Chapter 6: Choosing the right doctor

There is more than one specialty that deals with bladder control problems. General practitioners, family doctors, urologists, gynecologists, female urologists, and uro-gynecologists all evaluate and treat stress incontinence and overactive bladder.

How to go about choosing the right doctor for you?

General practitioners and family doctors - These are the first doctors many women see for their bladder control problems. Most general practitioners and family doctors will know how to perform the preliminary evaluation to reach an initial diagnosis and more importantly to rule out other medical conditions that can present as bladder control symptoms. Some general practitioners and family doctors will prefer to consult a more specialized professional immediately. Others may try to prescribe an anticholinergic medication for your overactive bladder symptoms and follow-up your progress for improvement, educate you on stress incontinence and pelvic floor exercises, or refer you to a physiotherapist who will teach you how to perform them.

These measures alone may help and even cure your problem. If these measures fail to improve your situation, you should ask your doctor whom he or she would recommend as a specialist, or seek a specialist’s opinion on your own.

Gynecologists – Many women choose their gynecologist to be their primary care physician. A special appointment can be arranged or you may take advantage of your upcoming yearly routine examination as a good opportunity to raise questions and ask for a consultation on your bladder control problems (if your gynecologist does not raise this issue first). Some gynecologists are well trained in all aspects of bladder control problems and pelvic floor prolapse and will be able to fully and extensively evaluate your condition, suggest a treatment plan and perform surgery to correct the condition if necessary.

Urologists – As opposed to gynecologists, urologists rarely serve as primary care physicians for women. They specialize in diseases of the urinary system in men and women. If you have a recurrent or persisting urinary tract infection or you have blood in your urine (hematuria) you will probably be referred to a urologist to be evaluated. Urologists, however, deal also with bladder dysfunction including bladder control problems in men and women. Many urologists have had exposure and training in treating incontinence and bladder control issues during their residency and therefore may be an excellent choice for you.

Uro-gynecologists – These are gynecologists who are highly specialized in the treatment of bladder control problems. To become a uro-gynecologist one has either dedicated most of his or her time to the treatment of women who suffer from these problems or to be fellowship-trained. A fellowship is an advanced 1-3 year training period taken after the completion of a full residency program. During this period fellows are exposed to a busy clinic that is highly specialized in uro-gynecology.

Female urologists – As opposed to what the term may imply, these professionals may be either men or women. Similar to uro-gynecologists these are highly specialized or fellowship trained urologists who deal mainly with bladder control problems.

How to choose?

There is no general rule in choosing the right professional to treat your bladder control problems. Availability of professionals in your area, health insurance restrictions, and cost may determine your choice. If many professionals are available to you, a good selection will depend on your willingness to do a little research and ask the right questions.

This is especially true if previous treatment has failed, making your treatment more challenging. Ask for recommendations and information about doctors’ expertise among friends who have had the same problem, relatives and friends who have connections in the medical field, and at the doctor’s office when you make an appointment. Finally, you may ask the doctor if bladder control problems and their treatment are his specialty and what kind of experience and expertise he has had with bladder control problems in women. Asked politely, most doctors will share this information with you without being offended.