By Elizabeth Landry
When Melanie McNally, MD first began practicing urology, she didn’t anticipate developing a focus on urologic issues specific to women. However, about five years into her practice, she found many women were experiencing urologic health concerns that gynecology was illequipped to manage.
“I originally went into urology thinking it was going to be all kidney stones and prostate cancer,” said Dr. McNally. “Then I saw that there was quite a dearth of people who knew how to take care of women effectively in urology. I eventually did a lot of self taught management of issues that are unique to women.”
Dr. McNally, who has 24 years of experience in general urology, recently returned to Associated Medical Professionals. Her practice serves patients in the Central New York area, with some patients coming from as far as Rochester, Oswego, and Binghamton. She attended the University of Buffalo for medical school, then completed her residency at the University of Rochester, graduating in 2002. Dr. McNally said one of the reasons she enjoys practicing urology is because each day is different. “It’s a wonderful combination of both medicine and surgery,” she explained.
Urologic Issues Women Face – and Shouldn’t Ignore
There are several urologic challenges facing women that Dr. McNally treats and manages in her practice. She explained that recurrent urinary tract infections, or UTIs, and kidney stones can often be quite complicated to treat, requiring a high level of detail during diagnostics. Overactive bladder and neurogenic bladder and two separate challenges that have similar symptoms, such as urgency, frequency and incontinence, Dr. McNally explained, but are caused by different factors.
“Overactive bladder may not have another cause other than genetics or pregnancy, whereas neurogenic bladder is directly related to a neurologic dysfunction like stroke, Parkinson’s, spinal stenosis or degenerative disc disease,” she said.
Dr. McNally emphasized that women shouldn’t brush off urologic symptoms, especially as they age, such as sudden or significant changes in bladder behavior or blood in their urine.
“A lot of women think, ‘I’m just getting older, it’s not a big deal,’ that leaking is inevitable, but that’s just not true,” said Dr. McNally. “If the bladder starts behaving significantly differently than it used to, something is going on, and in the worst-case scenario, it’s bladder cancer. It’s very important to take these symptoms seriously.”
Advanced Treatments Improving Quality of Life
Thankfully, there have been major advancements in urological treatment that are often minimally invasive. In fact, Dr. McNally said these advancements are one of the main reasons she continues to enjoy being a urologist.
“The technology that has come through in the last 24 years has been so amazing. It’s been fascinating to see how fast things have changed and how much better we are as a profession because we have embraced the technology and improved it over time,” she said.
Botox has significantly improved the lives of patients with overactive bladder and neurogenic bladder, Dr. McNally explained. Additionally, a minimally invasive procedure called posterior tibial nerve stimulation, or PTNS, has been instrumental in care for women with bladder issues. Dr. McNally also highlighted the impact of improved recurrent UTI management, which leads to less time in the doctor’s office, a reduction in cost of care, and overall improvement in patients’ quality of life.
“Treatment can mean the difference between patients not going out and doing anything to spending time with their grandchildren, going shopping, going on boat rides and airplanes – things they thought they would never do again because they were trapped next to their bathroom or having to pack a separate suitcase filled with adult diapers or pads,” said Dr. McNally.
Looking at the future of urologic care, Dr. McNally said she’s excited about an innovative implantable device for overactive bladder and various types of incontinence, advanced bladder cancer treatments and new antibiotics for UTI prevention that are being studied.
Making a Difference through Relationship-Based Care
Dr. McNally enjoys supporting patients through their long term course of care, since urology offers the opportunity to develop long-term relationships with patients – often for many years – that many other specialties don’t. And for her, helping patients achieve life-changing outcomes is what it’s all about.
When asked what keeps her passionate about what she does, day in and day out, she answered without hesitation: “When people come up and hug me in Wegman’s – that’s a big one. That’s what tells me I did a good job. That’s what keeps you going.”
