What to Expect at Your First Urogynecologist Appointment
If you've been referred to a urogynecologist for pelvic organ prolapse or other pelvic floor issues, you might be feeling anxious about what to expect. Will it be uncomfortable? What will they ask? What tests will they do? These are all normal concerns, and knowing what's coming can help ease your mind.
Let's walk through what typically happens at your first urogynecology appointment so you can feel prepared and empowered.
What is a Urogynecologist?
A urogynecologist is a doctor who specializes in pelvic floor disorders, including pelvic organ prolapse, urinary incontinence, and bowel control issues. They have additional training beyond gynecology specifically focused on the muscles, ligaments, and connective tissues that support your pelvic organs.
Think of them as pelvic floor experts who understand the complex relationship between your bladder, uterus, vagina, and bowel.
Before Your Appointment
What to Bring
Your medical history, including:
List of current medications and supplements
Previous surgeries (especially pelvic, abdominal, or back surgeries)
Pregnancy and delivery history
Any relevant medical conditions (diabetes, chronic cough, connective tissue disorders)
Insurance card and identification
A list of your symptoms, including:
When they started
What makes them better or worse
How they affect your daily life
Your questions - Write them down! It's easy to forget what you wanted to ask once you're in the exam room.
Practical Tips
Wear comfortable, easy-to-remove clothing. You'll likely need to change into a gown for the exam.
Don't schedule during your period if possible. While it won't prevent the exam, it's easier for both you and the doctor if you're not menstruating.
Empty your bladder before the appointment - unless you're asked not to. Some offices may want to do bladder tests, so check when you schedule.
Consider bringing a support person if it makes you more comfortable. Many women bring a spouse, partner, or friend.
What Happens During the Appointment
The Consultation (30-45 minutes)
Your appointment will likely start in an office or consultation room, not the exam room. This gives you time to talk with the doctor while fully clothed, which many women find less intimidating.
Your doctor will ask about:
Your symptoms in detail - Be honest and specific. Don't be embarrassed! Urogynecologists hear about bladder leaks, bulges, and bowel issues all day long. Nothing you say will shock them.
Your medical history - Including pregnancies, deliveries, previous surgeries, and chronic health conditions that might affect your pelvic floor.
Your quality of life - How are your symptoms affecting work, exercise, intimacy, and daily activities? This helps your doctor understand what matters most to you.
What you've already tried - Kegel exercises, lifestyle changes, other treatments.
Your goals - What do you hope to achieve? Understanding your priorities helps guide treatment recommendations.
The Physical Exam (15-20 minutes)
After the consultation, you'll change into a gown for the physical examination. Here's what typically happens:
General examination - Your doctor may check your abdomen, looking for hernias or other issues.
Pelvic exam - Similar to a regular gynecological exam, but more thorough. Your doctor will:
Examine the outside of your vagina for any visible prolapse, skin changes, or other issues
Use a speculum to look inside your vagina and check the vaginal walls, cervix, and uterus
Check for prolapse by asking you to bear down (like you're having a bowel movement) while examining you - this helps them see how far your organs are dropping
Perform a bimanual exam (one hand inside, one hand on your abdomen) to feel your uterus and ovaries
Check your pelvic floor muscle strength by asking you to squeeze (like doing a Kegel) while their fingers are inside your vagina
Standing exam - Many doctors will ask you to stand and bear down again. Prolapse is often more visible when you're upright and gravity is working against you.
Bladder and bowel assessment - Your doctor may ask you to cough or jump to check for urine leakage.
Possible Tests
Depending on your symptoms, your doctor might recommend additional tests, either during this visit or at a follow-up:
Urinalysis - A simple urine test to check for infection or other issues.
Bladder scan - A quick, painless ultrasound to see how much urine is left in your bladder after you pee.
Urodynamic testing - Tests that measure how well your bladder and urethra are working. These might be scheduled for another visit.
Cystoscopy - A thin camera inserted into your bladder to check for problems. Usually done at a separate appointment if needed.
Pelvic floor ultrasound - Imaging to see your pelvic organs and how they're positioned.
Not everyone needs all these tests. Your doctor will recommend what's appropriate for your situation.
Questions to Ask Your Doctor
Come prepared with questions! Here are some important ones to consider:
About Your Diagnosis:
What type of prolapse do I have? What stage is it?
What caused my prolapse?
Will it get worse over time?
Are there things I should avoid doing?
About Treatment Options:
What are all my treatment options?
What do you recommend for my specific situation, and why?
What are the pros and cons of each option?
If I don't want surgery, what are my alternatives?
What happens if I do nothing?
About Next Steps:
Do I need any additional tests?
When should I come back for a follow-up?
Can I exercise? What activities are safe?
Are there any lifestyle changes I should make?
Should I see a pelvic floor physical therapist?
About Your Doctor's Experience:
How many patients with my condition have you treated?
What are your success rates with the treatments you're recommending?
If surgery is recommended: How many of these procedures have you done?
Don't be afraid to ask for clarification if you don't understand something. A good doctor will take the time to explain things in terms you can understand.
What Comes Next
At the end of your appointment, you should have:
A clear diagnosis - Understanding what type of pelvic floor disorder you have and how severe it is.
A treatment plan - Whether that's conservative management (pessary, physical therapy, lifestyle changes) or surgical options.
Next steps - Any additional tests needed, referrals to other specialists (like pelvic floor physical therapists), and when to follow up.
Resources - Your doctor's office should provide educational materials about your condition and treatment options.
Tips for a Successful Appointment
Be honest and specific about your symptoms. Your doctor needs accurate information to help you. Don't minimize or exaggerate.
Advocate for yourself. If something doesn't feel right or if you don't understand the treatment plan, speak up.
Take notes or ask if you can record the conversation (many doctors are fine with this). It's hard to remember everything when you're anxious or processing difficult information.
Don't rush into decisions. Unless it's an emergency, you have time to think about treatment options, get a second opinion, or do research. A good doctor won't pressure you.
Bring a support person if it helps. Having someone with you can provide emotional support and help you remember what the doctor said.
Follow up. If you leave the appointment with unanswered questions, call the office. That's what they're there for.
Remember: You're Not Alone
Seeing a urogynecologist can feel overwhelming, especially if you're newly diagnosed with pelvic organ prolapse. But remember - these doctors specialize in helping women with exactly what you're going through. They've seen it all, and they're there to help, not judge.
Many women walk into their first appointment feeling anxious and embarrassed, and walk out feeling relieved and empowered. Having a doctor who understands your condition and can offer real solutions is a huge step forward.
You deserve expert care, honest answers, and treatment options that fit your lifestyle and goals. Don't settle for a doctor who dismisses your concerns or makes you feel uncomfortable. If your first urogynecologist isn't a good fit, it's okay to seek a second opinion.
Questions About Your Appointment?
Have questions or concerns about seeing a urogynecologist? Join the APOPS community forum where thousands of women share their experiences and support each other through every step of the prolapse journey.
You're not alone. We've got your back.
