Posts by Milena M. Weinstein, MD
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Omission of Preoperative Internal Pelvic Exam May Not Affect Safety of Gender-affirming Hysterectomy
Ellen Murphy, MD, Youngwu Kim, MD, and Milena M. Weinstein, MD, present retrospective evidence that omitting a preoperative internal pelvic examination may be a clinically acceptable practice before gender-affirming hysterectomy (with or without vaginectomy) or vaginectomy alone.
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Ensuring OB/GYN Care is Gender-affirming Care
Massachusetts General Hospital physicians collaborate across disciplines to ensure that OB/GYN care for transgender patients is safe, inclusive, and affirming.
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Digital Therapeutic That Guides Pelvic Floor Muscle Training Demonstrates Real-World Effectiveness
Mass General researchers gathered "real-world" data on the leva Pelvic Health System for guiding pelvic floor muscle training. They found 78% of users reported improvement in symptoms within eight weeks, and 62% met or exceeded the minimum clinically important difference on the Urogenital Distress Inventory.
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Vaginal Prolapse May Not Correlate With Radiographic Findings in Symptomatic ODS Patients
Milena M. Weinstein, MD, Marcus V. Ortega, MD, and colleagues found a disconnection between the anatomical versus the functional meaning of the radiologic rectocele in women with obstructive defecation syndrome, and they present evidence that patients with vaginal prolapse were more likely to splint to aide evacuation and demonstrated larger rectoceles on defecography.
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Women With More Severe Chronic Constipation Have More Urogenital Symptoms
In the first study of its kind, Milena M. Weinstein, MD, Liliana G. Bordeianou, MD, MPH, and Marcus V. Ortega, MD, found that in women with pelvic floor disorders, the presence of severe chronic constipation is associated with a significantly higher prevalence of urogenital symptoms, notably painful intercourse.
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Digital Therapeutic Device for Pelvic Floor Muscle Training Provides Faster, Better Results Than Conventional Exercises
Milena M. Weinstein, MD, and colleagues found in a randomized, controlled trial that pelvic floor muscle training guided by a digital therapeutic device yielded a greater reduction of stress urinary incontinence episodes and associated burden compared with home exercises based on written and verbal instructions.
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Motion-based Digital Therapeutic Device for Pelvic Floor Muscle Training Promising in Randomized Trial
Milena M. Weinstein, MD, and colleagues report a randomized, controlled trial that showed improvement in symptoms and quality of life in women with stress-predominant urinary incontinence who used a motion-based digital therapeutic device to guide pelvic floor muscle training, even though it was terminated prematurely.
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Fecal Incontinence Linked to High Prevalence of Urinary Incontinence in Women with Pelvic Floor Disorders
Marcus V. Ortega, MD, and Milena M. Weinstein, MD, of the Division of Female Pelvic Medicine and Reconstructive Surgery, and colleagues found a substantial overlap of fecal and urinary incontinence in women, and they suggest comprehensive screening for both conditions at the time of initial evaluation.
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Digital Muscle Trainer Benefits Women with Stress-predominant Urinary Incontinence
In the first randomized, controlled trial of its kind, Milena M. Weinstein, MD, of the Department of Obstetrics and Gynecology, and colleagues found that use of a motion-based digital device for pelvic floor muscle training (PFMT) provides benefits beyond those of unsupervised PFMT alone.
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IMPACT: A Standardized Tool for Assessment of Pelvic Floor Disorders
A consortium of professional societies caring for patients with different pelvic floor disorders (PVD) has reached consensus on standardized measures for initial assessment of the most commonly reported symptoms of PVDs.
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Variant Anatomy in Women with Horseshoe Kidney Can Make Pelvic Reconstruction Challenging
In women with a horseshoe kidney, preoperative imaging is important to determine whether surgery involving presacral dissection is safe or even feasible.
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Paradigm Change: Patient and Provider Expectations Around Same-day Discharge
Newly modified enhanced recovery after surgery (ERAS) protocol guides same-day discharge of vaginal hysterectomy patients while maintaining quality of patient care.
Biography
Milena Weinstein, MD, joined the division of Female Pelvic Medicine and Reconstructive Surgery at Massachusetts General Hospital in 2008 after completion of fellowship in Female Pelvic Medicine and Reconstructive Surgery at the University of California San Diego School of Medicine. She completed medical school and Obstetrics and Gynecology residency at University of California Los Angeles.
Dr. Weinstein evaluates and treat patients with a complex pelvic floor disorders including urinary incontinence and pelvic organ prolapse, which can include uterine prolapse, vaginal vault prolapse, anterior vaginal wall prolapse (cystocele) and posterior vaginal wall prolapse (rectocele). She also sees patients with mesh-related complications (mesh erosion, mesh exposure), urogenital fistula and other pelvic floor issues.
She is a member of the Mass General Pelvic Floor Disorders Service, a multidisciplinary group comprised of pelvic reconstructive surgeons, colorectal surgeons, urologists, gastroenterologists and physical therapists. The service provides surgical and nonsurgical treatment options, including minimally-invasive surgeries such as vaginal, laparoscopic and/or robotic assisted surgeries. The service holds regular multidisciplinary conferences to discuss discuss and coordinate the care of patients with complex and combined pelvic floor disorders
Dr. Weinstein has served on multiple national committees at American Urogynecolgic Society (AUGS). She also has been trained in three-dimensional pelvic floor ultrasound. She teaches on pelvic floor ultrasound nationally and uses pelvic floor ultrasound for research and to assist with diagnosis and treatment.
