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Medical Professionals

Q&A with Martin P. Michalewski, M.D., F.A.C.O.G.

What Women Should Know about Female Pelvic Medicine and Reconstructive Surgery Female Pelvic Medicine and Reconstructive Surgery (FPMRS) is an emerging subspecialty of medicine, combining the fields of urology with obstetrics and gynecology. Barnabas Health Medical Group physician Martin P. Michalewski, MD, FACOG, a nationally and internationally recognized expert in minimally invasive laparoscopic Urogynecology and Robotic Surgery, was among the first 500 U.S. physicians to obtain board certification in FPMRS. Here, Dr. Michalewski provides an overview of the developing subspecialty of FPMRS, which helps women restore or maintain a high quality of life.

Q: What is Female Pelvic Medicine and Reconstructive Surgery (FPMRS)? Dr. Michalewski: The field of urogynecology has evolved to be a unique subspecialty focusing exclusively on women's pelvic and abdominal health problems. The American Board of Medical Specialties approved Female Pelvic Medicine and Reconstructive Surgery (FPMRS), also known as urogynecology, as a certified medical subspecialty in 2011, with the first 500 doctors in the United States receiving board certification in 2013.

Q: What types of medical conditions are treated by a physician who is board certified in FPMRS? Dr. Michalewski: Urogynecologists certified in FPMRS focus on benign and malignant pelvic conditions, urinary tract disorders and pelvic floor dysfunction (PFD). This includes urinary or fecal incontinence, urinary urgency, painful bladder syndrome, chronic infections, pelvic organ prolapse, fibroids, endometriosis, adenomyosis, abnormal or heavy bleeding and a number of other female pelvic issues. Women suffering from these conditions may need to avoid social outings, exercise, long car rides or need to wear pads or diapers. Often, there is a significant negative impact on sexual function and/or daily activities, as women must always be worried about access to a bathroom.

Q: Why was there a need for the FPMRS subspecialty? How were women with these conditions being helped in the past? Dr. Michalewski: According to data from National Center for Health Statistics, our population is aging and living longer, with the average life expectancy reaching 78.8 as of 2014. Likewise, the number of women experiencing pelvic floor disorders, bladder problems and other similar issues is also growing. One out of every three women over 45, and half of women over 65, suffer from PFDs or their symptoms. Thirteen million U.S. women over age 45 experience stress urinary incontinence and 33 million women have prolapse. There are 3 million women living with fibroids, and, by the age of 60, one out of three will have their uterus removed. These statistics are alarming and speak to the need for treatment. In the past, and still today, there were many myths surrounding gynecological conditions, including the belief that these conditions are “a normal part of aging and women just need to deal with it.” Well, they are not – treatment for these conditions exist. Previously, if a woman had a problem relating to her bladder, pelvic or abdominal area, a gynecologist and an urologist would treat that patient together but if outcomes were not as expected, the patient would bounce back and forth between the two physicians without good resolution. The specialization in FPMRS provides women with a one-stop shop for any issues they may have and one physician responsible for delivering results.

Q: Why are so many women experiencing these issues? Dr. Michalewski: Unfortunately, the risk factors for PFDs have a lot to do with lifestyle and age. Other risk factors include: prior vaginal births; genetic predisposition, hormones and aging; obesity and heavy lifting; and prior hysterectomy.

About Barnabas Health Medical Group Barnabas Health Medical Group is a multi-specialty group practice comprising highly trained and experienced world class primary and specialty care physicians. Barnabas Health Medical Group physicians provide compassionate and innovative cutting edge care for people at every stage of life at easily accessible facilities conveniently located throughout New Jersey. Backed by the vast continuum of resources throughout RWJBarnabas Health, our dedicated physicians and expertly trained supporting staff continuously strive for clinical excellence. For more information, visit Previously, it was believed that if a woman was experiencing prolapse, the uterus should be removed. We now know that removing the uterus in these cases only adds to pelvic floor problems that are then more difficult to treat. Also, as mentioned, prior hysterectomy is in itself a risk factor for pelvic organ prolapse and bladder problems. The type of hysterectomy most commonly done today is open abdominal, also known as total abdominal hysterectomy (TAH). After undergoing a TAH, which includes total removal of the uterus and cervix, eight out of 10 women will have problems in the future. Thanks to advancements in technology and medicine, we now know that treating these issues correctly the first time is of the utmost importance. Proper and thorough evaluation, patient education and careful choice of treatment leads to the best outcomes and highest patient satisfaction. Research unequivocally proves that outcomes of high volume surgeons are by far superior, making the choice of physician very important. Patients must do their homework and ask the right questions before deciding on a surgeon.

Q: How are pelvic conditions, urinary tract disorders and other related disorders treated? Dr. Michalewski: Treatment is highly individualized and

Martin P. Michalewski, MD, FACOG Female Pelvic Medicine and Reconstructive Surgery Director of Minimally Invasive Urogynecology, Gynecologic and Robotic Surgery Dr. Michalewski is affiliated with Monmouth Medical Center in Long Branch and Community Medical Center in Toms River. To schedule an appointment with Dr. Michalewski, contact: 310 Route 34, Colts Neck, NJ 07722 255 3rd Avenue, Long Branch, NJ 07740 1 Route 70 W, Lakewood, NJ 08701 732.901.0211

The County Woman Magazine

includes a stepwise approach, as new options and medications are being approved regularly. In fact, most of the treatments in FPMRS are non-surgical - diet or lifestyle modifications, stress or pain management can often greatly help patients. A host of non-surgical treatments, including acupuncture, neuromodulation, computer-generated pelvic floor muscle therapy, bladder training techniques and Botox® injections, exist that can be completed in the office and have minimal or no side effects. If surgery is required, minimally invasive laparoscopic surgeries, robotic assisted surgery or single incision laparoscopic surgeries (SILS) are the norm – providing the best outcomes, fastest recovery and minimal time in the hospital, allowing patients to go home the very same day. FPMRS is not typically a life-saving area of medicine. However, thanks to advancements in medicine, in nearly all cases, it is life improving for our patients - allowing them to return to living life to the fullest.

November/December 2017

Monmouth County Woman - November/December 2017  

The County Woman ™ is part of a nationally syndicated publication and has been around for over 31 years. There are over 371 other counties t...

Monmouth County Woman - November/December 2017  

The County Woman ™ is part of a nationally syndicated publication and has been around for over 31 years. There are over 371 other counties t...