Urogynecology and pelvic floor care 

A urogynecologist is a doctor who specializes in pelvic floor disorders — including prolapse, urinary incontinence, overactive bladder, bowel incontinence and conditions requiring pelvic reconstructive surgery. They complete extra fellowship training beyond general OB/Gyn in the structures that support the bladder, uterus and other pelvic organs. 

Some insurance plans require a referral, but you may self-refer directly if your insurance allows it. Requirements vary by plan, so when in doubt, call the location near you and our team will help you figure out what's needed. Appointments are often available within 7–14 days, and we can expedite urgent referrals. We have offices throughout Northern California and the Central Coast, including Santa Barbara. Telemedicine is available for initial consultations and follow-ups if distance is a concern. 

It's common, but common isn't the same as normal. Leakage can persist for years after delivery, and it becomes more frequent with age. But it's a medical condition, not something you have to live with. Effective behavioral, medical and surgical treatments are available, and postpartum pelvic floor muscle training measurably reduces leakage.

No. Conservative and surgical treatments work in older women, and treatment decisions are based on your symptoms and goals, not your age. 

Sometimes, but unsupervised Kegels are frequently done incorrectly. The strong evidence is for supervised, structured pelvic floor muscle training, which is more than "just do your Kegels." That's why working with a pelvic floor physical therapist makes a real difference. 

Not necessarily. Many women manage symptoms without surgery, using pelvic floor therapy or a pessary. Surgery is typically considered when conservative treatments aren't enough and symptoms are significantly affecting your daily life. When surgery is the right choice, we offer both vaginal and minimally invasive robotic reconstructive approaches, individualized for your anatomy and goals. We'll walk you through every option. 

Yes. We treat the full spectrum of conditions, from stress and urge incontinence to overactive bladder, bowel incontinence and voiding dysfunction. We also evaluate and treat recurrent prolapse, mesh complications and other conditions following previous pelvic procedures. This is one of our areas of specialized expertise. 

Many procedures are minimally invasive, and you go home the same day. Light daily activity within a few days. Full internal pelvic floor healing and return to strenuous exercise typically take 4–6 weeks. Your surgeon will give you a specific recovery plan based on your procedure. 

Most plans cover urogynecology care, but coverage varies. We recommend checking with your insurance provider, and our team can help you understand what to expect before your visit.