dr amundsen continence care champion interview

October 6, 2017 (CHARLESTON, SC)

The National Association for Continence is proud to announce that the 2017 AUGS recipient of the Rodney Appell Continence Care Champion is Dr. Cindy L. Amundsen.  Dr. Amundsen was presented the award during the 2017 AUGS annual meeting in Providence RI on Oct 6th, 2017.  Dr. Amundsen was recognized for her outstanding work with patients, research and support of patient education.  Dr. Cindy Amundsen is an Urogynecologist at Duke University Medical Center, Durham, NC. . She received her medical degree from University of Tennessee College of Medicine and has been in practice for more than 20 years.

We asked Cindy to share a few insights with us on her background and her philosophy with her Urogynecology practice.

CAN YOU PROVIDE US WITH A LITTLE MORE ON YOUR BACKGROUND, CREDENTIALS, EDUCATION AND DEGREES?

I grew up in Hermitage, PA and after high school went to Northwestern University where I graduated with a degree in Neurobiology.  I received my medical degree from the University of Tennessee in Memphis, Tennessee and completed a residency in Obstetrics and Gynecology at the University of Texas, Houston.  After residency, I was interested in reconstructive pelvic surgery and the newly evolving subspecialty called Urogynecology.  I was accepted as a Female Urology fellow by Dr. Edward McGuire, who was considered one of the forefathers of Female Urology and a pioneer in the development of this combined gynecology and urology specialty.

CAN YOU GIVE US ANY CAREER HIGHLIGHTS OR SPECIAL RECOGNITIONS OR ACHIEVEMENTS, PUBLISHED STUDIES, ETC.?

My career has been dedicated to improving the lives of women with pelvic floor disorders, particularly urinary incontinence and voiding dysfunction.  Over the last 22 years, I have significantly impacted the quality of patient care both with my involvement in research, patient care, and trainee education.  My research has been on applying rigorous methods to test tools used for evaluation of lower urinary tract symptoms, studying safer surgical approaches, and testing novel therapies for lower urinary tract dysfunction, including urinary incontinence.

A particular achievement of mine was to lead the first multicenter trial comparing Botox therapy v. InterStim therapy for those women with refractory urgency urinary incontinence, the results of this study were published in the Journal of American Medical Association (JAMA).  Other highlights of my career have been 19 years of mentoring bright surgeon/scientists who have had as much passion as I do in providing top notch care to women with lower urinary tract and pelvic floor disorders.  As fellowship director of the Duke Female Pelvic Medicine and Reconstructive Surgery Fellowship, I have prided myself in selecting and training the next generation of highly skilled and knowledgeable Urogynecologists.

In addition, as my role as mentor to Junior faculty, I thrive to continue to advance the scientific basis of new therapies for urinary incontinence but also to understand the different etiologies of why patients develop these conditions to better tailor treatment to the individual patient.  

WHAT WAS IT THAT DREW YOU TO UROGYNECOLOGY?

After residency, I was interested in pursuing the new subspecialty of Urogynecology.  I saw the potential of great collaborations with a variety of experts in gynecology, urology, physical therapy, colorectal surgery as well as basic scientists to work together to enhance patient care.  

WHAT WAS YOUR CAREER PATH THAT LED YOU TO YOUR CURRENT SPECIALTY?  

The experiences during my fellowship propelled me into academic medicine.   At Duke, I was fortunate to collaborate with a world-renowned reconstructive urologist, Dr. George Webster along with other very well established scientists in other departments.

WHAT ACHIEVEMENT(S) IN YOUR CAREER ARE YOU MOST PROUD?  

I would say that I have a philosophy to “give it my all” in everything I do.   I want to provide the best care for my patients, every opportunity and resource for my trainees, and the highest quality and innovative research.  

WHAT IS MOST REWARDING ASPECT IN YOUR CURRENT ROLE?

The most rewarding aspect of my current role is my involvement in all aspects of medicine patient care, research and education.   Pursuing each area as provided me with the experience and information to enhance the other.  The patients I treat have usually not responded to first line therapy for their conditions; and thus, the complexity of their problems has provided the catalyst for developing important research questions.  Performing evidenced based research, has provided my patients with the state of the art technology and best treatments.

WHAT IS THE MOST CHALLENGING ASPECT ABOUT YOUR ROLE?

The most challenging aspect in my role as an Urogynecologist is not overextending myself.

WHAT IS YOUR PHILOSOPHY ON PROVIDING THE BEST UROGYNECOLOGY CARE?

My philosophy in achieving the best Urogynecology care is individualizing treatment for each patient – listening to my patient, taking into account their concerns, goals, and expectations and then designing a treatment strategy.

WHAT IN YOUR OPINION ARE THE KEYS TO SUCCESSFUL OUTCOMES FOR THE PATIENTS YOU TREAT?

I think the key to successful outcomes for my patients is to understand the patients’ concerns and goals communicate and educate them about their condition and various options, while providing realistic expectations and then meet those expectations.  Although there has been tremendous progress over the last 20 years in the treatment of urinary incontinence and other lower urinary tract dysfunctions; there still is a lot of research to be done.

WHAT AREAS OF RESEARCH WOULD YOU LIKE TO DO OR TO SEE BEING CONDUCTED TO FURTHER ADVANCE CARE OR PATIENT OUTCOMES?

In the area of research I would like to see important scientific advances into what is coined “personalized medicine”.  Our field must begin to better understand the various mechanisms of why patients develop these conditions so that we can better individualize treatment.  This will then provide patients with a more targeted and rationale approach to treatment, instead of the current algorithmic approach.  

WHAT HAS CHANGED IN THE LAST 10 YEARS FOR UROLOGY/UROGYN?

In the last 10 years, women’s quest for a better quality of life has brought recognition to pelvic floor and lower urinary tract problems.  Urogynecologic disorders create both significant personal distress as well as having a tremendous economic burden on society. While physicians have responded by addressing these conditions with patients and providing them with more treatment options than ever before, more funding for research and education is needed.

WHAT IS A COMMON MISPERCEPTION ABOUT UROGYN CARE?

A very common misperception in Urology care is that none of the therapies work and that they will be left with wearing Depends™ for the rest of their life.

WHAT AREAS DO YOU SEE NEED MORE IMPROVEMENT? PATIENT EDUCATION? AWARENESS?  

Both patient education and awareness in Urology are needed.  Awareness about bladder health should be emphasized at every stage of life and educating women on what they can do to maintain good bladder health and on seeking expert advice when problems arise.

WHAT DOES BEING RECOGNIZED BY NAFC AS A CCC MEAN TO YOU?

I am honored to be recognized by NAFC as a Continence Care Champion for my commitment to women’s health in Urogynecology.  I will continue to lead efforts that will enhance women’s quality of life for those who suffer from pelvic floor and lower urinary tract conditions.