Pelvic floor dysfunction

So a urogynecologist is a subspecialty of obstetrics and gynecology.

The focus is predominantly on female pelvic medicine, pelvic floor disorders, sexual dysfunction.

But the road to get to there was not so direct.

I always envisioned myself as a surgeon, but what type of surgery would I really feel that I could contribute most in wasn't determined until I was already in my last year of medical school.

So somehow during my training, especially in my early years of residency, when I did match into OB-GYN, I found that there's so much more that has not been talked about.

Besides pregnancy, besides disease, states, and cancer, and annual screening for preventive reasons, what about the wants? What about the lifestyle choices or the impact on quality of life after having children or after cancer treatment? So that really opened my eyes to an opportunity where I could serve our patients best.

So I pursued urogynecology, which is all about pelvic floor disorders and quality of life issues that more than half of the female population experience.

So as a urogynecologist, what that is, is the most common things that patients may be aware of, whether they experience it or they know somebody who has, we talk about these things in silence because of stigmas and shame, like incontinence or pelvic organ prolapse or changes in sexual health.

Thank you so much for having me.

So today we're going to talk all about pelvic floor disorders, your specialty.

But before we do that, for those who have not heard some of your prior podcasts, tell us a little bit about yourself and how did it come to the point that you came to the Cleveland Clinic?

Well, you recruited me to Cleveland Clinic.

Dr. Steele brought me over almost five years ago now, and I'm a colorectal surgeon, and I was kind of interested in pelvic floor, and he recruited me to do that.

And ever since coming to the clinic, I have built a multidisciplinary collaboration and pelvic floor service line, and we see patients from all over the country, really, with complex pelvic floor disorders.

We're so glad to have you here.

So, you know, we've touched on pelvic floor disorders on Butts and Guts several years ago, but we have a lot of new listeners, so we want to circle back.

If this natural gear shifting is so perfectly designed, why does it fail so spectacularly in the pelvic floor for millions of people?

Yeah, let's get into that because pelvic floor dysfunction or PFD is incredibly common.

It

really is.

What do you mean?

Like, if my arm is weak, I go to the gym, I pick up a dumbbell, I focus really hard, and I force it to get stronger.

Why can't someone dealing with pelvic floor dysfunction just hit the metaphorical gym, do a thousand Kegel exercises, and just force the muscle back into shape?

I mean, it is the most logical assumption to make.