The research interests of Annetta M. Madsen, M.D., are in the areas of female pelvic anatomy and childbirth-related pelvic floor disorders. She also is interested in developing innovative solutions that improve patient care and surgical quality. Dr. Madsen focuses on areas where there are gender-based disparities in scientific knowledge and health care outcomes. She uses a patient-centered approach to research questions, interventions and outcome measures.
- Childbirth-related pelvic floor disorders. Dr. Madsen currently leads a multidisciplinary collaboration among Mayo Clinic experts in obstetrics, urogynecology and physical therapy. The group is developing a clinical and research infrastructure aimed at improving knowledge, early detection, coordinated care and innovative treatment solutions for people experiencing traumatic injuries and other pelvic floor disorder symptoms after childbirth.
- Female pelvic anatomy. Dr. Madsen is involved in a national work group aimed at exploration and dissemination of knowledge about female pelvic anatomy. Specifically, she studies the structures of the vulva and perineum, vagina, and pelvic floor.
- Quality improvement. Dr. Madsen is involved in a quality improvement initiative using multiple evidence-based interventions. These interventions allow patients to recover from minimally invasive gynecologic surgery without the use of opioid medications.
Significance to patient care
Due to gender-based disparities, there are gaps in the knowledge of female pelvic anatomy in both the medical community and society. Childbirth has occurred since the beginning of human existence. But the effects of pregnancy and childbirth on the pelvic floor remain unclear. Furthermore, there is a lack of knowledge about which childbirth injuries become pelvic floor disorders and which heal or resolve on their own. There is also an insufficient understanding of how to recognize and treat injuries early and how to prevent further progression of pelvic floor disorders. Dr. Madsen's work is aimed at addressing these knowledge gaps.
Societal expectations, lack of awareness and embarrassment can prevent people from seeking help when they have symptoms of a pelvic floor disorder. Thus, Dr. Madsen's work aims to address health disparities around childbirth-related pelvic floor disorders by improving knowledge of female pelvic anatomy and the effects of childbirth. She is creating an infrastructure for people to connect with knowledge and care and transforming the approach to postpartum pelvic health care. Dr. Madsen also develops innovative solutions aimed at early recognition and treatment of childbirth-related pelvic floor injuries.
Opioid medications were once the mainstay of postoperative pain management, but they come with side effects and risks. For example, prescription opioids can be misused by patients or their friends and family, contributing to the ongoing opioid epidemic in the United States.
Dr. Madsen investigates various strategies for reducing how much opioids patients need after surgery. When used in combination, these strategies may help prevent routine prescribing of opioids after minimally invasive surgeries altogether. This would reduce not only the negative side effects patients experience, such as nausea, constipation and lightheadedness, but also the risk of opioid dependence and misuse.
- Childbirth-Related Pelvic Floor Disorders Special Interest Group, American Urogynecologic Society, 2021-present.
- Leader, Subcommittee on the Digital Library for Female Pelvic Anatomy, Pelvic Anatomy Group, Society of Gynecologic Surgeons, 2017-present.
- American Urogynecologic Society Pelvic Floor Disorders Research Foundation grant, "Improving Patient-Centered Care for Pelvic Floor Disorders Through Perioperative Peer Support," 2015-2017.