Magee-Womens Research Institute & Foundation

by: Gina Edwards

Whether they’ve suffered for months or years with unexplained urinary incontinence, debilitating pelvic pain, or troubling symptoms of prolapse, there is a common confession from new patients at their first urogynecologist appointment: “I didn’t know this kind of doctor existed.”

It’s a public health issue that the team of surgeon-scientists in the Division of Urogynecology & Pelvic Reconstruction at UPMC Magee-Womens Hospital is determined to address. Under the direction of Dr. Pamela Moalli, who is also the Interim Executive Director of Magee-Womens Research Institute, the Division at UPMC Magee is one of the largest academic urogynecology groups in the United States –– providing world-class, evidence-based care while generating novel research and innovations aimed at supporting women’s pelvic floor health.  

“While pelvic floor disorders affect millions of women, scientifically based therapies to treat them are sparse,” Dr. Moalli says. “We aim to improve the lives of women by making current treatments more effective and developing novel therapies specifically targeted at repairing underlying injury.”

The Division of Urogynecology at UPMC Magee is dedicated to a broad array of conditions impacting female pelvic health. Because these conditions have traditionally been undertreated and underrecognized, some people quietly live with them for years.  

“Patients delay coming to see a specialist because they simply do not know there is one,” explains Dr. Jocelyn Fitzgerald, Assistant Professor of Urogynecology and Reconstructive Pelvic Surgery. “Then they come to see us at 65 instead of 35.”

Cross-Disciplinary Care: Division of Urogynecology Clinical Programs

With combined expertise in urology and gynecology, urogynecologists are uniquely trained to address conditions affecting both the pelvic organs and urinary tract, like urinary and fecal incontinence, pelvic organ prolapse, and urinary tract infections. The Division uses a multidisciplinary approach to empower women with the knowledge and support they need to achieve optimal health and wellness.

“We are committed to enhancing the quality of life for our patients by offering innovative treatments, advanced surgical techniques, and personalized care plans,” says Dr. Megan Bradley, Urogynecology and Reconstructive Pelvic Surgery Fellowship Program Director.    

While the Division treats a variety of conditions, it has dedicated programs for chronic pelvic pain through the Endometriosis and Chronic Pelvic Pain Center and peri-/postpartum pelvic floor issues at the Postpartum Pelvic Floor Healing Clinic.  

"We are proud to provide high-quality comprehensive care for pelvic floor disorders both at UPMC Magee-Womens Hospital and across a wide range of locations in Western and Central Pennsylvania thanks to the commitment of our providers and staff, and the uptake of telemedicine by providers and patients alike,” Dr. Bradley says.  

Innovating Pelvic Floor Treatments: Urogynecology Research Programs 

Current solutions for prolapse, lower-urinary tract symptoms, and other pelvic floor disorders can lead to significantly improved quality of life, but there is still significant room for improvement. The Division’s goal is to push the boundaries of current treatment paradigms to improve outcomes for women with these problems across the life course.

“Because much is still unknown about why pelvic floor disorders occur and how to treat them, our team has a broad research portfolio to tackle the research gap,” says Dr. Bradley.

Research from the faculty surgeon-scientists in the Division at UPMC Magee is robust –– with collaborations at the Magee-Womens Research Institute, Erie Campus, located within UPMC Hamot, and through Western and Central Pennsylvania.  

Current initiatives include developing new biomaterials to improve outcomes in disorders such as prolapse and incontinence; understanding recurring urinary tract infections in older women with the goal of creating better protocols that limit antibiotic use; and developing robust biomimetic models for teaching surgical residents and fellows using minimally invasive surgical techniques, such as laparoscopy and robotics.

De-Stigmatizing & Raising Awareness: Urogynecology Education Programs

With one of the largest Urogynecology and Reconstructive Surgery (URPS) fellowships in the country, the Division trains two fellows per year for a complement of six fellows. Division faculty are also educators at the annual Eastern OH/ Western PA/ Western NY Regional URPS Fellows course, which brings together fellows from multiple institutions in the Great Lakes region to lead simulation activities for trainees.

"We are currently working with trainees at all levels and across specialties, including ob-gyn, urology, internal medicine, and geriatrics, to ensure that pelvic floor disorders are de-stigmatized and discussed with patients,” Dr. Bradley explains. “We hope that providing trainees with the tools and resources to broach these subjects will allow for patients to have quicker access to evidence-based therapies and subspecialty referrals when needed."

In addition to teaching in the operating room and office, the Division strengthens residents' surgical skills through simulation including vaginal hysterectomy models, cadaver labs, and robotic simulation. There are weekly conferences in addition to weekly fellow didactic sessions that the resident on service attends. 

As the Division continues to enhance and evolve its programs, its faculty members work towards raising public awareness of the field in the pursuit of helping more women access the care they need to live their best lives. Dr. Bradley credits her Division’s collaborative approach to not only bettering women’s quality of life but also driving their discipline forward:

“Our dedication to research, education, and patient-centered care drives us to continually advance the field of urogynecology and improve the lives of those we serve.”