MDNews - Long Island

PAIRING PASSION AND EXPERTISE SCOTT M. PRESS, MD, a board-certified urologist at the Female Urinary Incontinence and Pelvic Floor Center at St. Charles Hospital, completed his medical degree at Weill Cornell Medical College and performed residency training in urology at Long Island Jewish Medical Center. During his residency, Dr. Press worked with Gopal Badlani, MD, a pioneer in the field of female urinary inconti- nence. Under Dr. Badlani's tutelage, Dr. Press mastered the various techniques available to treat incontinence. When he entered private practice 18 years ago, he began receiving referrals from area gynecologists, and his interest in female pelvic medicine and reconstructive surgery continued to grow. Dr. Press received board certification in female pelvic medicine and reconstruc- tive surgery through the American Urogynecologic Society several years ago, when the American Board of Obstetrics and Gynecology and the American Board of Urology came together to form a new subspecialty dedicated to treating female uri- nary incontinence and pelvic organ prolapse. "In the past, there was no board certi- fication for female pelvic floor disorders," Dr. Press says. "Urologists and gynecologists treated these conditions independently. Solidifying a subspecialty dealing with these particular disorders allows referring physicians to send patients to physicians who see a high volume of cases and have specialized expertise. Currently, there is controversy surrounding the use of mesh to treat prolapse. The gynecologists who see these patients in their offices are shying away from treating them surgically. There is a bigger push to refer patients to specialists." In addition to caring for women with pelvic floor conditions, Dr. Press provides the full gamut of pediatric and adult uro- logic services, including robotic urologic surgery. He is a Fellow of the American College of Surgeons and a member of the American Medical Association and the American Neurological Association. important to note, however, that the American Urological Association and the American Urogynecologic Society have since released position statements stating the potential for complication exists solely following the use of mesh for bladder prolapse repair. According to Dr. Press, the use of a mesh sling to treat stress incontinence is still the gold-standard treatment. The pros of this surgery outweigh the cons, and the risk of complications is low. At St. Charles Hospital, Dr. Press offers an innovative approach to sur- gical stress incontinence treatment: the 7-Minute Sling. A vaginal sling procedure trademarked by Dr. Press, the 7-Minute Sling has been used to treat severe stress incontinence in more than 1,000 patients. Dr. Press makes a one-inch incision in the vagina and positions a mesh sling under the urethra to correct hypermobility. The surgical stitches are dissolvable, and the chance of urinary retention following surgery is minimal. The difference between the 7-Minute Sling and other outpa- tient vaginal sling procedures revolves around the time it takes Dr. Press to complete the operation. "The actual technique of sling place- ment during the 7-Minute Sling surgery is similar to the standard technique, Many patients seek out Dr. Press if they experience urinary leakage after delivering children. but I have performed so many vaginal sling surgeries it takes me far less time — approximately seven minutes — to do the procedure," Dr. Press says. "Some patients are reluctant to have surgery. Trademarking the 7-Minute Sling lets patients know they are going to get an immediate fix for their incontinence without a lengthy surgery or recovery. Patients come in for their outpatient surgery in the morning, and when they leave around noon, they no longer have to worry about incontinence." A Case for Mesh Prolapse Repair The FDA warning regarding the use of mesh slings to repair bladder prolapse was issued because of complications such as chronic pain, extrusion and mesh erosion. "When the warning was first issued, I was shocked because none of my patients had experienced any of the mentioned complications," Dr. Press says. "Board certification for female M D N E W S . CO M ■ MD NEWS Long Island | 9

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