In the past year, three urogynecology and reconstructive pelvic surgery specialists have joined UMass Memorial Medical Center, providing extensive expertise for treating the full spectrum of pelvic floor disorders. They are Michael Flynn, MD, MHS, director of urogynecology and reconstructive pelvic surgery, along with colleagues Jyot Saini, MD, and Danielle Patterson, MD.
This team, in fact, is the largest group of fellowship-trained urogynecologists in Central New England — and the only one actively training the next generation of urogynecologists, with two physicians currently completing three-year fellowships. A nurse midwife skilled in the nonsurgical care of women suffering from incontinence and prolapse also is part of the team.
“While we are experts in straightforward urogynecologic surgical problems such as stress urinary incontinence and pelvic organ prolapse, we’re especially qualified to take care of complex cases such as fistulas or failed previous prolapse repairs,” Dr. Flynn explained. Notably, he and his team are the only specialists in the region using the da Vinci robot for the surgical correction of prolapse, expecting to perform about 60 procedures this year.
“The patient benefits from an easier recovery with this minimally invasive technique,” he said, noting that vaginal, open and traditional laparoscopic abdominal approaches can be excellent options for certain patients. Further, he stresses that surgery isn’t the only treatment for prolapse; a pessary or even watchful waiting can be very effective options.
“A patient ultimately decides what treatment is best for her,” Dr. Flynn said. “In most cases, pelvic floor dysfunction is a quality-of-life issue, and that is defined by the patient. We find that our patients respond well to having this kind of control over their bodies and their medical care.”
Dr. Flynn and his team also provide cutting-edge expertise in treating severe refractory overactive bladder. Botox injected into the detrusor muscle can block the signals that tell this muscle to contract, relieving the urge to go. (Dr. Flynn has been involved in several clinical trials including an NIH-funded trial that he directed affirming the effectiveness of this treatment.) And Dr. Patterson is experienced in neuromodulation. Similar to a cardiac pacemaker, this procedure involves implanting a small electrical wire through the skin and next to the lower portion of the pelvic bone (sacrum). The device delivers a minute electrical charge to the nerve that runs to the bladder and by stimulating this nerve the bladder often will become less overactive.
“We’ve seen patients go from wearing multiple diapers daily to wearing thin pads,” Dr. Flynn said. “While these techniques don’t work for everyone, we’ve seen dramatic improvements for many appropriately selected patients.”