Dear Doctor: Allison Polland
The Brooklyn urologist on exciting developments in women’s sexual health.
Practicing at Maimonides Medical Center in Brooklyn, New York, Dr. Allison Polland’s passion lies in researching women’s sexual health and educating other female physicians about urology, a field dominated by men. Dr. Polland spends part of her week doing procedures in her office and at the hospital, as well as teaching urology residents and urogynecology fellows at the Zucker School of Medicine at Hofstra University/Northwell. Read on to learn about her choice to go into urology, her national research project’s interim findings, and what intriguing new treatment could solve female sexual dysfunction.
“I was a biomedical engineering major in college, and I thought that I wanted to be an engineer when I grew up. I found that for every project we did in engineering school, the initial idea came from a doctor. They were on the front lines seeing patients, while the engineers were the ones putting things into practice. From that point on, I realized that I wanted to be the one coming up with the ideas, so I decided to go to medical school.”
Studying Urology
Urology is a great field for anyone because you get to do both medicine and surgery, while also having long-term relationships with your patients.
There aren’t very many women in urology, yet as patients, women deal with everything from kidney stones to overactive bladder to urogynecological issues — so there’s definitely a place for female physicians in this specialty.
As a urologist, I have a unique background and perspective on a lot of the urogynecologic issues like prolapse, urinary incontinence, and pelvic floor dysfunction. Since I did my residency in urology, during my fellowship, I had a lot of gynecology learning to do. However, from urology I had that strong background in bladder function and dysfunction and the way that neurological diseases and diabetes can affect the bladder, bladder cancer, and kidney stones. This allows me to treat a patient who may come in with urinary incontinence, but has underlying urologic issues. I work closely with urogynecologists who have gynecology backgrounds. We bounce ideas off of each other and refer to one another when appropriate. We want to be sure all of our patients are receiving the proper care.
I love being a urologist because I can help improve patients’ quality of life. Sometimes just telling a patient to drink less coffee at night, to start on medication, or to recommend a surgery can change their life completely. They may have been running to the bathroom all night or leaking urine when coughing or sneezing and a simple modification, surgery, behavioral adjustment, or pelvic floor exercises, can make a huge difference.
The Society of Women in Urology
There’s a society of women in urology that started in 1980 with five female urologists. They found each other at the American Urological Association, which is where they decided to form the society. Since its formation, it has really grown, now with hundreds of members across the country. While it’s amazing, it’s still hundreds, not thousands of members, which is not a lot when you think about the population of the U.S.
As a medical resident, I was a representative to the board, which was a great opportunity to work with urologists from all over the country. The representatives were involved in planning the society’s annual meeting, coming up with a scientific program for the meeting, and organizing mentorship opportunities. A lot of these meetings have scientific programs where you learn about what other people are doing. It’s really great to be able to have a female mentor in the specialty who has gone through a lot of the same steps as you. They’re very helpful for questions about career and personal lives, including giving advice on contracts for employment and how to talk to your boss about the terms of your maternity leave.
I think for many years urology was thought of as a “boys club,” and it certainly is about taking care of a lot of men; but unlike gynecology where you only take care of women, urologists don’t only take care of men.
In general urology, you can take care of men, women, and children. I see both men and women in my practice, and I never felt that I was at a disadvantage for being a woman in this field that was predominantly male. I think it’s a great field for women, I always encourage medical students to look into it, especially if they’re interested in urogynecology. It’s a really great background to move on to the subspecialty.
Women’s Sexual Health
Every single urologist learns to always ask all male patients about erectile dysfunction; if you don’t ask them, they’ll ask you. Nobody really talks about female sexual function. It’s not taught in medical school or residency in either urology or gynecology. It’s a field that’s neglected. A lot of women don’t even ask their doctors about it because they think that nothing can be done.
However, there is a lot of research being done on the topic. The International Society for the Study of Women’s Sexual Health sets aside grants to fund innovative research projects of different physicians around the world who are exploring this topic. I have a grant from them that is funding a project I launched in January 2017. I’m looking at the effect of treatment of overactive bladder on female sexual function. We are recruiting for the study here at Maimonides, as well as at Georgetown University, Oklahoma University, Indiana University, University of Louisville, and UT Southwestern.
As the principal investigator for the study, which is organized through the American Urogynecologic Society’s fellows pelvic research network, I’m the one who coordinates with the different centers around the country making sure that patients are being recruited and followed. Here at Maimonides, I work on the project with my research assistant and the help of one of the urogynecology fellows at Northwell. This summer, a Hofstra medical school student will be joining the team.
We are set to complete the recruitment in June 2019. After that, we’ll analyze the results. We did an interim analysis and the initial results showed that certain medications for overactive bladder are actually better for female sexual dysfunction than other medications. This finding wasn’t known before, so if the final results of the study are consistent, it can change the treatment of overactive bladder. If someone comes in with overactive bladder and is also experiencing sexual dysfunction, we will give them a certain medication that will improve both simultaneously.
One of the things that we’re specifically doing research on is Percutaneous Tibial Nerve Stimulation or PTNS. It’s an acupuncture-type treatment used for overactive bladder, and we’re using it to see the effects on female sexual function. There are some animal studies that show it improves things that impact sexual function like blood flow to the clitoris. The thought is that it may improve sexual function in women as well. It would be so cool for a woman to be able to walk into their doctor’s office, say that they’re experiencing sexual dysfunction, then right there have access to an acupuncture-like procedure that could help. They could leave the doctor’s office, go home, and have better sex.
Lightning Round
If I weren’t a doctor, I’d be…an engineer.
One thing I hope my patients take away with them after seeing me…there’s a lot of things that we can do to treat the common problems of incontinence and prolapse. They aren’t all surgery, so it’s worth it to come into the doctor, talk about it, and learn about the options available.
I feel looked after when…my husband makes me breakfast before work.
Favorites
NYC park: Prospect Park.
Local coffee/ tea shop: Jade Bakery, right by my office in Sunset Park.
Lunch spot: The supermarket on the corner of 64th and 8th for dumplings.
App: ParkNYC…I love being able to pay for parking on my phone not have to worry about a meter.
You can learn more about Dr. Allison Polland here.
Know a great female doctor in NYC? We’d love to meet her, introduce us here!
