Female Pelvic Medicine, Reconstructive Surgery, and Neurourology Fellowship
The fellowship program in Female Pelvic Medicine, Reconstructive Surgery, and Neurourology (FPMRSN) in UT Southwestern’s Department of Urology is co-directed by Philippe Zimmern, M.D., and Gary Lemack, M.D..
The program is offered to U.S. residents completing their training who seek additional specialized training in both the clinical and research aspects in the field. This includes female pelvic disorders, incontinence, pelvic organ prolapse, and voiding dysfunction. In addition, this fellowship features clinical and research experience with a variety of genitourinary disorders in neurologic disease, focusing on patients with spinal cord injury and multiple sclerosis.
The program, which is approved as an ABU-ABOG (American Board of Urology-American Board of Obstetrics and Gynecology) accredited fellowship, offers a single two-year position each year. In the first year, the fellow immerses him/herself in clinical aspects of FPMRSN, particularly focusing on incontinence and neurourology. An equal amount of time is spent in research activities and in clinical medicine.
The fellow works with Dr. Lemack in the clinic and operating room. During this first year, the fellow gains vast experience performing and interpreting urodynamics, learning indications and techniques for the use of neuromodulation and botulinum treatments, and performing surgical repair for other more common pelvic floor disorders (midurethral slings, vaginal, and abdominal approaches to pelvic prolapse). The fellow also devotes some clinical time on the multiple sclerosis service and the physical medicine and rehabilitation service during the first year. The remainder of the time is spent in research activities.
In addition, per ABU-ABOG accreditation regulations, fellows must complete two university graduate courses during the fellowship. The first course should be in qualitative techniques such as biostatistics or research design. The second must be relevant to the subspecialty of Female Pelvic Medicine and Reconstructive Surgery. These courses are completed in the first year of fellowship.
The second year is devoted more specifically to female pelvic medicine disorders, with emphasis on treatment of female incontinence, pelvic prolapse conditions (including open and robotics-assisted laparoscopic sacrocolpopexy), and other unusual disorders, such as vesico-vaginal fistula and urethral diverticulum.
During this year, 50 percent of time is spent in research activities; the remainder of time is spent in the clinic and operating room of Dr. Zimmern, as well as running the Incontinence Clinic at Parkland Memorial Hospital. The fellow also spends time during this year rotating on the urogynecology and colorectal surgery services.
Research is carried out during both the first and second years. The direction of the research is largely dictated by the interest of the fellow.
Past research projects of fellows have been of both basic science and clinical research types. For example, past bench research projects have focused on detrusor smooth muscle responses to bladder outlet obstruction in spinal cord injury. Clinical research projects have examined the Department’s extensive urodynamics database in order to answer research questions regarding a variety of pathophysiologies, from neurogenic bladder to voiding dysfunction in pelvic organ prolapse.