Uro-gynaecology
What is uro-gynaecology? Uro-gynaecology is a subspecialty of gynaecology that treats women for urinary issues. What are the types of uro-gynaecology conditions? Urinary incontinence such as stress incontinence or over active bladder Recurrent urinary tract infections Bladder pain Vaginal prolapse, where one or more of the organs in the pelvis slip down from their normal position and b
What it is
Common presentations include stress urinary incontinence (leak on cough/laugh/exercise), urge incontinence and overactive bladder, mixed urinary incontinence, pelvic organ prolapse, and recurrent urinary tract infection.
When this is relevant
- Leaking urine on cough, sneeze, exercise or lifting.
- Sudden urgency to pass urine, sometimes with leaking before the toilet.
- A sensation of dragging, heaviness or "something coming down" in the vagina.
- Difficulty emptying the bladder, weak stream or incomplete emptying.
- Three or more urinary tract infections in 12 months.
How we investigate
Detailed history with frequency-volume chart, pelvic examination including POP-Q prolapse staging, urinalysis, mid-stream urine culture, ultrasound bladder scan, urodynamics referral where indicated.
Options at The Vesey
- Pelvic-floor physiotherapy - first-line for stress incontinence and mild prolapse; coordinated with partner specialist physio.
- Bladder training for urge / overactive bladder.
- Antimuscarinic or beta-3 agonist medication for refractory overactive bladder.
- Vaginal pessary fitting for prolapse where surgery is not indicated or wanted.
- Topical vaginal oestrogen for atrophic urinary symptoms.
- Onward surgical referral - mid-urethral sling, sacrospinous fixation, vaginal repair, sacrocolpopexy.
What is the difference between stress incontinence and overactive bladder? +
Stress incontinence is leaking triggered by physical activity — cough, sneeze, exercise — due to a weak or damaged urethral sphincter. Overactive bladder causes sudden strong urgency, with or without leaking, driven by abnormal bladder muscle contractions. They often coexist.
Do I need urodynamic studies before starting treatment? +
Not always. Many women with a clear clinical picture of stress or urge incontinence start conservative treatment (pelvic floor exercises, bladder training) without urodynamics. Urodynamic studies are recommended before surgery or when the diagnosis is uncertain.
Are ring pessaries effective for managing prolapse? +
For many women, yes. A correctly fitted ring or Gellhorn pessary gives effective, reversible symptom relief. Success rates at one year are around 50–70%. They require changing every 4–6 months. Topical oestrogen alongside improves tissue tolerance.
At what point should I consider surgery for urinary incontinence? +
Surgery is considered after at least 3 months of supervised conservative treatment has not given adequate improvement. For stress incontinence, a mid-urethral tape is the most evidence-based option. For urge incontinence, sacral neuromodulation is a minimally invasive alternative to medication.
Pricing at a glance
Initial consultation £260. Urodynamic studies via partner from £450. Pessary fitting £180. Surgical pricing patient-specific. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to book
Book if urinary symptoms or prolapse are affecting daily life, you have recurrent UTI, or you want a structured non-surgical management plan before considering surgery.
Cost and pathway
Initial consultation £260. Urodynamic studies via partner from £450. Pessary fitting £180. Surgical pricing patient-specific.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our gynaecology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
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Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
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