Why OB/GYNs Refer Complex Cases to Dr. John Miklos and Dr. Robert Moore – Fellowship-Trained Urogynecologists
Understanding the Role of a Urogynecologist in Women’s Pelvic Floor Health
Most women begin their healthcare journey with a trusted OB/GYN. Obstetrician-gynecologists diagnose and treat a wide range of women’s health conditions and often serve as a patient’s primary women’s healthcare provider for decades.
However, when pelvic floor disorders become more complex, many OB/GYNs refer patients to fellowship-trained urogynecologists for specialized evaluation, second opinions and treatment.
This referral process is common and reflects a collaborative approach designed to ensure women receive care from physicians with advanced training in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). Drs. Miklos and Moore have three decades of experience with complex urogynecologic cases.
What Is a Fellowship-Trained Urogynecologist?
A urogynecologist is an OB/GYN who completes additional fellowship training focused exclusively on pelvic floor disorders.
After a four-year OB/GYN residency, fellowship-trained urogynecologists spend additional years receiving advanced education in:
- Pelvic organ prolapse
- Urinary incontinence
- Overactive bladder
- Reconstructive pelvic surgery
- Pelvic floor dysfunction
- Complex revision surgery
- Vaginal mesh complications
This specialized training allows urogynecologists to focus on some of the most challenging conditions affecting women.
Why Do OB/GYNs Refer Patients?
Referral does not mean something is wrong or that the patient has a severe condition.
Instead, referral often occurs when specialized expertise may help evaluate more complex pelvic floor concerns.
Common Reasons for Referral
Advanced Pelvic Organ Prolapse
Pelvic organ prolapse occurs when support structures weaken and allow the bladder, uterus, rectum, or vaginal apex to descend into the vaginal canal.
Women with advanced prolapse often benefit from consultation with a fellowship-trained specialist because multiple treatment options may be available.
Recurrent Prolapse
One of the most common reasons for referral is recurrent pelvic organ prolapse.
Women who have undergone previous prolapse surgery may experience:
- Return of symptoms
- New pelvic floor concerns
- Additional prolapse compartments becoming involved
These cases often require advanced evaluation and individualized treatment planning.
Urinary Incontinence
Urinary leakage affects millions of women.
Referral may occur when:
- Conservative treatment has not helped
- Symptoms are significantly affecting quality of life
- Surgical treatment is being considered
- Additional testing is needed
Complex Pelvic Floor Disorders
Women may experience multiple conditions simultaneously, including:
- Prolapse
- Urinary incontinence
- Overactive bladder
- Pelvic pressure
- Bowel dysfunction
Managing these overlapping conditions often requires specialized expertise.
Vaginal Mesh Complications
Some patients seek evaluation for:
- Mesh exposure
- Mesh erosion
- Pelvic pain
- Persistent symptoms following prior surgery
These situations often require advanced pelvic floor evaluation.
What Makes Pelvic Floor Disorders So Complex?
The female pelvic floor is made up of muscles, connective tissue, nerves, ligaments, and organs that must function together.
A woman may have:
- Bladder prolapse
- Rectocele
- Urinary incontinence
- Pelvic floor dysfunction
all occurring simultaneously.
Because these conditions frequently overlap, treatment often requires a comprehensive approach rather than focusing on a single symptom.
Why Experience Matters
When considering treatment for pelvic floor disorders, many women look for physicians who routinely evaluate and treat these conditions.
Experience can be especially important when managing:
- Recurrent prolapse
- Failed prolapse surgery
- Multi-compartment prolapse
- Revision surgery
- Complex urinary incontinence
- Mesh complications
Patients often feel more comfortable knowing their physician regularly treats similar conditions.
Why Many OB/GYNs Refer to Dr. John Miklos and Dr. Robert Moore
For more than three decades, Dr. John Miklos and Dr. Robert Moore have focused their practice exclusively on Female Pelvic Medicine and Reconstructive Surgery.
Their practice evaluates women experiencing:
- Pelvic organ prolapse
- Recurrent prolapse
- Urinary incontinence
- Pelvic floor dysfunction
- Vaginal mesh complications
- Previous failed pelvic floor surgery
Many patients arrive after referral from:
- General OB/GYNs
- Gynecologic surgeons
- Primary care physicians
- Urologists
- Other specialists
Fellowship Training
Both physicians completed advanced fellowship training focused on:
- Urogynecology
- Female pelvic medicine
- Reconstructive vaginal surgery
- Pelvic floor reconstruction
- Advanced minimally invasive surgery
Specialized Focus
Unlike general gynecology practices that manage a wide range of women’s health conditions, their practice is dedicated almost exclusively to pelvic floor disorders and reconstructive surgery.
Experience with Complex Cases
Many women seek consultation after:
- Failed prolapse surgery
- Recurrent prolapse
- Persistent urinary symptoms
- Previous pelvic floor procedures
- Mesh-related concerns
Every treatment recommendation is individualized based on a patient’s anatomy, symptoms, goals, and medical history.
Conditions Frequently Evaluated by Urogynecologists
Pelvic Organ Prolapse
Common types include:
- Bladder prolapse (cystocele)
- Rectocele
- Uterine prolapse
- Vaginal vault prolapse
- Enterocele
Urinary Incontinence
Including:
- Stress urinary incontinence
- Urge incontinence
- Mixed incontinence
Overactive Bladder
Symptoms may include:
- Urinary urgency
- Frequency
- Nighttime urination
- Urgency-related leakage
Pelvic Floor Dysfunction
Symptoms may affect:
- Bladder function
- Bowel function
- Sexual function
- Daily activities
Frequently Asked Questions
Why would my OB/GYN refer me to a urogynecologist?
Referral often occurs when specialized pelvic floor expertise may help evaluate prolapse, urinary incontinence, pelvic floor dysfunction, or other complex conditions.
Does referral mean I need surgery?
No. Many women referred to a urogynecologist ultimately pursue non-surgical treatment options.
Can a urogynecologist provide a second opinion?
Yes. Many women seek consultation to better understand available treatment options before making decisions.
What is the difference between a urogynecologist and an OB/GYN?
A urogynecologist completes additional fellowship training focused specifically on pelvic floor disorders and reconstructive pelvic surgery.
Do urogynecologists treat urinary incontinence?
Yes. Urinary incontinence is one of the most common conditions treated by urogynecologists.
Can a urogynecologist help if my prolapse came back?
Many urogynecologists routinely evaluate women with recurrent prolapse and discuss available treatment options.
Do all women with prolapse need surgery?
No. Treatment recommendations depend on symptoms, anatomy, and patient goals.
Serving Women Throughout Metro Atlanta and Georgia
Patients frequently travel from:
- Atlanta
- Alpharetta
- Roswell
- Johns Creek
- Sandy Springs
- Milton
- Buckhead
- Brookhaven
- Duluth
- Suwanee
- Marietta
- East Cobb
- Kennesaw
- Woodstock
- Canton
- Gainesville
- Athens
- Macon
- Savannah
- Augusta
Many women also travel from throughout Florida, Alabama, Tennessee, North Carolina, and South Carolina seeking specialized pelvic floor care.
Schedule a Consultation
Women experiencing pelvic organ prolapse, urinary incontinence, recurrent prolapse, pelvic floor dysfunction, or other pelvic floor concerns often benefit from evaluation by a fellowship-trained urogynecologist.
Dr. John Miklos and Dr. Robert Moore proudly provide specialized pelvic floor care for women throughout Atlanta, Georgia, and the Southeast.