have to be.

Urogynaecology is all about improving quality of life. It provides specialised care for women with pelvic floor conditions, combining expertise from obstetrics, urology, and gynaecology. This means women benefit from a truly comprehensive approach, with close links to related services such as obstetrics, urology, and colorectal care.

HOW DO YOU KNOW IF YOUR BLADDER HAS FALLEN?

Signs of a Prolapsed Bladder (Cystocele)

A prolapsed bladder—sometimes called a cystocele or “dropped bladder”—can cause a range of symptoms. These vary from woman to woman, but common signs include:

• A bulge at the vaginal opening – the most common symptom, sometimes noticed as a feeling of something “coming down.”
• Bladder problems – such as a slow urine stream, difficulty fully emptying your bladder, needing to go more often, or leaking when you cough, sneeze, or exercise (stress incontinence).
• Frequent urinary tract infections (UTIs).
• Pelvic pressure or discomfort – a feeling of fullness, heaviness, or even pain in the pelvic area or lower back, often worse after standing, lifting, or at the end of the day.
• Discomfort during sex.
• Difficulty using tampons or applicators.

If you notice any of these symptoms, it’s important to remember you’re not alone—many women experience them, and effective treatments are available.

WHAT IS THE RECOVERY TIME FOR A UROGYNAECOLOGY PROCEDURE?

The recovery process of a urogynaecology procedure will depend on your health condition and the procedure you are having done.

If you have a flexible cystoscopy, you can go home shortly afterward and return to your normal activities including work and exercise as soon as you feel able to.

A vaginal pessary is fitted by a urogynaecologist or nurse and women don’t usually require recovery.

Pelvic organ prolapse surgery can take up to six weeks to recover. If you have keyhole surgery, your recovery may be reduced to one to two weeks.

You will be invited for a follow-up appointment to check your recovery after surgery.

Useful links:

• https://www.yourpelvicfloor.org/leaflets/
• https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-floor-repair-operation-recovering-well/
• https://bsug.org.uk/pages/for-patients/bsug-patient-information-leaflets/154