A Revolutionary Development in Urogynecology in Turkey

The average life expectancy in developed countries is experiencing a steady increase. The extended lifespan experienced by individuals has significant implications for women's health. The significance of health issues resulting from pelvic floor insufficiency is growing in prominence within this domain. The population of elderly women is experiencing notable growth in our nation. Based on statistics provided by the Turkish Statistical Institute, it is projected that the elderly population, which amounted to 10.2 million individuals in 2023, will experience an increase to 20.8 million by 2050 and further rise to 27.7 million by 2075. In Turkey, a study has shown an overall incidence of 67.5% of women experiencing

pelvic floor dysfunction of at least one significant type, which was defined as urinary incontinence, anal incontinence, obstructed defecation, or constipation. Urogynecology training is included in the residency syllabus. There are no fellowship programs in Turkey. But there are lots of courses, workshops, and congresses conducted as continuing medical education in every part of the country, especially in İstanbul and Ankara. The emergence of the ‘Urogynecology and Pelvic Reconstructive Surgery Association' served to heighten medical professionals' understanding of urogynecology. Since the organization was founded in 1997, research on urogynecology has seen a significant uptick in interest. In the given setting, a considerable number of Turkish books authored by multiple individuals were made accessible to medical professionals. They organized a lot of meetings and workshops in most parts of the country. Nearly every gynecological science conference also includes urogynecology presentations and often hosts courses in the field. As part of the International Urogynecology Association (IUGA), the organization maintains strong connections with other organizations around the world. The Urogynecology Unit began conducting clinical and research activities in the year 1994 at Istanbul University, and the Urogynecology Department was formally founded in the year 2011. After that, the subspecialty of urogynecology started to gain popularity over the entirety of Turkey. However, the inclusion of urogynecology as a subspecialty program similar to perinatology and oncology has not been approved by the higher education institution. The implementation of a Ph.D. program is being considered as a potential solution to the problem.

Urogynecology education in Turkey has reached an educational standard that can be accepted in both the national and international community with the opening of an internationally accredited four-year urogynecology doctoral program with a thesis at the Ankara University Faculty of Medicine in the academic year 2019-2020. This program is still the only one in the country that leads to a Ph.D. degree in urogynecology. Over the course of the past three decades, urogynecology has risen to popularity not only among urologists and gynecologists but also gained the attention of physical rehabilitation specialists. Pelvic floor rehabilitation clinics have been built, and a multidisciplinary and holistic approach has been produced in Turkey.

Acknowledgments

I would like to thank Prof. Dr. Fulya Dokmeci, the founder of the doctorate program of urogynecology at Ankara University in Turkey, and Prof. Dr. Onay Yalçın for the book” Urogynecology from Past to Present.” For agreeing to an interview and contributing to this piece.