Newly expanded program at Rush offers relief from pelvic floor problems

Trouble with urine or bowel control, bladder pain, recurring urinary tract infections, constipation and other sexual function issues frequently can be traced to a dysfunctional pelvic floor -- the layer of muscles that support the bladder and bowel in men, and bladder, bowel and vagina in women.

Twenty-five to 30 percent of adults between the ages of 25 and 55 have a weak pelvic floor. Unfortunately, the symptoms often go under-reported and undiagnosed.

Different studies rate the prevalence of incontinence in women alone as between 15 percent up to 50 percent.

"The numbers vary because there is a lot of under-reporting, due to the embarrassment associated with problems in this area," said Dr. Sheila Dugan, director of the Program for Abdominal and Pelvic Health at Rush University Medical Center.

Unique to the Chicago area, the Program for Abdominal and Pelvic Health at Rush offers a multi-specialty approach to diagnose and treat a wide range of conditions.

Newly expanded, the Program for Abdominal and Pelvic Health at Rush brings together a team of experts to address the complexity of pelvic health conditions and treat men and women suffering from them. The team includes gynecologists, urogynecologists, colorectal surgeons, gastroenterologists, urologists, physical medicine and rehabilitation specialists, physical and occupational therapists, psychologists, radiologists and nurses.

Program aims to restore normal function and quality of life

"Pelvic health is an extremely important and can greatly affect quality of life," said Dugan. "Your pelvic floor is like a hammock – a sling of muscles, which when healthy and strong can support and lift the internal abdominal and pelvic organs and give us control when we hold or release the contents of our bladder or bowels."

"We know that incontinence related to pelvic floor problems is very common, and we are not seeing all the people that we could help. These problems affect women, men and children," said Dr. Joanne Favuzza, co-director of the Program for Abdominal and Pelvic Health at Rush.

"We understand that having a pelvic organ disorder can greatly affect a patient's quality of life, and we are committed to helping them regain normal function and return to their daily activities without having to worry about their symptoms getting in the way," Dr. Dana Hayden, a colorectal surgeon at Rush and doctor in the program.

Nonsurgical treatments and minimally surgical techniques available

Many problems can be treated using nonsurgical approaches such as acupuncture, biofeedback, botox injections, nutrition and diet modification, pain management, pelvic floor physical therapy, psychological support and stress management and relaxation techniques.

When surgery is required, the Rush team also offers the latest in minimally invasive surgical procedures, including laparoscopic and robotic-assisted surgery as advanced techniques such as sacral neuromodulation, an innovative treatment for fecal and urinary incontinence that can reduce or eliminate symptoms. The Rush team also offers the latest in minimally invasive surgical procedures such as transanal endoscopic microsurgery for removal of rectal tumors and early stage rectal cancer without major abdominal surgery, which can limit the negative impact to muscle function, and sacral neuromodulation, which is an innovative treatment that can reduce or eliminate fecal and urinary incontinence symptoms.

The Program for Abdominal and Pelvic Health at Rush provides treatment for the following common issues:
• Chronic abdominal pain
• Colorectal cancer
• Constipation
• Cystitis (also known as interstitial cystitis), an inflammation of the bladder that causes frequent urination, burning sensation while urinating and the persistent urge to urinate
• Diarrhea
• Endometriosis
• Fecal incontinence
• Irritable bowl syndrome
• Pain after prostate cancer removal (prostatectomy)
• Prolapse of the bladder, rectum or vagina
• Rectal, abdominal, urinary, bladder or pelvic pain
• Sexual dysfunction
• Urinary incontinence
• Urinary infection
• Uterine fibroids
• Fistulas
• Pain in the vulva

The team of specialists includes colorectal surgeons Dr. Joanne Favuzza, Dr. Dana Hayden and Dr. Theodore Saclarides; colorectal surgery physician assistant Rachel Hendee; gastroenterologists Dr. Rana Abraham, Dr. Michael Brown, Dr. Kenika Robinson, Dr. Keith Bruninga; urologists Dr. Sarah Adelstein, Dr. Lev Elterman, Dr. Jerome Hoeksema, Dr. Laurence Levine; urology nurse practitioner Katherine Marchese; gynecologist Dr. Joseph Maurice; urogynecologists Dr. Cynthia Brincat; physiatrist Dr. Sheila Dugan; physical and occupational therapists Cara Murphy, Maureen Brennan, Lauren MacZak-McCarthy and Mary Mesch; psychologists Dr. Ann Hartlage, Dr. Nicole Heath, Dr. Sharon Jedel and Dr. Vanessa Tirone; and Rush radiologists.