Peter Finamore, MD: Pressing Urogynecology Needs, Treatments

Where are the most pressing areas of development in urogynecology?

The most pressing area of development in urogynecology is the development of a registry for our patients. Traditionally, the treatment for urogynecologic conditions has been carried out by general gynecologists, as well as same generally urologists. In about the last 10 to 15 years, we've developed subspecialty fellowships in this area to really kind of train surgeons how to deal with these issues in a more specific way. A registry would allow us to really kind of track these patients, track the success of some of these surgeries and some of the risks of complications, and hopefully guide better patient care by allowing us to follow the surgeons and the particular operations, and really develop a better way to care for our patients. So I think that would be very helpful to those of us who practice urogynecology.

What therapies, technologies, or practices are in development for the field?

One of the most important things that we've been working in a new area of research in urogynecology is the use of trans-vaginal mesh for prolapse. We've been using mesh for many years in urogynecology and in general surgery for a variety of different reasons. Several years ago people started to use trans-vaginal mesh to help lift some of these prolapsed organs — if a woman had a dropped bladder or prolapsed uterus, people were putting mesh vaginally to help cure that problem.

In 2011 the FDA issued a public health notification about trans-vaginal mesh, and it's become quite controversial. There are a lot of studies that have been going on since that point, where we're kind of trying to figure out the details of this. Is there a type of mesh that would work well for this type of operation, is there a patient that would benefit more from a trans-vaginal mesh.

I'm kind of anxiously waiting some of the research that's been going on for the last several years regarding trans-vaginal mesh to see if there is a potential role in our treatment for the condition of prolapse.