Victor W. Nitti, MD discusses the evolution of urology within the field of female pelvic medicine and reconstructive surgery and the new series, Female Pelvic Surgery Video Atlas.
I became interested in female pelvic medicine and reconstructive surgery during my residency, when I thought that there were certain things that, at least as urologists, we could do better than we were doing at that time I can now say 20 years later that we do do things a lot better than we used to do. Our surgical procedures are better; they’re more precise. We’ve learned a lot from those who came before us, and now I think that the procedures we do for our patients are better understood by us — better understood by all of those that are performing the procedures — and as such I think the quality of care that we can deliver, from diagnosis all the way through treatment, particularly surgical treatment, has changed for the better in the last 20 years, and it’s been really great to be part of that.
The concept that I had in mind when we were conceiving the Female Pelvic Surgery Video Atlas Series was to be able to take surgeons step-by-step through different procedures that we commonly perform for a variety of different female pelvic medical conditions. I think that step-by-step approach is really valuable to those who are already doing surgery, or who are just getting started in doing female pelvic surgery. It gives the readers an opportunity to benefit from the years of experience of the authors who have written the chapters and the surgeons who have performed the procedures, and we’ve really tried to make it as simple to follow as possible, so that by reading the step-by-step descriptions, and viewing the numerous videos that are associated with those procedures, surgeons can get a really good idea of how we do things and then can adapt some of those principles to their own practices.
One area of female pelvic medicine and reconstructive surgery that has really been a hot topic as of late is the repair of pelvic organ prolapse, and over the past decade the use of different graft materials became increasingly popular. Over time, we’ve seen that, for some patients, such materials may be appropriate, and for others they may not be appropriate. So there has been a trend towards going back to using native tissue repairs and using graft material in very select cases. I think it’s very important for people that practice female pelvic reconstruction to understand all of the techniques, and to know how to use different techniques, particularly native tissue techniques in different situations so that we can deliver optimal care to our patients. Sometimes for a variety of reasons, one can’t the operation that he or she anticipated doing. In such instances it is imperative that surgeons have an adequate reconstructive armamentarium to customize case to a particular patient, even when somewhat unexpected.
One of the reasons that I choose academic medicine was really for a love of teaching, and a love of exploration and research. Texts like Vaginal Surgery for the Urologist allow me and my partners, Dr. Nirit Rosenblum and Dr. Ben Brucker, to reach out and teach a large group of people in a style that is applicable to and appreciated by most readers. Being able to provide such information to a large number of people is really an extension of the kind of teaching that we do every day with our residents and with our fellows.
Victor W. Nitti, MD is a Professor of Urology and OB/GYN, Vice-Chairman of Urology, Director of the Female Pelvic Medicine and Reconstructive Surgery at New York University Langone Medical Center. A graduate of the University of Medicine and Dentistry of New Jersey, Dr. Nitti completed his urology residency at SUNY Downstate in Brooklyn, NY and his fellowship in Female Urology, Neurourology, and Reconstructive Urology at UCLA.
He is a Fellow of the American College of Surgeons and the American Board of Urology, Past President of the Society for Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU), and a member of the American Urological Association, International Continence Society, and the American Urogynecologic Society. Dr. Nitti has presented his ongoing research at national and international meetings, in lectures as a visiting professor, and in postgraduate courses around the world. He is an author of Vaginal Surgery for the Urologist and editor for the Female Pelvic Surgery Video Atlas series.