ABMS Accredits Female Pelvic Reconstructive Subspecialty

An Expert Interview With Deborah L. Myers, MD, and Victor Nitti, MD

Laurie Barclay, MD

April 05, 2011

April 5, 2011 — Editor's note: The American Board of Medical Specialties (ABMS) and the American Council for Graduate Medical Education Recently announced that they have accredited the new subspecialty of female pelvic medicine and reconstructive surgery. This subspecialty is now supported by 43 jointly accredited fellowship programs and is jointly boarded by both the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

To learn more about the new subspecialty and its effect on fellowship training and on healthcare, Medscape Medical News interviewed Deborah L. Myers, MD, and Victor Nitti, MD. Dr. Myers is president of the American Urogynecologic Society (AUGS) and professor of obstetrics and gynecology at the Alpert Medical School of Brown University in Providence, Rhode Island, and director, Division of Urogynecology and Reconstructive Pelvic Surgery and Center for Women's Pelvic Medicine and Reconstructive Surgery, Women and Infants Hospital of Rhode Island. Dr. Nitti is president of the Society for Urodynamics and Female Urology (SUFU), professor of urology and vice chairman of the Department of Urology, and director of female pelvic medicine and reconstructive surgery at New York University Langone Medical Center in New York City.

Dr. Deborah Myers

Medscape: What therapeutic areas and procedures does the subspecialty of female pelvic medicine and reconstructive surgery encompass?

Dr. Myers and Dr. Nitti: The subspecialty...encompasses the diagnosis and treatment of disorders of the female pelvic muscles. These disorders, also known as pelvic floor disorders, include urinary incontinence, childbirth-related fecal/anal incontinence, and pelvic organ prolapse. Other related symptoms and conditions which frequently accompany pelvic floor disorders are sensory and emptying abnormalities of the lower urinary tract and bowel, pelvic and abdominal pain, musculoskeletal dysfunction of the pelvic muscles/ligaments, and constipation and diarrheal states. Comprehensive management includes the preventive, diagnostic, and therapeutic procedures necessary for the total care of the female patient with these conditions, complications, and abnormalities resulting from them.

Medscape: How will delivery of healthcare be improved now that ABMS has approved the subspecialty of female pelvic medicine and reconstructive surgery?

Dr. Myers and Dr. Nitti: With the increase in the aging population, it is projected by the US Census Bureau that by the year 2030, the population over age 65 will double to over 70 million in the United States alone, and over 1 billion worldwide. Pelvic floor disorders are an issue of growing importance, from both an individual and public health point of view. National rates for each pelvic floor disorder from the US Census Bureau population have been projected through 2050. It is estimated that 28.1 million American women will suffer from at least 1 disorder in 2010, and 43.8 million in 2050.

Dr. Victor Nitti

During this same time period, the number of women with urinary incontinence will increase by 55%, from 18.3 million to 28.4 million. For fecal incontinence, affected women will increase by 59%, from 10.6 to 16.8 million, and women with pelvic organ prolapse will increase 46%, from 3.3 to 4.9 million. As age is a major risk factor for these conditions, it is projected that one half of women 80 years and older will be affected.

These findings have broad implications for those responsible for administering programs to care for women, allocating research funds in women's health and geriatrics, and training physicians to meet this rapidly escalating demand. To meet this growing demand for services, it is critical to have a dedicated group of providers, researchers, and educators to meet these needs of women. The approval of [female pelvic medicine and reconstructive surgery] as a subspecialty validates this group of medical disorders and will allow further advances in the field.

Medscape: What is the role of AUGS/SUFU regarding ABOG and ABU?

Dr. Myers and Dr. Nitti: The subspecialty societies of AUGS and SUFU are professional medical societies of those physicians, scientists, and allied health providers that care for women who suffer from pelvic floor disorders. The societies' missions are to promote the highest-quality patient care through excellence in education, research, and advocacy related to female pelvic medicine and reconstructive surgery. The governing boards of ABOG and ABU oversee and regulate the certification of physicians and maintenance of certification.

Medscape: What are the future goals of AUGS/SUFU?

Dr. Myers and Dr. Nitti: The subspecialty societies of AUGS and SUFU continue to work collaboratively in education of our members, addressing future research in the field, and meeting the needs of our patients. Our continued collaboration is critical to providing education, information, and support for female pelvic medicine and reconstructive surgeons that will serve as the foundation for the subspecialty and advance women's health.

Dr. Myers and Dr. Nitti have disclosed no relevant financial relationships.

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