Urogynecology and Pelvic Reconstructive Surgery Program
The Massachusetts General Hospital Urogynecology and Pelvic Reconstructive Surgery Program provides comprehensive evaluation and treatment (non-surgical and surgical) for female pelvic floor problems, ie, pelvic organ prolapse and urinary incontinence, helping women return to a normal lifestyle.
Our staff includes obstetricians and gynecologists who understand a woman's changing needs throughout her lifetime. We work as a tightly knit team, sharing our expertise with our peers to offer patients individualized care for their particular symptoms.
What to Expect
Patients can access our services in several convenient locations: on the hospital's main campus in Boston, in Waltham and at our.
During your first visit, you and your doctor will talk about the symptoms you are experiencing. Your doctor will also conduct a comprehensive physical examination. As a next step, you may need to schedule urodynamic testing of your bladder and urethra function.
At your follow-up appointment, you and your doctor will discuss an individualized treatment plan that targets your particular condition. We often recommend patients begin with nonsurgical approaches, such as targeted physical therapy, an approach that can be quite effective for treating mild prolapse, incontinence and other pelvic disorders.
If nonsurgical approaches are ineffective—or inappropriate for your condition—only then do we proceed with surgery. Our physicians are highly skilled in performing the full spectrum of surgical procedures, including minimally invasive laparoscopic and robotic-assisted surgeries.
A Multidisciplinary Approach to Pelvic Health
We realize our patients' problems usually are multifaceted. For instance, bladder control issues may overlap with prolapse, or urinary and fecal incontinence may be interconnected. When more than one organ is involved, we work closely with the Pelvic Floor Disorders Service, a multidisciplinary team of experts dedicated to women's pelvic health.
This service offers a comprehensive one-stop center for treating pelvic floor symptoms caused by a weakening of the muscles and ligaments that hold up the pelvic organs. Patients see the most appropriate caregiver for their particular treatment. Our goal is to treat all of the patient's problems so she can enjoy a successful outcome and can return to a normal life.
Patient education is an important component of treatment, as lifestyle changes, exercises and other steps can alleviate symptoms. Our nurses have years of experience addressing these sensitive conditions and working with patients on a long-term basis to reach successful outcomes.
About This Program Women with urinary incontinence or problems related to changes in the pelvic organs often suffer in silence. That’s because many patients are uncomfortable talking about their symptoms or assume these problems can’t be corrected. Rather than seeking medical help, they endure countless inconveniences along with a decline in quality of life.
Patients count on our clinicians to provide compassionate care for conditions that may be difficult to discuss. The most common examples are:
- Urinary incontinence (leaking urine), including stress incontinence, urge incontinence and overflow incontinence
- Other bladder function problems not related to urinary tract infections
- Pelvic organ prolapse (when pelvic organs slip out of place and descend, putting pressure on the bladder, urethra or other parts of the pelvis)
- Fecal incontinence and constipation
- Bladder or urethral fistulas and rectal fistulas
We take pride in developing individualized treatment plans for each patient, incorporating the most advanced surgical and nonsurgical options available today.
Our treatment philosophy, and the preference of most patients, is to avoid surgery whenever possible. Many symptoms can be address using nonsurgical approaches such as:
- Targeted physical therapy: Our physical therapists specialize in the muscles of the pelvic floor, treating disorders such as pelvic organ prolapse and urinary incontinence
- Pessary: Placing a removable device such as this into the vagina can provide support to treat prolapse of the uterus
- Biofeedback: Using biofeedback methods may help patients learn to identify, strengthen and control pelvic floor muscles
- Mind/body medicine: Mind/body techniques such as meditation can empower women who experience urinary incontinence and other bladder disorders
For patients who do require surgery, we are committed to developing and introducing minimally invasive procedures that involve less pain and a shorter recovery time. Examples include:
- Slings to treat stress urinary incontinence: We insert a thin piece of material under the urethra or bladder neck to provide support and improve continence
- Vaginal surgery to treat pelvic organ prolapse: Vaginal surgery often requires incisions inside the vagina
- Laparoscopic surgery to treat pelvic organ prolapse: In certain cases, we can use laparoscopic techniques, which require only small incisions in the abdomen
- Robotic surgery: In June 2008 we became the first urogynecology group in Boston to offer robotic surgery to treat pelvic organ prolapse.
Skilled, Experienced Leadership
Program director May Wakamatsu, MD, trained under the late David Nichols, MD, a nationally known gynecologic vaginal surgeon. Associate director Samantha Pulliam, MD, is a fellowship-trained urogynecologist, as is Milena Weinstein, MD.
Our staff also includes three physicians who practice obstetrics and gynecology and also specialize in urogynecologic surgery and perform many procedures to treat urinary incontinence and prolapse.
In addition to our physicians, we have three experienced urogynecologic nurses who provide support.
Cystocele is the name for a hernia-like disorder in women that occurs when the wall between the bladder and the vagina weakens, causing the bladder to drop or sag into the vagina.
Pelvic pain may originate in genital or extragenital organs in and around the pelvis, or it may be psychological, which can make pain feel worse or actually cause a sensation of pain, when no physical problem is present.
The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.
Urogynecology & Pelvic Reconstructive SurgeryYawkey Center for Outpatient Care
32 Fruit Street
Boston, MA 02114
Mass General West
40 Second Avenue
Waltham, MA 02451
Mass General/North Shore Center for Outpatient Care
104 Endicott Street
Danvers, MA 01923