Geriatric Urology Program
The Massachusetts General Hospital Geriatric Urology Program specializes in the innovative diagnosis, treatment and management of urological conditions experienced by patients age 60 and older.
- Phone: 617-726-8482
Our Geriatric Urologist
Pablo Gomery, MD
We realize the needs of older patients differ dramatically from those of younger adults. As a result, we approach treatment with a unique perspective, using novel strategies we have developed and refined through years of clinical experience in working with seniors. The cornerstone of our program is collaboration among the patient's geriatrician, primary care physician, urologist and other specialists.
What to Expect
Treatment begins with an evaluation in our offices in the Department of Urology. At your first appointment, we review your medical records, a complete list of all medications and supplements (both prescribed and over-the-counter) you are taking and any relevant test results.
During the evaluation with your urologist, you can expect:
- An in-depth conversation about your lower urinary-tract symptoms and normal function before the condition appeared
- A review of your medical history from your primary care physician and geriatrician
- A discussion of your lifestyle and treatment expectations
For your convenience, additional testing (when necessary) is performed onsite. Tests may include standard ultrasound scans, CT scans or video urodynamics, an advanced method for collecting biofeedback from patients whose urological conditions have proven difficult to diagnose.
An Innovative Strategy for Treating Seniors
After the in-office evaluation, we create a treatment plan tailored to your needs and goals for treatment. We develop this plan in partnership with your primary care physician and geriatrician, carefully considering the various factors that may affect your physical health and quality of life, including:
- Multiple medications and how their interactions may impact you
- Any illnesses, which tend to be more acute than in younger adults
- Aging-related physiological changes (e.g. bladder-muscle degeneration, hearing loss, impaired vision, changes in nightly sleep patterns)
- Physical mobility
- Cognitive abilities
- Living situation (e.g. home, assisted living, nursing home, rehabilitation center, relative's home)
- Support system (e.g. family, friends, neighbors, visiting nurses, therapists, social workers)
- Previous surgical procedures
We work closely with you, your primary care physician and those who support you to manage your condition. Ideally we begin your treatment with conservative measures, which may include:
- Lifestyle modifications
- Physical therapy
- Oral medication
- Other innovative therapies and minimally invasive treatments
Before you leave our office, we carefully describe how to manage your medications or other therapies when you return home. We also answer all of your questions and coordinate follow-up care to monitor your progress.
Comprehensive Care Through Collaboration
The Geriatric Medicine Unit founded its primary-care clinic for seniors in 1995 and continues to expand its services in nursing homes and assisted-living communities throughout Greater Boston. At the Department of Urology, we are committed to collaborating with our colleagues in geriatric medicine and primary care physicians to ensure seniors receive comprehensive and highly coordinated care.
Our Geriatric Urologist
Pablo Gomery, MD
About This Program
As we age, many adults develop urinary-tract problems that interfere with the activities of daily life.
The Geriatric Urology Program at Mass General helps address this growing health care need. Our program is a unique partnership of geriatricians, primary care physicians and urologists focused on managing urological diseases and disorders in seniors.
We treat the complete range of urological conditions affecting patients age 60 and older, including:
- Urgency and urge incontinence: The need to urinate with little or no warning (also known as overactive bladder)
- Stress incontinence: Uncontrolled urination resulting from coughing, laughing or sneezing
- Voiding dysfunctions (e.g. painful urination, incomplete bladder emptying, slow urinary stream)
- Urinary tract infections (UTIs)
- Bladder and kidney stones
- Sexual dysfunction, such as erectile dysfunction (ED)
A Breakthrough, Collaborative Approach
At many other hospitals, patients often are evaluated by an internist and referred to a urologist who specializes in a particular disorder. These physicians exchange medical records and test results but do not have close communication in most cases.
Our approach brings together physicians from multiple disciplines with extensive expertise in treating seniors, including primary care providers—the physicians who understand their patients best.
Our experienced team members not only focus on patients' medical needs but also consider the various social, emotional and other factors influencing their patients' lives. As a result, we can tailor a personalized treatment plan for each patient, helping the person manage his or her urological symptoms and enjoy a more fulfilling life.
World-Class Urological Expertise
Our program's urologists possess a rare combination of qualifications:
- Expertise in the urological complications of neurodegenerative disorders
- Extensive experience in treating seniors with urinary-tract symptoms
Why is this specialization so important for our patients?
First, urological conditions, from incontinence to UTIs, may be associated with neurodegenerative disorders (e.g. Parkinson's disease and multiple sclerosis). However, many conditions commonly experienced by seniors, from diabetes to hypertension, can affect the nervous system and thus disrupt healthy urological function.
Second, diagnosing and treating seniors with lower urinary-tract symptoms is learned through lengthy clinical practice and specialized training. It requires a fresh perspective, exceptional communication skills and deep knowledge of a broad range of lower urinary-tract symptoms and medical conditions. Seniors comprise many of the thousands of people we treat annually in the Department of Urology, and we have developed a keen understanding of their unique needs.
All of our program services and resources are available to patients, including:
- Dedicated and experienced geriatric urologists and nurses
- One-on-one patient evaluations and consultations
- A full range of diagnostics (e.g. video urodynamics, ultrasound scans and CT scans)
- Patient and caregiver education
- Referrals to the Mass General's world-class geriatricians, physical therapists, occupational therapists and other specialists
- A confidential clinic for patients with ED
Benign prostate problems are clinical conditions of the prostate gland that are not cancer, such as prostatism (any prostate condition that interferes with urine flow), prostatitis (an inflamed prostate gland), prostatalgia (pain in the prostate gland) or benign prostatic hyperplasia (enlarged prostate).
Impotence, or erectile dysfunction (ED), may result from the total inability to achieve erection, an inconsistent ability to achieve an erection, or the ability to only sustain a brief erection.
A kidney stone is a solid piece of material that forms from crystallization of excreted substances in the urine.
The following problems are often associated with a neurogenic bladder: urine leakage, urine retention, damage to the tiny blood vessels in the kidney, and infection of the bladder or ureters.
Urinary tract infections describe a health problem that results from a bacterial infection along the urinary tract.
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Geriatric Urology Progam
Phone: Contact by doctor
All patient information is confidential, and we insure your privacy at all times.
Dr. Pablo Gomery
- Phone: 617-726-8482