Dr. Heisler's Research

Research Focus: Quality Improvement in Surgery; Surgical Education

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Department of Ob-Gyn leadership, awards, research and more at 2024 SGS Annual Meeting

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Grand Rounds: Heisler presents “Reconstructive Vulvar Surgery: Beyond Cosmetic Gynecology”

On July 6, 2023, UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery Director Christine Heisler, MD, MS, presented the Grand Rounds lecture “Reconstructive Vulvar Surgery: Beyond Cosmetic Gynecology”.

In the lecture, Heisler explained relevant vulvar anatomy, described specific clinical conditions that may present for surgical management, discussed available evidence and how it influences surgical decision-making, and offered examples of corrective surgical approaches and outcomes.

Watch the whole lecture here!

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Heisler appointed permanent Division Director of FPMRS

After nearly a year of exemplary service as Interim Division Director in the Division of Female Pelvic Medicine and Reconstructive Surgery (soon to be the Division of Urogynecology and Reconstructive Pelvic Surgery), Christine Heisler, MD, MS, has agreed to become the permanent director of the division. Please help us congratulating Dr. Heisler on this well-deserved appointment, effective January 1, 2024.

Heisler took on the interim URPS/FPMRS Division Director role on February 1, 2023. Since then, the division experienced unprecedented clinical and surgical growth, owing to an innovative restructuring of the clinic workflow and improving clinic procedure access. She promoted the development of subspecialty clinics, including overactive bladder, perineal laceration and vulvar health, as well as generated novel collaborations with the AFCH Gender and Sex Development Program. Heisler’s leadership for Eastpark Medical Center planning resulted in significant expansion of the multidisciplinary program which will improve patient access and allow for a more robust cross-disciplinary clinical and educational platform. Under her leadership, the URPS/FPMRS Division successfully recruited Caroline Cox, MD, back to Wisconsin; Heisler is currently leading recruitment for another faculty physician. 

In addition to her busy year as division director, Heisler had many exciting accomplishments in the academic realm, including presenting multiple Grand Rounds lectures and earning a Top Reviewer award from the journal Urogynecology. 

Heisler joined our department in 2016, developing a distinguished reputation as a leader in clinical care, education, and research over the past several years. Since 2021, she has been the Perioperative Services – Surgery Medical Director at UnityPoint Health-Meriter Hospital. In that role, she serves as the physician expert for the hospital’s surgical services, including leading strategic direction for new programs and services, solving problems that affect quality and safety, and otherwise improving physician and patient experiences at UPH-Meriter. 

She was instrumental in creating our urogynecology fellowship program in 2018, the first such fellowship in Wisconsin, which she now leads as Fellowship Program Director. 

After her many years of academic and clinical leadership in the department, we are thrilled that Dr. Heisler will take on the important role of URPS/FPMRS Division Director in an official capacity. Please help us congratulate Dr. Heisler!

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Division of FPMRS at 2023 AUGS annual meeting

Members of the Division of Female Pelvic Medicine and Reconstructive Surgery brought research and leadership to the PFD Week 2023 meeting in Portland, OR in early October: 

Dobie Giles, MD, MS, MBA, professor in the Division of FPMRS, moderated a general session during the conference. 

Poster: Development of a Multidisciplinary Curriculum for Urogynecology and Colorectal Surgery Fellows – co-authors: Ushma Patel, Stephen Ranney, Ray King, Christine Heisler 

Congratulations, all!  

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Heisler earns Top Reviewer award from Urogynecology

Congratulations to Christine Heisler, MD, MS, associate professor and director of the Division of Female Pelvic Medicine and Reconstructive Surgery! She was named a 2023 Top Reviewer by the journal Urogynecology.

Urogynecology selected the Top Reviewer Award recipients based on their high-quality, timely reviews of articles for the publication.

Thanks to Dr. Heisler for her extensive contributions to research and clinical excellence, in our department and beyond!

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Heisler authors paper, earns Best Diversity Paper Award

Huge congratulations to Christine Heisler, MD, of the UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery! Heisler authored a paper in a recent edition of the American Journal of Surgery – the paper was presented at the 2020 Association of Women Surgeons Annual Conference, where it won the Best Diversity Paper award!

“Leading from Behind: Paucity of gender equity statements and policies among professional surgical societies” examined publicly available policies and statements addressing gender equity, harassment, pay equity, discrimination, and more in eight surgical specialties:

“Addressing the multitude of gender inequities requires recognition of the problems, analysis of underlying mechanisms responsible for and propagating the problems, and proactive measures to overcome them. One step in this process involves professional surgical societies publicly acknowledging the issues for which position statements may be developed. Statements and policies reflect the leadership’s awareness of these problems and the steps taken for correction. Statements provide a framework that guides the specialty with expectations of performance and behavior that upholds a set of core values. Moreover, these statements and policies should have actionable consequences for deviations in professionalism and metrics to capture meaningful improvements in gender equity.”

Heisler’s publication received an invited commentary in the American Journal of Surgery as well. You can read Heisler’s publication here, and the invited commentary here. Incredible work, Dr. Heisler!

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Heisler published in AJOG; response from Dee Fenner

An article published by Christine Heisler, MD, of the UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery in the American Journal of Obstetrics and Gynecology garnered a responding editorial from legend in the field Dee Fenner, MD (ob-gyn department chair at the University of Michigan).

Heisler’ article “Has a critical mass of women resulted in gender equity in gynecologic surgery?” examines gender bias and gender discrimination in gynecologic surgery, including in areas of gender role expectations, sexual harassment, surgical education and training, wage gaps, advancement and leadership, and more. 

In the responding editorial, Fenner bolsters findings of Heisler’s article:

“Heisler et al in their thoughtful and thorough review article set out to answer the question “Has a critical mass of women resulted in gender equity in gynecologic surgery?” Their hypothesis is that in comparison with other surgical specialties, where women continue to be a minority, in obstetrics and gynecology, we should see equity in salaries and leadership positions and acceptance and advancement of female surgeons by patients, peers, and colleagues and that the specialty should be more family friendly than male-dominated surgical fields. Unfortunately, their findings across all these domains show that female gynecologists continue to experience gender bias and that long-held gender stereotypes of men and women have not significantly changed, despite the increase of women in our field. Thus, gender equity is far from being achieved.”

Fenner goes on to outline the ways a lack of diversity in medicine affects patients, practitioners, and institutions, and offer some next steps for improving representation in medical specialties. Read “Equality, Equity, and Justice” in AJOG’s November 2020 issue.

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Heisler presents at Society of Gynecologic Surgeons conference

Christine Heisler, MD, MS, of the UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery presented her research about gender disparities in the field of obstetrics and gynecology at the Society of Gynecologic Surgeons conference in June.

Heisler was invited by the meeting’s scientific program chair to present the special guest lecture “Ready, Set, ACTION! Directions toward Gender Equity in Gynecologic Surgery.” In her lecture, Heisler outlined salary disparities, differences in evaluation, and gaps in promotion between men and women in ob-gyn.

Heisler received a standing ovation for the lecture, which sparked important conversations at the conference. Read some of the powerful reviews of Dr. Heisler’s lecture on Twitter here, here, here, and here!

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UW Ob-Gyn research and presentations at 2022 ACOG Annual Meeting

The American College of Obstetricians and Gynecologists held the Annual Clinical and Scientific Meeting in San Diego May 6-8, 2022. Faculty, fellows and residents in the UW Department of Ob-Gyn brought many exciting presentations and projects to the conference. Read more about some of their awesome accomplishments:

Division of Academic Specialists in Ob-Gyn Director Makeba Williams, MD gave the Morton and Diane Stenchever Lecture “The Women’s Health Initiative: Controversy, Confusion, Consensus” at the opening of the day on May 8: 

“In 2022, is hormone therapy safe? Have we reached a point of consensus? The Women’s Health Initiative hormone therapy trial preliminary results were released summer 2002, completely altering the practice of prescribing hormone therapy to midlife and menopausal women. Controversy and confusion immediately ensued. Attend this thought-provoking session to better understand current recommendations, management strategies and treatment options for menopausal patients.”

Division of Gynecologic Oncology Director Stephen Rose, MD, presented “A Revised Markov Model Evaluating Oophorectomy at the Time of Hysterectomy for Benign Indication”, co-authored by Gynecologic Oncology Fellow Shannon Rush, MD, during a late-breaking abstracts session on May 8.

More posters and presentations:

Black Women With Low Numeracy Fare Worse in Diabetic Pregnancies - Jennifer Jacobson, MD; Amy Godecker, PhD; Jennifer Janik, MD; April Eddy, MS; Jacquelyn Adams, MD

Assessment of In-Hospital Pain Control After Childbirth and Its Correlation With Anxiety in the Postpartum Period – Clara Olson, BS; John Poehlmann, MD; Zachary Stowe, MD; Kathleen Antony, MD

Clinical Application of a Previously Validated Pregnancy-Specific Screening Tool for Sleep Apnea – Kathleen Antony, MD

Operationalizing Aspirin to Reduce Preeclampsia Risk and Related Morbidity and Mortality – Maya Gross, MD; Katherine Sampene, MD

Leveraging Quality Improvement to Promote Health Equity: Prenatal Aspirin Recommendations by Race - Maya Gross, MD; Katherine Sampene, MD

In the Eye of the Beholder: Perspectives of Fellowship Applicants on Virtual Interviews - Christine Heisler, MD

Cost-Effectiveness of Opportunistic Salpingectomy Following Vaginal Delivery for Ovarian Cancer Prevention – Matthew Wagar, MD; Makeba Williams, MD

Incredible work, all!

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Heisler to serve as Interim Division Director of Female Pelvic Medicine and Reconstructive Surgery

Christine Heisler, MD, MS, associate professor in the Division of Female Pelvic Medicine and Reconstructive Surgery (FPMRS), has agreed to serve as Interim Division Director of FPMRS! She will step into the role on February 1, 2023.

Dr. Heisler joined the department in 2016, developing a distinguished reputation as a leader in clinical care, education, and research over the past several years. Since 2021, she has been the Perioperative Services – Surgery Medical Director at UnityPoint Health-Meriter Hospital. In that role, she serves as the physician expert for the hospital’s surgical services, including leading strategic direction for new programs and services, solving problems that affect quality and safety, and otherwise improving physician and patient experiences at UPH-Meriter.

She was instrumental in creating our FPMRS fellowship program in 2018, the first such fellowship in Wisconsin, which she now leads as Fellowship Program Director. Her ongoing research interest in gender equity in medicine led to several peer-reviewed publications and presentations about the topic, including one Best Diversity Paper award at the 2020 Association of Women Surgeons Annual Meeting.

Dr. Heisler has agreed to serve in this role for the next two years and continue the impressive growth in academic and clinical services in the division. This will allow her to lead the transition of outpatient FPMRS services to the Eastpark campus in 2024. Dr. Heisler’s academic and leadership experience make her well-qualified to lead the Division of FPMRS during this transition.

This concludes the current open search; the department extends thanks to the search committee for the FPMRS Division Director position and all department members who participated in the search process over the past year, including Dr. Heidi Brown, who served as the interim division director since July 2022.

Please help us congratulate Dr. Heisler as she steps into this new role!

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Division of FPMRS brings presentations to AUGS/IUGA 2022 conference

Faculty and fellows in the UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery will bring research and presentations to the American Urogynecologic Society and International Urogynecological Association 2022 Annual Scientific Meeting in Austin, TX, June 15-16! Read more about some of the exciting developments they will share at the meeting:

Oral abstract: A Pilot Study of Home-Based Pelvic Muscle Training for Vaginal Symptoms Among Survivors of Breast Cancer (Jon Pennycuff, MD, MSPH, presenter)

Oral abstract: The Variation of Chargemaster Price Listings for Urogynecologic Procedures (Dobie Giles, MD, co-author)

Oral abstract: BP Connect: Referring Urogynecology Patients with High Blood Pressure for Primary Care Follow-up (Heidi Brown, MD, MAS, presenter; Makeba Williams, MD, co-author)

Oral abstract: Urinary Incontinence Prevalence and Care-seeking in a Predominantly Black / African-American Sample of Community-dwelling Women (Kristina Warner, MD, presenter)

Abstract: A Comparison of Vaginal pH using Prasterone, Estradiol Cream or Non-hormonal Vaginal Moisturizer for Genitourinary Syndrome of Menopause (VpHresh) (Jon Pennycuff, MD, MSPH, co-author)

Abstract: Surgeon Counseling Regarding Return to Sexual Activity After Pelvic Reconstructive Surgery (Christine Heisler, MD, co-author)

While at the meeting, the FPMRS team will also compete in the AUGS/IUGA Foundations' Fun Walk/Run & Cornhole Tournament for Pelvic Floor Disorders. Learn more about how you can support the Wisconsin Honey Badgers in the cornhole tournament!

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Heisler promoted to Associate Professor (CHS)

Please join us in congratulating Christine Heisler, MD, MS, of the UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery! The UW School of Medicine and Public Health CHS Faculty Appointments and Promotions Committee unanimously promoted Heisler to the rank of Associate Professor (CHS), effective July 1, 2022.

Heisler joined our department in 2016. Since then, she has developed a distinguished reputation as a surgeon, clinician and researcher. She was instrumental in creating our FPMRS fellowship program, the first such fellowship in Wisconsin, which she now leads as Fellowship Program Director.

Congratulations on this well-deserved honor, Dr. Heisler!

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Heisler published in Journal of Surgical Education

What can professional introductions before Grand Rounds lectures tell us about hierarchical, gender, or descriptive bias? A new article in the Journal of Surgical Education aims to find out.

“Professional Address during Obstetrics and Gynecology Grand Rounds Introductions: Setting the Stage, Setting the Standard”, by Christine Heisler, MD, of the UW Ob-Gyn Division of FPMRS, Emily Buttigieg, MD, of the UW Ob-Gyn Division of ASOG, and others, examined speaker introductions from 57 Grand Rounds lectures to assess for bias:

“Consistent use of “doctor” was similar by men and women introducers….Assistant professors were more likely to maintain professional address during introductions, compared to associate or full professors…Trainees were less likely than faculty to be addressed professionally at any time during introductions…Descriptors were used for men and women presenters, though men received more female-gendered descriptors than women…Women introducers used productivity descriptors less often than men introducers.”

Read the whole article here!

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Division of FPMRS brings research and leadership to AUGS annual meeting

Huge congratulations to the UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery, as well as fantastic UW Ob-Gyn residents and UW undergrads, who brought presentations and research to the PFD Week 2021 Annual Meeting, hosted by the American Urogynecologic Society!

In addition to the presentations, UW was mentioned twice in the President’s Address: research by Christine Heisler, MD, MS in the area of pay gaps between genders in the field of medicine got the first shout-out. The Mind Over Matter community dissemination project, led by Heidi Brown, MD, MAS, was also highlighted!

Several members of the team were able to attend the hybrid meeting, which required proof of vaccination as well as masks in meeting areas. Here is a summary of the presentations/posters from our faculty, fellows, residents and undergrads:

Short oral: 

U Patel, A Godecker, D Giles and H Brown. Updating the Prevalence of Urinary Incontinence in Adult Women Using 2015-2018 Data from a National Population-Based Survey.

B Mumm, J Barnet, T LeCaire, K Malecki, M Wise, D Newman, and H Brown. Who are we leaving high and not dry? Reach of Bladder Health Promotion via Email. 

G Halder, R Rogers, A White, H Brown, L Caldwell, and M Constantine. Measuring Preparedness for Surgery Validation of a Novel Surgical Preparedness Survey.

S Baban, C Grimes, A Kadesh, J Shi, J Ahluwalia, A Lui, D Giles, A Amin, M White, G Daly, S Reddy, A Block, and R Chaudhan. Variation of Chargemaster Price Listings for Sling Procedures Across Five States.

Scientific Salon:

J Pennycuff, M Pauliukonis, M Yasukawa, A Shimada, and T Parker. The Role of Breast Cancer Treatment in Pelvic Floor Symptoms and Sexual Dysfunction in Breast Cancer Survivors.

J Pennycuff, J Orzel, and L Richter. Surgical Outcomes for Breast Cancer Survivors Undergoing Prolapse and Anti-Incontinence Surgery.  

Poster:

G Avery, M Moureau, M Piper, N Werner, and H Brown. Reach and Teach: Pilot-Testing a Continence Self-Management Website.

Moderator:

H Brown Scientific Salon I – Functional Anatomy of the Pelvic Floor

Congratulations to all on this incredible showing!

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Grand Rounds: Heisler and Higgins present Equity Badger Bytes

On July 15, 2021, researchers in the UW Department of Ob-Gyn presented a Badger Bytes research Grand Rounds.

Jenny Higgins, PhD, MPH, of the Division of Reproductive and Population Health, presented “Economics and Erotic Inequity: Poverty and Sexual Wellbeing.” During her presentation, Higgins defined erotic equity and shared main findings from the literature and a new empirical data analysis related to consistent, positive relationships between economics and sexual wellbeing.

Christine Heisler, MD, MS, of the UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery, presented “Gender Equity in Ob-Gyn: What the Data Tell Us.” In her presentation, Heisler described three gender equity issues in ob-gyn, as well as three objective, measurable outcomes to improve gender equity.

Watch the lectures here!

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Patel and Heisler author article in Obstetrics and Gynecology Clinics of North America

Christine Heisler, MD, MS, of the UW Ob-Gyn Divison of Female Pelvic Medicine and Reconstructive Surgery and resident Ushma Patel, MD PGY-4 co-authored an article in the journal Obstetrics and Gynecology Clinics of North America.

In “Urinary tract injury during gynecologic surgery: prevention, recognition and management”, Patel and Heisler review important anatomy involved in gynecologic surgery, discuss risks for lower urinary tract injuries during surgery, offer suggestions for preventing injury, and walk through steps for identifying and managing injuries during surgery.

“LUT injuries are a recognized complication of gynecologic surgery, occurring as a consequence of the close proximity of the reproductive organs to the urologic organs. Considering the morbidity associated with LUT injury, prevention through knowledge of pelvic anatomy, high level of surgical skill, and understanding of patient risk factors are emphasized. In the setting of iatrogenic complications, the primary aim must be early intraoperative diagnosis and treatment. To combat delayed postoperative recognition of iatrogenic LUT injury, gynecologic surgeons must maintain an appropriate degree of suspicion for injuries by preserving familiarity with the types, locations, and mechanisms of injuries. Equally important, surgeons must be familiar with the wide range of patient symptoms and preferred diagnostic imaging to promptly diagnose LUT injury in the postoperative period. Finally, LUT injuries should be evaluated and repaired by a surgeon who is familiar with such procedures and the necessary postoperative management.”

Read the whole article here. Incredible work, Dr. Patel and Dr. Heisler!

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FPMRS Division brings posters, presentations to virtual AUGS meeting

The UW Ob-Gyn Division of Female Pelvic Medicine and Reconstructive Surgery shared research and new developments at the annual American Urogynecologic Society (AUGS) Meeting October 8-10, 2020! Since the meeting was held virtually (instead of in Vancouver), attendees joined from the wonderful offices within Meriter Hospital.  

Our group presented three oral presentations and two posters.  Heidi Brown, MD and Division Director Dobie Giles, MD also served as moderators for two sessions.

Oral Presentations:

Updating the prevalence of urinary incontinence in adult women using 2015-2016 data from a national population-based survey

U. J. Patel, A. L. Godecker, D. L. Giles, H.W. Brown. 

A randomized control trial evaluating preoperative telephone calls on surgical preparedness in urogynecology

G. E. Halder, A. B. White, H.W. Brown, L. Caldwell, D. L.Giles, C. A. Heisler, D. Bilagi, R. G. Rogers

Is it worth the cost? A cost benefit analysis of postoperative post-void residual bladder scan thresholds

S. M. Jansen, A.Woll, S. E. Swift, C. A. Heisler

Posters:

Is fecal incontinence (FI) associated with urinary tract infection (UTI)?

S. M. Jansen, K. Pellino, H.W.Brown, Q.Zhao, C.A.Heisler

How well does post-void residual by subtraction correlate with objective urinary retention in the postoperative setting?

S. M. Jansen, A.Woll, H.W. Brown, S. E. Swift, Q. Zhao, C.A.Heisler

Congratulations to all  who presented and attended – amazing work!

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