Urogynaecology at The Cherwell Hospital in Banbury

Urogynaecology is a subspeciality of gynaecology that focuses specifically on pelvic floor disorders in women and the issues they cause, including urinary and faecal incontinence, recurrent urinary tract infections, pelvic organ prolapse, chronic pelvic pain, and sexual dysfunction.

Ramsay Health Care is a leading provider of urogynaecology treatments across the UK, with our hospitals offering fast access to expert private gynaecologists who specialise in female pelvic floor and bladder health. 

If you’re experiencing any pelvic floor problems, we’re here to help you find the right treatment and get back to feeling like yourself.

What is urogynaecology?

Urogynaecology is a subspecialty of gynaecology that focuses on pelvic floor disorders and bladder problems in women. 

Your pelvic floor is a complex network of muscles, ligaments, and connective tissues that stretches from your tailbone (coccyx) at the back of your pelvis to your pubic bone at the front. It acts as a supportive hammock for your pelvic organs, including your bladder, uterus, and bowel, keeping them in the correct position. 

The pelvic floor plays three essential roles: 

• Supporting your pelvic organs

• Controlling bladder and bowel function (continence)

• Contributing to sexual sensation and satisfaction

Your pelvic floor can become weakened or damaged for various reasons. Pregnancy and childbirth place significant strain on these muscles, while ageing and menopause reduce oestrogen levels that keep pelvic tissues strong. Chronic straining from constipation or heavy lifting, previous pelvic surgery, being overweight, and genetic factors can all contribute to pelvic floor weakness. When the pelvic floor weakens, it can lead to various issues, including urinary incontinence, pelvic organ prolapses, faecal incontinence, chronic pelvic pain, and sexual dysfunction. 

Pelvic floor disorders are more common than many people realise. Research suggests that up to one in three women (32%) experience pelvic floor issues that can affect bladder or bowel control. The good news is that these conditions are highly treatable. Whether through pelvic floor exercises, medication, or surgical procedures, most women find significant relief with the right specialist care.

What is a urogynaecologist?

A urogynaecologist is a specialist doctor who focuses exclusively on pelvic floor disorders in women. They are consultant gynaecologists with advanced subspecialty training that combines expertise in both gynaecology and female urology, allowing them to diagnose and treat complex bladder and pelvic floor conditions that general gynaecologists may not routinely manage.

Specialist training and expertise

Urogynaecologists are consultant gynaecologists who complete additional years of structured subspecialty training in female urology and urogynaecology, focusing on the diagnosis and treatment of complex pelvic floor issues.

This advanced training covers:

• Female urinary incontinence and bladder dysfunction

• Pelvic organ prolapse, including prolapse of the uterus, bladder, or bowel

• Specialist diagnostic techniques, such as urodynamic testing

• Advanced surgical and non-surgical management of pelvic floor conditions

• Complex cases requiring multidisciplinary care

Many urogynaecologists in the UK are members of professional bodies such as the British Society of Urogynaecology (BSUG), which promotes the highest standards of clinical care and ongoing professional development in the field. This ensures they remain at the forefront of the latest evidence-based treatments and techniques.

When to see a urogynaecologist vs. a gynaecologist

Understanding which specialist you need can help you get the right care faster.

A general gynaecologist typically focuses on:

• Menstrual problems and heavy periods

• Contraception and family planning

• Fertility concerns

• Pregnancy-related care

• Menopause management

A urogynaecologist specialises in:

• Urinary incontinence (stress, urge, or mixed)

• Overactive bladder symptoms

• Recurrent bladder issues linked to pelvic floor weakness

• Pelvic organ prolapses

• Pelvic floor dysfunction and chronic pelvic pain

• Complex cases involving both bladder and reproductive organs

Most patients are referred to a urogynaecologist by their GP or general gynaecologist after initial assessment. Your GP will evaluate your symptoms and recommend the most appropriate specialist for your condition. In some cases, your general gynaecologist may refer you to a urogynaecologist if you need more specialised pelvic floor care.

At Ramsay, we also offer self-referral, meaning you don't need a GP referral to see one of our expert urogynaecologists. If you've been told you need to see a urogynaecologist, or if you're experiencing symptoms such as bladder control problems or pelvic organ prolapse, you can contact us directly to arrange a prompt appointment with a specialist.

Urogynaecology conditions we treat at Ramsay

Our expert urogynaecologists have extensive experience in diagnosing and treating a comprehensive range of pelvic floor and bladder disorders. Whatever your concern, we provide specialist care tailored to your individual needs.

Urinary incontinence

Urinary incontinence is the involuntary leakage of urine. There are several different types of urinary incontinence that we can treat at Ramsay:

Stress urinary incontinence (SUI)

The most common type of urinary incontinence, stress incontinence, causes leakage during physical activity such as coughing, sneezing, laughing, or exercise. It’s usually caused by weakening of the pelvic floor muscles and/or the urethral sphincter and is commonly associated with childbirth or menopause.

Urge incontinence (overactive bladder)

This involves a sudden, intense urge to urinate that can be difficult to control, usually combined with needing to urinate more frequently. Many women experience increased urinary frequency during both day and night and may not reach the toilet in time. Symptoms can significantly affect daily life and confidence.

Mixed incontinence

A combination of both stress and urge incontinence symptoms. Careful assessment is required to determine the dominant symptoms and their cause, to guide effective treatment.

Other types of incontinence

Less common forms of urinary incontinence include:

• Overflow incontinence - caused by an overfull bladder that doesn’t empty properly

• Functional incontinence - when you have a normally functioning bladder but struggle to reach a toilet in time due to physical or cognitive reasons

• Temporary incontinence - caused by an infection or other reversible condition.

Pelvic organ prolapse

A prolapse occurs when the pelvic floor muscles and tissues weaken, causing an organ to slip, sag, or drop out of its normal position. Pelvic organ prolapses happen when the pelvic floor weakens and one or more of the pelvic organs, such as the bladder, bowel, or uterus, descend into or through the vagina. 

While this can be distressing, prolapses are common and highly treatable. We have expertise in treating all types of pelvic organ prolapse at Ramsay Health Care, including:

Cystocele (bladder prolapse)

Caused by a weakness of the front vaginal wall that allows the bladder to drop into the vagina. Symptoms may include a vaginal bulge, difficulty emptying the bladder, or urinary retention.

Rectocele (rectal prolapse)

A weakness of the back vaginal wall allows the rectum to push forward into the vagina. You may experience persistent constipation, difficulty with bowel movements, or a sensation of vaginal bulging.

Uterine prolapse

Weakening of the pelvic floor causes the uterus to drop into the vaginal canal. The prolapse can range from mild to complete, and may cause heaviness, pressure, or a visible bulge.

Vault prolapse

The descent of the top of the vagina, which typically occurs after a hysterectomy. A vault prolapse requires specialist assessment and management to address it effectively.

Enterocele

A small bowel prolapse where the small intestine descends into the lower pelvic cavity and pushes against the top part of the vagina, creating a hernia. This often occurs alongside other types of pelvic organ prolapse.

Recurrent urinary tract infections (UTIs)

Recurrent UTIs are typically defined as two or more infections within six months, or three or more within a year. Symptoms may include burning during urination, frequent urge to urinate, cloudy or strong-smelling urine, and pelvic discomfort.

Recurrent UTIs may be linked to incomplete bladder emptying, post-menopausal changes, or underlying structural abnormalities. A thorough investigation is essential to identify the contributing causes and find the right treatment to prevent further episodes.

Bladder pain and painful bladder syndrome

Chronic bladder-related pain conditions can significantly impact quality of life and often require specialist assessment. These include:

Interstitial cystitis and bladder pain syndrome

A chronic, non-infectious condition causing long-term bladder pressure, pain, and urinary urgency/frequency, often without an identifiable infection. Also known as painful bladder syndrome, this can be particularly distressing and requires specialist management.

Other bladder and pelvic pain conditions

• Urethral pain – discomfort or pressure in the urethra, sometimes related to bladder dysfunction

• Vaginal pain syndromes – chronic pain often associated with pelvic floor dysfunction

These conditions often require a multidisciplinary approach to be treated effectively, as symptoms can overlap with other chronic pelvic pain disorders.

Bowel control disorders

Pelvic floor dysfunction can also affect bowel control, often resulting in:

Faecal incontinence

The inability to properly control bowel movements. This condition most often results from childbirth-related injuries, anal sphincter damage, or nerve injuries. Specialist assessment can identify the cause and guide appropriate treatment. 

Chronic constipation

Pelvic floor damage or weakening can impair proper bowel function, leading to persistent constipation. In some cases, chronic straining can result in further pelvic floor complications and make prolapses more likely. Addressing bowel health issues is an important part of a comprehensive pelvic floor treatment program.

Pelvic floor injury after childbirth

Childbirth can cause significant strain or injury to the pelvic floor. Birth-related injuries include:

Third- and fourth-degree tears

Severe tears affecting the perineal area (the tissue between the vagina and anus) require specialist assessment, treatment, and long-term follow-up, particularly when the anal sphincter is damaged. While these injuries can be distressing, with proper care, most women recover well.

Levator ani muscle damage

Injury to these key pelvic floor muscles may not cause immediate symptoms but can increase the risk of prolapse or incontinence later in life. Specialist assessment can identify this damage and guide preventive treatment.

Other birth-related injuries

These may include nerve damage or generalised pelvic floor weakness. Early intervention and targeted rehabilitation are often highly effective and can significantly reduce the risk of long-term complications.

Symptoms that might mean you should see a urogynaecologist

Too many women suffer in silence, thinking their symptoms are "just part of ageing" or "normal after having children”. The truth is, these symptoms are treatable, and you don’t have to live with them. Seeking specialist care can make a significant difference to your quality of life, even if you’ve been experiencing symptoms for years. 

You should seek help if you experience any of the following:

Urinary symptoms

These symptoms can indicate a bladder or urinary disorder:

• Leaking urine when you cough, sneeze, laugh, or exercise

• Sudden, urgent need to urinate that’s difficult to control

• Frequent trips to the bathroom, including multiple times at night

• Difficulty emptying your bladder completely

• A weak or slow urine stream

• Needing to strain to urinate

• Recurrent bladder infections

Pelvic symptoms

One or more of these symptoms may indicate a pelvic floor problem:

• Feeling or seeing a bulge in your vagina

• Heaviness or pressure in your pelvis

• Feeling like “something is falling out”

• Lower back pain that worsens throughout the day

• Difficulty inserting tampons

• Discomfort during sex or inability to have intercourse

Bowel symptoms

Pelvic floor dysfunction can also affect your bowel control:

• Difficulty controlling wind or faeces

• Chronic constipation

• Needing to support your vagina or perineum to empty your bowels

• Sensation of incomplete bowel emptying

Other symptoms

Additional symptoms that may benefit from specialist urogynaecologist care:

• Persistent pelvic pain or discomfort

• Chronic bladder pain

• Vaginal or urethral pain

• Any symptoms that significantly impact your quality of life, social activities, or ability to exercise

Diagnostic tests and investigations

Accurate diagnosis is essential for effective treatment. Our Ramsay urogynaecologists use state-of-the-art diagnostic tools to fully evaluate your symptoms and guide your personalised treatment plan.

Your diagnostic journey at Ramsay Health Care may involve:

Initial assessment

Your urogynaecology journey begins with a comprehensive consultation with one of our specialist urogynaecologists. This initial assessment typically includes:

• A detailed medical and gynaecological history

• Validated symptom questionnaires to accurately assess your condition

• A quality of life assessment to understand how symptoms affect your daily activities

• Review of your bladder diary if you’ve been asked to keep one

• A thorough pelvic examination

• Urine sample and analysis

This comprehensive assessment ensures we fully understand your condition and helps determine which diagnostic tests will be most helpful for you.

Urodynamic testing

What it is:

Urodynamics is a specialised test that assesses how the bladder stores and releases urine. It measures bladder pressure, capacity, and urinary flow, helping to identify the underlying cause of incontinence or voiding difficulties and determine the best treatment approach.

What to expect:

The test typically takes around 30 to 60 minutes and involves inserting a small catheter (a thin, flexible tube) into your urethra. This may feel uncomfortable, but it is usually not painful. The procedure is performed in the consultation room, and results are often available immediately, so we can discuss them with you during the same appointment.

Flexible cystoscopy

What it is:

Flexible cystoscopy is a minimally invasive visual examination of your bladder and urethra. A very thin, flexible telescope with a camera (cystoscope) is gently inserted through the urethra and into the bladder. This allows us to identify structural problems, inflammation, bladder stones, or other issues that may be causing your symptoms. 

What to expect:

This is a quick outpatient procedure taking just 10 to 15 minutes. Local anaesthetic gel is applied to reduce discomfort. You can usually go home immediately after the procedure. 

Uroflowmetry

Uroflowmetry is a simple, non-invasive test that measures the rate, volume, and pattern of your urine flow. You’ll be asked to urinate into a special device (which looks like a funnel attached to electronic equipment), and the test assesses how efficiently your bladder empties. It’s a quick and painless procedure that can provide valuable information about bladder function. 

Imaging studies

Advanced imaging allows us to examine your pelvic structures in detail without invasive procedures. The most common imaging techniques used in urogynaecology are:

Ultrasound scanning

Pelvic or transvaginal ultrasound uses high-frequency sound waves to create real-time images of your pelvic organs. This can reveal structural abnormalities, measure bladder wall thickness, and check for residual urine after voiding to assess whether your bladder is emptying properly.

MRI scanning

Magnetic resonance imaging (MRI) is a radiation-free technique that uses powerful magnets and radio waves to generate highly detailed images of your pelvic floor structures. MRI is typically used in complex cases for surgical planning or to assess previous surgical repairs, providing exceptionally detailed visualisation of soft tissues.

Other specialised tests

For specific conditions, we may also use additional diagnostic tools:

• Pad tests - to quantify the amount of urine leakage over a set period

• Anal manometry - to assess bowel control and anal sphincter function

• Endoanal ultrasound - detailed imaging of the anal sphincter to identify damage or weakness

• Defecography - specialised imaging to evaluate bowel emptying and pelvic floor movement

Your urogynaecologist will recommend the most appropriate tests based on your individual symptoms and medical history, ensuring you receive a thorough and accurate diagnosis.

Preparing for your urogynaecology appointment

Being well-prepared for your appointment will help us assess your condition accurately and discuss the most appropriate treatment options for you. Here's how to prepare:

Before your appointment

Complete a bladder diary

We'll typically ask you to keep a bladder diary for three to seven days before your appointment. This should include:

• All fluid intake (what you drink and when)

• Every toilet visit and approximate volume passed

• Any leakage episodes, including what you were doing at the time

• Bring your completed diary to your appointment

Prepare your medical history.

Your urogynaecologist will need information about:

• Previous pregnancies and deliveries (including any complications)

• Previous pelvic or abdominal surgeries

• Current medications and supplements

• Other medical conditions, particularly chronic conditions

• Relevant family history of pelvic floor problems

Write down your symptoms.

Note down details about your symptoms, including:

• What symptoms you're experiencing and their severity

• When they started

• What makes them better or worse

• How they impact your daily life, work, and activities

• Any previous treatments you've tried and their effectiveness

•  

Prepare your questions

Write down any questions or concerns you have so you don't forget to ask them during your appointment. Remember:

• No question is too embarrassing - we discuss these issues every day

• Include any concerns about specific treatments or procedures

• Ask about anything that's worrying you

What to wear

Wear comfortable, easy-to-remove clothing to your appointment. As you may need an internal examination. Bring a sanitary pad with you, as you may experience light spotting after an examination.

Urogynaecology treatment options at Ramsay Health Care

Our expert urogynaecologists are highly experienced in treating the full spectrum of pelvic floor and bladder conditions. Your treatment plan will be tailored to your individual condition, symptoms, and preferences and may include:

Conservative treatments

Pelvic floor muscle training, lifestyle modifications, and specialist physiotherapy tailored to address your specific pelvic floor dysfunction.

Medical treatments

Depending on your condition, appropriate medications may include antibiotics for recurrent urinary tract infections, medications to reduce urgency and frequency of urination for an overactive bladder, or pain management for bladder pain syndrome.

Vaginal pessaries

A removable device inserted into the vagina to support pelvic organs affected by prolapse. Pessaries can be used as a long-term solution or as a temporary option while considering other treatments such as surgery.

Minimally invasive procedures

Procedures such as percutaneous tibial nerve stimulation (PTNS) to improve overactive bladder symptoms by gently stimulating the nerves involved in bladder control.

Surgical treatments

For more severe or persistent symptoms, surgical options may be recommended. Procedures are tailored to your specific condition and may include:

Vaginal hysterectomy for uterine prolapse

• Laparoscopic sacrocolpopexy for pelvic organ prolapse

• Sphincter repair for anal sphincter injury

• Colposuspension for stress urinary incontinence

• Mid-urethral sling procedures for stress incontinence

Your consultant will discuss all appropriate treatment options with you, including the benefits, risks, and expected outcomes, to help you make an informed decision about your care.

Why choose private urogynaecology?

Choosing private urogynaecology can offer a range of benefits, including:

• Enhanced privacy and dignity – Your own private room throughout your visit, giving you the comfort and discretion you need when discussing sensitive symptoms and receiving treatment.

• Faster access to specialist care – Private care means you can see an expert urogynaecologist quickly, at a time that suits you, rather than being placed on a lengthy waitlist. 

• Continuity of care – You'll be cared for by the same specialist consultant from initial consultation through to follow-up care, building a relationship with an expert who understands your individual needs and treatment plan.

• Flexible appointments – Consultations, diagnostic tests, and follow-up appointments arranged at times that work around your schedule.

What is the cost of private urogynaecology treatment?

Urogynaecological treatment costs with Ramsay Health Care will depend on the details of your treatment, including the specific procedures required, any diagnostic tests needed, and which Ramsay hospital you attend. 

We’ll give you a personalised price for your urogynaecology treatment after a consultation with one of our urogynaecologists, which will be valid for up to 60 days.

We can offer you a range of payment options for your treatment, including:

• 0% Payment Plans – Allowing you to spread the cost of your treatment with fixed monthly payments made over a time period that suits you.

• Self-funded treatment – With our all-inclusive Total Care package, you’ll make a one-time payment at a pre-agreed price that covers all the treatment you’ll need.

• Private medical insurance – Your healthcare insurance may cover your urogynaecological treatment. You should get written confirmation from your insurance provider before booking your treatment with us.

Urogynaecology at Ramsay Health Care

Have your urogynaecology treatment with Ramsay to get quick access to the expert healthcare you need, delivered in a hospital close to you. 

You'll enjoy patient-focused care from experienced consultant urogynaecologists with subspecialty accreditation. Your appointments will be arranged at times to suit you, and you'll receive a comprehensive assessment, treatment, and recovery plan tailored to your individual needs. 

Our multidisciplinary approach means your consultant works collaboratively with specialist physiotherapists and other healthcare professionals to provide you with holistic care.

Your Ramsay experience:

• Convenient locations across the UK, many with on-site parking

• State-of-the-art facilities equipped with the latest urogynaecology diagnostic and treatment technology

• Comprehensive care from initial consultation to full recovery

• Dedicated patient support with easy access to your specialist team throughout your journey

• Experienced consultants who specialise in pelvic floor and bladder disorders

Ready to take the next step? Contact us today to speak to one of our friendly advisors, find out more about urogynaecology treatment at Ramsay Health Care, and book your consultation.

Urogynaecology FAQs