Program Description

The Fellowship Program in Urogynecology and Reconstructive Pelvic Surgery (URPS) in UT Southwestern’s Department of Urology is directed by Maude Carmel, M.D..

The Program is offered to any resident who will be eligible to sit for the American Board of Urology exam in URPS and who is completing their training and 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, an accredited ACGME fellowship, offers a single two-year position each year. 

Faculty

The core faculty includes Philippe Zimmern, M.D., founder of the fellowship and Professor of Urology, Gary Lemack, M.D., Professor of Urology, Ramy Goueli, M.D., Assistant Professor of Urology, and Maude Carmel, M.D., Associate Professor of Urology, and Medical Director of URPS/Urodynamics at Parkland Memorial Hospital.

Other faculty members include Urogynecology (Joseph Schaffer, M.D., Clifford Wai, M.D., Marlene Corton, M.D., and David Rahn, M.D.), Colorectal, and Physical Medicine and Rehabilitation (Kelly Scott, M.D.).

Conferences

The fellow participates in weekly URPS conference/lecture series/research updates, as well as journal clubs monthly. In addition, there are quarterly journal clubs with the Colorectal service and Urogynecology, as well as quarterly multidisciplinary meetings of the Comprehensive Pelvic Floor Team, including Urogynecology, Urology, Colorectal, Radiology, and Physical Medicine Services.

Year One

The fellow works with Drs. Lemack, Carmel, and Zimmern 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 spends one month on the Urogynecology service. There is ample protected time to initiate a required independent research project. To aid with this, the first-year fellow audits a course on clinical trial design taught at UT Southwestern. By the conclusion of year one, it is anticipated that the research project will be well underway.

Year Two

The second year is devoted to more advanced female pelvic medicine disorders, with emphasis on treatment of complex female incontinence cases, advanced pelvic prolapse conditions (including open and robotic-assisted laparoscopic sacrocolpopexy), and other unusual disorders, such as vesico-vaginal fistula and urethral diverticulum.

During this year, there are additional core rotations in colorectal surgery and pelvic floor physical therapy with UTSW physiatrists. 

Research Program

Research is carried out during both the first and second years. The direction of the research is largely dictated by the fellow's interest. Past research projects 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, prolapse/incontinence, and neurourology databases in order to answer research questions regarding a variety of clinical disorders, from neurogenic bladder to voiding dysfunction in pelvic organ prolapse.

The fellow is tasked with identifying a research question in their area of interest during the first year, developing an IRB-approved study, carrying out the study, and ultimately presenting their findings to the group and research mentor prior to graduating. Clinician scientists, statisticians, and research mentors round out the research team and provide ongoing support for all research activities.