Harvard Catalyst Profiles

Contact, publication, and social network information about Harvard faculty and fellows.

William Douglas Winkelman, M.D.

Title
Institution
Department
Address
Profile Picture

Biography
Dartmouth College, Hanover, NHBA05/2009Religion
Harvard Medical School, Boston, MAMD05/2013Medicine
University of California, San Francisco, San Francisco, CA06/2017Obstetrics and Gynecology
Harvard Medical School, Boston, MA06/2020Female Pelvic Medicine and Reconstructive Surgery
2006
Tucker Fellow of Service, Spirituality and Social Justice
2009
Rufus Choate Scholar
2016
Pacific Coast Reproductive Society In-Training Scholarship
2016
Clinical and Translational Science Institute Travel Award
2017
Resident Research Award
2018
Fellow Scholar
2018
Patient Safety Award
2018
Best Clinical Research Project
2019
Humanitarian Grant

Mentoring
Available: 01/10/22, Expires: 03/01/24

Pelvic organ prolapse is a prevalent condition; population based studies estimate that up to 8% of women may report symptoms of prolapse and the lifetime risk of undergoing surgery for pelvic organ prolapse may be as high as 13-19%. Within the United States, over 200,000 surgical procedures for the treatment of prolapse are performed annually. Like any surgical procedure there is an inherent recovery period after surgery. Surgery often induces an acute decline in physical functioning and the postoperative period is often characterized by reduced health-related quality of life. Integral to the decision to undergo surgery is an understanding of the postoperative recovery period. Patients may need to take time off from work, may need to arrange for additional assistance, or make arrangements for their dependents during the recovery period. We know that patients with worse preoperative functional status are more likely to experience postoperative complications and more likely to be readmitted following surgery. For patients undergoing pelvic reconstructive surgery, studies have shown that over 90% of patients either return to baseline or improve in functional status by three months after surgery. While it is reassuring to know that patients will generally recovered from surgery by three months, patients are typically interested in the anticipated recovery during a much shorter timeline. The goal of this study is to understand the normal trajectory of recovery after surgery and to identify risk factors for those who may have delayed resumption of functional activity. Patients complete the The Activity Assessment Scale (AAS) at 2 days, 2 weeks and 6 weeks after surgery. A student is needed to review medical records and collect the postoperative data so that we can begin analysis.

Available: 01/10/22, Expires: 03/01/24

OnabotulinumA (Botox) administered intravescially is an effective treatment for idiopathic overactive bladder and was approved by the Food and Drug Administration for this indication in 2013. While generally well tolerated, in the phase 2 clinical trials as many as 40% of patients developed a urinary tract infection and in the phase 3 clinical trials, 24% developed a urinary tract infection. In clinical practice, the rate of urinary tract infections following intravesical onabotulinum toxin A for idiopathic overactive bladder ranges from 14% to 28%. Given the frequency of infections reported in the early clinical trials, antibiotic prophylaxis is a widely used practice. A number of different antibiotic regiments have been proposed to reduce the risk of a postprocedural UTI. However, the data supporting the use of prophylactic antibiotics is limited. For cystourethroscopy with manipulation or break in mucosal barriers, the American Urologic Association recommends that the provider takes into consideration both the patient risk factors and the invasiveness of the procedure. If antibiotics are decided to be necessary, the AUA recommends the use of trimethoprim-sulfamethoxazole, a first- or second-generation cephalosporins, amoxicillin/clavulanate, or an aminoglycoside ± ampicillin. This recommendation is largely based on data from patients undergoing bladder or prostate resection which is a significantly more invasive procedure than intradetrussor onabotulinum toxin A injections. The American College of Obstetrics and Gynecology doesn't provide any specific guidance on the use of prophylactic antibiotics before intradetrussor Onabotulinum toxin A injections. In our clinical practice we had traditionally administered a single dose of preprocedural nitrofurantoin 100mg which patients took approximately ten to thirty minutes before beginning the procedure. Given the low rates of urinary tract infections we observed in our clinical practice, as well as the rising rates of antibiotic resistance, in July 2020, we decided to stop the routine use of prophylactic antibiotics. This is a retrospective study that will involve analysis of UTI rates before and after implementation of our new protocol. We are looking for a student who will help review medical records to identify UTIs 30 days after OnabotulinumA (Botox) injections. This can be done remotely during free time and there is no specific deadline.


Bibliographic
Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
Newest   |   Oldest   |   Most Cited   |   Most Discussed   |   Timeline   |   Field Summary   |   Plain Text
PMC Citations indicate the number of times the publication was cited by articles in PubMed Central, and the Altmetric score represents citations in news articles and social media. (Note that publications are often cited in additional ways that are not shown here.) Fields are based on how the National Library of Medicine (NLM) classifies the publication's journal and might not represent the specific topic of the publication. Translation tags are based on the publication type and the MeSH terms NLM assigns to the publication. Some publications (especially newer ones and publications not in PubMed) might not yet be assigned Field or Translation tags.) Click a Field or Translation tag to filter the publications.
Updating...
This operation might take several minutes to complete. Please do not close your browser.
Local representatives can answer questions about the Profiles website or help with editing a profile or issues with profile data. For assistance with this profile: HMS/HSDM faculty should contact contactcatalyst.harvard.edu. For faculty or fellow appointment updates and changes, please ask your appointing department to contact HMS. For fellow personal and demographic information, contact HMS Human Resources at human_resourceshms.harvard.edu. For faculty personal and demographic information, contact HMS Office for Faculty Affairs at facappthms.harvard.edu.
Winkelman's Networks
Click the
Explore
buttons for more information and interactive visualizations!
Concepts (133)
Explore
_
Co-Authors (18)
Explore
_
Similar People (60)
Explore
_
Same Department 
Explore
_
Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.