Urogynaecology is the subspecialty that treats problems at the intersection of gynaecology and urology in women — principally urinary incontinence (urine leakage), pelvic organ prolapse (when the uterus, bladder, or rectum drops from its normal position), and overactive bladder. In India, these conditions are severely under-reported because many women feel embarrassed or believe that leaking urine after childbirth is simply normal. At Charak Hospital, we offer comprehensive assessment including urodynamic studies, pelvic floor physiotherapy, pessary fitting, and minimally invasive surgical repair — including TVT sling for incontinence and vaginal repair for prolapse.
Common Symptoms — When to Seek Help
- Leaking urine when you cough, sneeze, laugh, or exercise (stress incontinence)
- Sudden strong urge to urinate that is difficult to control (urge incontinence)
- Frequent urination (more than 8 times a day)
- Waking more than once at night to urinate (nocturia)
- A feeling of heaviness or a bulge in the vaginal area
- Difficulty emptying the bladder or bowel completely
- Pelvic pressure that worsens when standing or walking
- Uterine or vaginal prolapse visible at or outside the vaginal opening
Conditions We Treat
Stress Urinary Incontinence
Treated with pelvic floor exercises (Kegel exercises), physiotherapy, and TVT sling surgery for persistent cases. Surgery has a 90%+ long-term success rate.
Pelvic Organ Prolapse
Uterine, bladder (cystocoele), or rectal (rectocoele) prolapse managed by pelvic floor physiotherapy, pessary ring, or surgical repair including vaginal hysterectomy with pelvic floor reconstruction for severe prolapse.
Overactive Bladder
Managed with bladder retraining, anticholinergic medications, and Botox injections into the bladder wall for refractory cases.
Assessment & Treatment Pathway
- Detailed pelvic floor assessment and voiding diary review
- Urodynamic studies to classify incontinence type precisely
- Pelvic floor physiotherapy programme (first-line for mild-moderate cases)
- Pessary fitting for prolapse in women who prefer to avoid surgery
- TVT sling for stress urinary incontinence
- Vaginal repair (anterior/posterior colporrhaphy) for cystocoele and rectocoele
- Sacrocolpopexy or vaginal vault suspension for vault prolapse
Recovery & Aftercare
Pelvic floor physiotherapy requires 8–12 weeks of regular exercises. After TVT sling surgery, most women are discharged within 24 hours and return to light activities within a week. After prolapse repair, heavy lifting should be avoided for 6–8 weeks. Long-term outcomes are excellent with proper pelvic floor care.
Why Choose Charak Hospital?
- NABH-accredited facility
- Senior gynaecology team
- Laparoscopic & advanced surgical options
- 24×7 emergency care
- Full NICU & PICU backup
- Transparent treatment planning
- Compassionate multilingual staff
- Affordable, transparent pricing
Frequently Asked Questions
This is called stress urinary incontinence and happens when the pelvic floor muscles—which support the bladder—have been weakened, usually after childbirth, multiple pregnancies, or with age and menopause. It is extremely common, affecting millions of Indian women, and is absolutely not 'normal ageing' that must be accepted. Effective treatments ranging from pelvic floor exercises to a minor day-surgery procedure (TVT sling) can completely resolve the problem.
Some temporary leakage immediately after delivery is common as the pelvic floor recovers. However, if leakage persists beyond 6–12 weeks postpartum, you should see a urogynaecologist. Pelvic floor physiotherapy started early is very effective. Do not simply 'manage' with pads—this condition can and should be treated.
Uterine prolapse occurs when the uterus descends into or outside the vagina because the pelvic floor muscles and ligaments have stretched and weakened. It is very common in Indian women who have had multiple vaginal deliveries, do heavy physical work, or have gone through menopause. Women often describe a feeling of 'something coming down', heaviness in the pelvis, or discomfort when sitting or walking. It is treatable—do not ignore it.
Many women with mild to moderate prolapse can have sexual intercourse, though they may notice discomfort or a feeling of pressure. Prolapse itself does not make sex dangerous, but the discomfort can affect quality of life and intimate relationships. Treating the prolapse—through exercises, a pessary, or surgery—usually resolves the issue, and your gynaecologist can guide you on what is safe in your specific situation.
Yes—pelvic floor exercises (Kegel exercises) are the first and most important treatment for mild to moderate prolapse and stress incontinence. Done correctly and regularly (3 sets of 10–15 contractions daily), they can significantly strengthen the pelvic floor and reduce or eliminate symptoms within 3–6 months. A physiotherapist trained in women's health can teach you the correct technique to ensure you are doing them properly.
No—surgery is not always needed. Mild to moderate prolapse is often managed with pelvic floor exercises and, for older women who are not candidates for surgery, a vaginal pessary (a removable supportive device). Surgery is recommended for severe prolapse, when symptoms significantly affect quality of life, or when conservative measures have not helped. The surgical options today are minimally invasive with good outcomes.
A pessary is a removable silicone device inserted into the vagina by a gynaecologist to support the uterus, bladder, or vaginal walls when they have prolapsed. It is particularly useful for women who are not suitable for surgery due to age or health issues, or who prefer a non-surgical option. Pessaries are safe, comfortable once fitted correctly, and most women cannot even feel them during daily activities.
Frequent urination (more than 8 times a day) or a sudden urgent need to urinate (urgency incontinence / 'overactive bladder') is different from stress incontinence and has different causes—including bladder sensitivity, low oestrogen after menopause, or nerve issues. It is treatable with bladder training, medications, and in some cases minor procedures. An accurate diagnosis first is important so the right treatment is given.
No—urinary incontinence and pelvic organ prolapse are not caused by cancer and do not indicate cancer. They are mechanical problems related to weakened supportive tissues, not abnormal cell growth. However, if you notice blood in urine, unusual vaginal discharge, or unexplained pelvic pain alongside these symptoms, those should be separately evaluated by your doctor.
Common symptoms include a dragging, heavy feeling in the pelvis, a visible or felt bulge at or outside the vaginal opening, difficulty passing stools or urine, backache that improves when you lie down, and discomfort during intercourse. Symptoms often feel worse at the end of the day or after prolonged standing. If you have any of these, a gynaecological examination is all that's needed to make a diagnosis.
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