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Why women should care about the new board certification for urogynecologists

After years spent developing criteria for assessing quality care, the American Board of Obstetrics and Gynecology and the American Board of Urology in 2013 granted its first certifications in the specialty of Female Pelvic Medicine and Reconstructive Surgery to qualified urogynecologists.

Urogynecology takes a comprehensive approach to managing pelvic disorders that used to require women to see multiple specialists depending on the location of their issue.  A problem with the bladder - in the front of the pelvis – may be referred to an urologist, the middle section involving the uterus can be seen by the gynecologist and a colorectal surgeon may deal with rectum problems. Yet, all of these organs share the same connective tissue, the same nerves and the same blood supply. Anything done to one is going to affect another. The awareness of this is how the subspecialty of urogynecology came about to create an expertise that masters the entire pelvis.  

What are the sub-specialties of Obstetrics and Gynecology?

In the field of  Obstetrics and Gynecology serving women of all ages and stages, subspecialties are divided as follows according to the American Board of Obstetrics and Gynecology :  Maternal-Fetal  Medicine provides care for high-risk pregnancy; Gynecologic Oncology deals with cancers of the reproductive system; Reproductive Endocrinology and Infertility involves care of hormonal or infertility problems; and  Female Pelvic Medicine and Reconstructive Surgery (Urogynecology) focuses on care of urinary tract dysfunction and disorders stemming from loss of support of pelvic structures

The American Board of Medical Specialties (ABMS) approved board certification for Female Pelvic Medicine and Reconstructive Surgery in 2012 to “verify appropriate training, knowledge and credentials in the field.” Physicians had to meet strict criteria to be permitted to sit for the board in 2013. Dr. Farnam was among the first specialists in the nation to qualify, pass the exam and receive the board certification. He is the only board-certified urogynecologist in private practice in West El Paso.

Urogynecology Subspecialists have more experience and expertise in pelvic floor surgery

Why should women care about board certification? Not all physicians are board certified in a specialty. The certification reflects the vigorous training and performance required to achieve a high level of expertise. The ABMS cites numerous studies that have demonstrated that physicians who are board certified “deliver higher quality care and have better patient care outcomes than physicians who are not board certified.”

The National Institutes of Health estimates one-third of women in the U.S. will experience pelvic disorders in their lifetime. Symptoms of pelvic disorders include feeling pressure, urinary or fecal leakage, pain during intercourse, frequent urination or inability to empty bladder.  U.S. Census population data shows 300,000 adult women live in El Paso County, meaning 100,000 will likely face at least one type of pelvic disorder.  A large study presented at the American Urogynecologic Society’s Annual Scientific Meeting in October reported that a woman’s lifetime risk of surgery for stress urinary incontinence or pelvic organ prolapse is 20 percent, almost twice the risk previously reported two decades ago.

Board-certified urogynecologists see and treat these issues with greater frequency than non-specialists which results in the highest chance of long-term success. For example, with a traditional surgery for a prolapse repair (native tissue bladder repair) the failure rate is approximately 30 percent. But a subspecialist with advanced training can perform a surgery such as sacrocolpopexy with a success rate of 88 to 92 percent. For moderate issues a routine repair is standard, but more advanced conditions call for a surgeon with more advanced training.

Don’t suffer in silence when most issues can be corrected

For many women who aren’t aware there are treatments, pelvic disorders can be embarrassing and may even lead to greater medical complications if not treated. Routine examinations in general physicians’ offices don’t always screen for pelvic floor disorders. Women who are experiencing symptoms should not be afraid to speak up.  Symptoms like leaking or vaginal bulges are not a normal part of aging. Urogynecology specialists are used to talking about these issues and can help. Women who take an active role in their care will find that they are not alone and have a variety of options - both surgical and non-surgical – for restoring their quality of life.

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