Colorectal surgeon encouraging patients to seek care for defecatory disorders before symptoms limit their quality of life
A new center for Female Pelvic Health at The Ohio State University Wexner Medical Center hopes to encourage patients to seek care for fecal incontinence and other pelvic floor conditions. Physicians and surgeons at the center at Outpatient Care New Albany use a collaborative, multidisciplinary approach.
Amber Traugott, MD, a national expert on colorectal pelvic floor disorders, says these are embarrassing problems to have. “Many times, patients don’t tell close family or even their spouse about their symptoms,” she says.
Pelvic floor-related bowel dysfunction can greatly impact one’s quality of life.
“If you have a bowel accident at the store and see someone you know, imagine how difficult it would be to see that person again or go back to that store,” Traugott says. “It can be functionally home binding, even if it’s not a life-threatening problem.”
Treatment that changes lives
The Female Pelvic Health Center is a first-of-its-kind practice in central Ohio that provides coordinated, comprehensive care from multiple specialists. Experts diagnose and treat a full range of pelvic floor disorders, including:
- Fecal incontinence
- Mesh complications
- Overactive bladder
- Outlet constipation
- Painful bladder syndrome
- Pregnancy and postpartum healing issues
- Pelvic floor-related bowel dysfunction
- Pelvic organ prolapse
- Rectal prolapse
- Recurrent urinary tract infections
- Urinary incontinence
- Vesicovaginal and rectovaginal fistula
Patients can visit with physicians about their conditions and symptoms, undergo testing such as anorectal manometry and ultrasound and receive certain procedures, like sacral nerve stimulation — in a single, convenient location with easy parking. All the resources of an academic health center are available if needed.
The pelvic health care team works with all other specialists at the clinic to provide one-stop care for patients. Colorectal surgeons like Traugott, gastroenterologists, gynecologists, obstetricians, physical therapists, reconstructive surgeons, sexual health experts, urologists and urogynecologists collaborate to give patients the best outcomes.
“Our innovative approach is intended to simplify the entire treatment process for patients while maximizing long-term recovery and daily quality of life,” Traugott says.
Removing the stigma of bowel disorders
Pelvic floor disorders and other bowel conditions are more common in women, but are not unique to them. Traugott says women might discuss these conditions more often with their obstetrician or gynecologist.
“Patients who are not women may not be as educated or as aware that there are treatments available,” Traugott says.
The center aims to educate more people about their options so that they talk to their doctors about symptoms. Traugott says many people don’t seek help until their symptoms are life-limiting.
“Other undiagnosed problems can exist that contribute to these issues — like diabetes or severe spinal cord impingement,” Traugott says. “I might be the first person they see because they are incontinent — but in reality, they need emergency spine surgery.”
Innovative care for colorectal conditions
Traugott leads the center’s colorectal surgical care team and provides comprehensive pelvic health care to women and men, nonbinary and transgender patients. Her practice is not limited to pelvic floor disorders. She also focuses on:
- Anorectal disease
- Bowel incontinence
- Colorectal cancer
- Conditions related to previous pelvic surgery or radiation treatment for cancer
- Pelvic floor-related bowel dysfunction due to childbirth, aging and inflammatory bowel disease
- Rectal prolapse
Traugott was the first surgeon to start a pelvic floor clinic at Ohio State, where she’s been on the faculty for more than six years. Her patients have access to diagnostic 3D manometry and endorectal ultrasound.
Her surgical expertise includes implanting sacral nerve stimulator devices and laparoscopic and robotic surgery for pelvic operations.
Traugott is a big believer in collaborative care to give patients the best outcomes.
“These are multidisciplinary problems,” she says. “It’s pretty unusual that a patient has an isolated surgical problem and doesn’t need any other input from other providers.”
A coordinated team approach
The pelvic health team builds on Ohio State’s collaborative approach to care and research, Traugott says. “We are very good at this type of multidisciplinary care.”
The New Albany facility allows expert physicians, diagnostic testing, procedure suites and operating rooms to be geographically co-located.
“That makes it so much easier to collaborate,” Traugott says. “We can evaluate a patient or discuss test results together to make better decisions.”
That’s not typical for most big tertiary care centers. The pelvic health care team also attends educational activities, research seminars and care conferences together where they “discuss problems and patients with challenging situations and talk about the best way to proceed,” Traugott says.