I was drawn to the field by the possibility of pursuing academic research and surgery and helping women with urologic and pelvic floor conditions who are often underserved. In the late 1990s, what was then called the field of female urology was an open field. Most publications focused on case studies and case series with outcomes of surgical techniques; few basic or translational studies had been completed. I found that many patients were suffering in silence despite the profound impact of these conditions on their quality of life, and I wanted to make discoveries that would improve their lives. The career I envisioned for myself did not fit the traditional career pathway for what we called a female urologist. Instead, I charted my own path.

After completing my residency and fellowship in female/reconstructive urology, while an assistant professor I did a postdoctoral research fellowship in the departments of pharmacology and urology at the University of California, Los Angeles (UCLA) under the mentorship of Nobel laureate Louis Ignarro, PhD, now professor emeritus of molecular and medical pharmacology at UCLA. During that fellowship, I devoted 2 years almost exclusively to research.

Some colleagues were concerned I would not meet my full career potential on this unconventional journey, studying an off-the-beaten-path topic. Instead, I have thrived with continual funding from the National Institutes of Health for over 20 years and more than 100 studies published in peer-reviewed journals. This includes several studies describing and validating new surgeries for urinary incontinence, novel preclinical animal models of lower urinary tract symptoms, studying the role and contribution of environmental stress on urinary frequency and bladder pain, and tissue engineering for the treatment of stress incontinence, among others. I am proud of having mentored more than 40 fellows who have inspired me to be a better teacher, surgeon, and scientist. In 2021, I was named chair of the department of urology at Weill Cornell Medicine, and urologist-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center in New York City.

Having my unusual career pathway, field, and dedication recognized by my colleagues with the Victor A. Politano Award is a great honor. It is even more meaningful knowing that my clinical fellowship mentor at UCLA, Shlomo Raz, MD, was the first Politano Award winner in 2008.¹ Dr Raz, now a distinguished professor emeritus of urology at UCLA, has been a driving force in female urology and played a pivotal role in my career. He gave me a tremendous amount of freedom to focus on areas lacking attention in the field, such as the need for more basic science and rigorous clinical research on female urology and pelvic floor conditions. He later hired me as a faculty member at UCLA, helping launch my academic career.

It has been gratifying to see the volume and quality of research in our newly named urogynecology and reconstructive pelvic surgery field grow substantially over the past 10 to 15 years due to the efforts of a dedicated cadre of colleagues. As principal investigator of the National Institutes of Health–funded Multidisciplinary Approach to the Study of Urologic Pelvic Pain Research Network, I have participated with a team of brilliant colleagues to make important discoveries. We have shown that abnormalities in the way the nervous system processes peripheral stimuli cause some patients’ bladder pain and that treating the root cause of these conditions is essential.² My colleagues and I have also demonstrated stress’ important role in bladder conditions like interstitial cystitis, further emphasizing the importance of the central nervous system.³ Despite the growing understanding of the biological basis of these conditions, we have found that many women are still dismissed or disbelieved by physicians, leaving them to find alternate coping strategies.⁴

New models of care are emerging to help. I assembled a team of urologists, gynecologists, colorectal surgeons, rehabilitative medicine specialists, and physical therapists at Weill Cornell Medicine’s Center for Female Pelvic Health. Bringing all those specialties together allows us to provide a one-stop shop for pelvic floor conditions. It will also allow us to learn from each other, think outside the box of our specialties, and develop ways to treat our patients more holistically. We are also working to reduce disparities in care for pelvic floor disorders and bring care to underserved communities by opening satellite sites in Queens and Brooklyn.

There is still much more to discover about these conditions and how to treat them, especially in the areas of identifying women at risk and developing preventive interventions. There are a lot of opportunities for young clinicians and investigators to help grow and diversify the field. Women currently make up about 11% of urologists—one of the lowest proportions of any specialty—but there is a robust pipeline of trainees poised to boost the ranks of women in the field.⁵ There is a great need to increase the number of urologists from other underrepresented groups as well, as the proportion of Black and Hispanic or Latinx urologists remains below the representation of these groups in medicine overall.⁵ The AUA, its leadership, editors, and editorial boards have done admirable work drawing attention to the need to diversify our specialty. But there is more work we can all do to help provide diverse cohorts of young clinicians with exposure to urology and mentorship in the field. Growing our diversity will bring valuable new perspectives to the field and help increase patient-provider concordance, which studies show improves care.

I encourage young clinicians to choose urology, follow their passions, and create the career they want—something this specialty provides the flexibility to do. Though less-traveled paths may come with more uncertainty early on, they will provide you with opportunities to make a greater impact.