Thomas Mechas, MD, FACOG, FPMRS
Female Pelvic Medicine and Reconstructive Surgery
Dr. Thomas Mechas (Double Board Certified Obstetrics and Gynecology and Female Pelvic Medicine and Reconstructive Surgery), has been practicing OB/GYN in London, KY since 1997. Although still doing some general OB/GYN, most of Dr Mechas’ practice is dedicated to pelvic medicine, reconstruction surgery and urinary problems with an emphasis on vaginal and minimally invasive surgery.
What is a Urogynecologist?
A urogynecologist is a surgeon who has specialized in the care of women with pelvic floor disorders.
The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis that provides support for a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum. A pelvic floor disorder occurs when women have weakened pelvic muscles or tears in the connective tissue due to excessive strain on the pelvis due to childbirth, repeated strenuous activity, menopause, chronic disease, or pelvic surgery. Other factors that can weaken the pelvic floor include repetitive heavy lifting, tobacco use, and genetics.
Problems that arise from damage to the pelvic floor include:
- Incontinence: loss of bladder or bowel control, leakage of urine or feces
- Prolapse: descent of pelvic organs; a bulge and/or pressure; ‘dropped uterus, bladder, vagina or rectum.’
- Emptying Disorders: difficulty urinating or moving bowels.
- Pain: discomfort to the lower back, pelvis or bladder and/or urethra.
- Overactive Bladder: frequent need to void, bladder pressure, urgency, urge incontinence (difficulty holding back urine when having the urge to urinate)
- Fistulas: abnormal hole between the vagina and rectum (rectovaginal), vagina and urethra (urethrovaginal), or vagina and the bladder (vesicovaginal
What Kind of Training Does a Urogynecologist Have?
Urogynecologists are physicians who have completed medical school and a residency in Obstetrics and Gynecology or Urology. These physicians become specialists with additional years of fellowship training and certification in Female Pelvic Medicine and Reconstructive Surgery. The training consists of providing expertise in the evaluation, diagnosis, and treatment of conditions that affect the muscles and connective tissue of the female pelvic organs. These physicians are also knowledgeable on the latest research in the field pertaining to these conditions.
What Does Board Certified Mean?
Board certification in Female Pelvic Medicine and Reconstructive Surgery means that the physician has passed an exam from the American Board of Obstetrics & Gynecology (ABOG) and American Board of Urology (ABU) or the American Osteopathic Association (AOA) and American Osteopathic Board of Obstetrics and Gynecology (AOBOG) attesting that a physician has exceptional expertise in this particular specialty. The first ABOG/ABU board certification exam was in 2013. For physicians completing training after 2012, they must have participated in an accredited fellowship in order to be eligible for board certification. The first AOA/AOBOG board certification exam was in 2012. For physicians American Urogynecologic Society | 1100 Wayne Ave, Suite 825 | Silver Spring, MD 20910 | P (301) 273-0570 www.voicesforpfd.org | info@augs.org completing training after 2016, they must have participated in an accredited fellowship in order to be eligible for board certification.
When Should I See a Urogynecologist?
Although your primary care physician, OB/GYN, or urologist may have knowledge about these problems, a urogynecologist can offer additional expertise. You should see (or be referred to) a urogynecologist when you have problems of prolapse, and/or troublesome urinary or fecal incontinence or when your primary doctor recommends consultation. Other problems for which you or your doctor might think about consulting a urogynecologist include: problems with emptying the bladder or rectum, pelvic pain or bladder pain, fistulas, and the need for special expertise in vaginal surgery.
What Treatment Options are Available from a Urogynecologist?
A urogynecologist can recommend a variety of therapies to cure or relieve symptoms of pelvic floor disorders. You should choose the one that works best for your lifestyle and meets your goals.
Sometimes simple changes and interventions can have a significant impact on daily quality of life. He or she may advise conservative (non-surgical) or surgical therapy depending on your wishes, the severity of your condition and your general health. Conservative options include medications, pelvic exercises, behavioral and/or dietary modifications and vaginal devices (also called pessaries). Pelvic Floor Therapy with Biofeedback and Electric Stimulation are also treatments that your urogynecologist may recommend. Safe and effective surgical procedures are also utilized by the urogynecologist to treat incontinence and prolapse.
Need Additional Information?
For additional information, visit https://www.augs.org/.