Professor Anna Rosamilia is a subspecialist urogynaecologist and Head of the Pelvic floor Unit at Monash Medical Centre, Southern Health in Melbourne.
In recognition of International Urogynaecology Day celebrated annually on 20 February, the College caught up with Professor Rosamilia, who shared insights into her career journey, the evolving field of urogynaecology, and why this subspecialty plays such an important role in women’s health care.
What motivated you to become a urogynaecologist?
I first learnt about urogynaecology while working in Manchester in the UK, where I spent two years as a registrar and senior registrar. The unit was led by David Warrell and Tony Smith, two giants of the field, and it was there that I was drawn to this emerging subspecialty.
Can you tell us a bit about your journey to becoming a subspecialist?
When I returned to Melbourne, I was fortunate to train with Peter Dwyer and Peter Glenning. More than 30 years ago, urogynaecology was only just beginning to develop as a distinct field, both in the UK and Australia. Being part of something so new — and so clearly needed — was deeply motivating.
Being focused on urogynaecology, I may have missed a few family planning lectures — we had four children in seven years! That period coincided with establishing a private practice and being encouraged to undertake a PhD.
From being a junior trainee at Monash just after its transition from the Queen Victoria Hospital, to being elected President of the International Urogynecology Association (IUGA) for 2025–26, I have been supported by many champions and allies.
I am especially grateful to Professor Peter Dwyer, who mentored me in subspecialty training and has been a true champion of urogynaecology in Australia and worldwide. I was encouraged along an academic path by the late Professor David Healy, and I owe much to Dr Geoff Edwards, who stepped aside so I could become Head of the Monash Pelvic Floor Unit, and to Professor Beverley Vollenhoven, the current Head of Gynaecology, who makes things happen.
For people who may not have heard of it before, what exactly is urogynaecology — and how does it differ from general gynaecology? Are there common misconceptions?
Urogynaecology focuses on pelvic floor disorders, which affect around one in four women. The most common include pelvic organ prolapse, urinary and faecal incontinence, fistula, voiding dysfunction, perineal trauma and recurrent urinary tract infections.
Every obstetrician and gynaecologist manages women with these conditions, so in that sense we all practice some urogynaecology. A subspecialist’s role is to optimise management — particularly in complex, persistent or severe cases.
A common misconception is that these problems are minor or simply part of ageing or childbirth. They can be life-altering, and they are treatable.
What might a typical day look like for you?
A typical day involves hearing women share deeply personal and confronting concerns and working with them to find solutions together.
Being a urogynaecologist has its challenges. In a single clinic day, we may need to be a psychologist, pain physician, dermatologist, sports coach, sexual counsellor and endocrinologist — as well as a skilled surgeon and thoughtful clinician.
It can feel impossible to give patients all the time they need while empowering them to make informed decisions, managing complications, and knowing when to ask for help.
On reflection, this mirrors many aspects of parenting. Whether at home or work, I try to stay humble about what I know, curious about what I don’t, and always keep communication open. We are all works in progress.
What do you find most rewarding about your work?
I am deeply proud of the Pelvic Floor Unit at Monash Health, a busy tertiary service across multiple campuses. We are a close-knit team that offers exceptional care to women and excellent training to RANZCOG Certificate of Urogynaecology (CU) trainees, as well as international fellows and observers, over more than two decades.
It is immensely rewarding to see our trainees’ become consultants in Australia and overseas, and to watch them emerge as leaders in their own right. I also value the research collaborations we have fostered — working with basic scientists and engineers at the Hudson Institute, alongside funding bodies increasingly interested in advancing urogynaecology.
Serving as President of IUGA is rewarding because it allows me to advocate for pelvic health as part of women’s health globally and raise public awareness of urogynaecology as a subspecialty. For a society more than 3,000 members strong across 110 countries, this is no less than a civic duty — especially at a time in world affairs when bold collaboration is essential.
This month we were able to add pelvic floor disorders to the Women’s Health Strategy submitted to the European Parliament. We have also published a white paper that argues pelvic floor disorders should be included in maternal health policy which will lead to increased access to care in low resource settings.
In our field, empathy is fundamental. Some may view pelvic floor problems as minor inconveniences, but they are anything but minor. Our interventions can be transformative and so rewarding for ourpatientsand ourselves.
I think of the marathon runner whose continence and prolapse surgery restored her love of running. The cancer survivor with painful intercourse who was expected simply to be grateful she had survived. The woman who says “bless you, doctor” every time she does star jumps without leaking. The patient who believed the misery of recurrent UTIs would never end. The woman whose refractory overactive bladder was cured with Botox.
These are real people whose lives were transformed by thoughtful, evidence-based care.
It is often said that patients don’t care how much you know until they know how much you care. As urogynaecologists — and as gynaecologists more broadly — we should commit to beginning with empathy and ending with excellence.
