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Froedtert Today

March 2008 Issue

Team Specializes in Women’s Sexual Health, Pelvic Disorders and Incontinence


Urinary incontinence, pelvic organ prolapse and sexual health issues may be difficult to discuss, even with a physician. In addition to causing discomfort and inconvenience, these problems often cause unnecessary stress, embarrassment and social isolation.

Women experiencing these health concerns can find compassionate care through the Women’s Incontinence and Sexual Health (WISH) Program at Froedtert & the Medical College of Wisconsin. Experts who specialize in women’s pelvic and sexual health disorders help women deal with the physical and emotional aspects of these problems. The program is unique in the Midwest in the size and expertise of its staff and in the scope of services offered.

Program Designed by Women
The WISH Program design was based on feedback from women regarding the types of services they want. With patient privacy in mind, the WISH clinic has a discreet entrance, its own waiting room and a bathroom in each exam room. All services are provided in the clinic.

Specialized Team
The WISH team is dedicated solely to improving the quality of life for women. Team members treat the whole woman – body and mind.

When a woman first calls, program coordinator Julie Rack, RN, spends time discussing the woman’s concerns.

“I determine which team member a woman should see based on her concerns, the type of doctor she’s looking for and the urgency of her problem,” Rack said.

Team members include fellowship-trained physicians:

  • Urogynecologists – gynecologists who are specially trained to treat problems of the female urinary and reproductive system, such as incontinence and pelvic organ prolapse
  • Urologists who specialize in women’s urologic conditions
  • A urologist who only treats women’s sexual health issues

The comprehensive WISH team also includes a clinical psychologist, physician assistant, physical therapist and nurse practitioner. Physicians conduct a thorough evaluation and create a personalized care plan to meet each woman’s unique needs. Team members fully explain disorders and treatment options to help women make educated choices.

Sexual Health Issues
Medical College of Wisconsin urologist Margarita Kressin, MD, specializes in evaluating and treating women’s sexual health issues, including low libido, lubrication/arousal problems, orgasm disorders and sexual pain disorders.

“These problems affect women of all ages and are caused by psychological issues, medical problems, low hormone levels and other factors,” Dr. Kressin said. “That’s why we use a team approach for each patient we see.

“There’s no other program like this in Wisconsin from a sexual health standpoint, and our multidisciplinary team approach is unique. We provide a confidential place to address these concerns.”

During the initial visit, Dr. Kressin takes a medical history, does a physical exam, and performs nerve function and pelvic blood flow tests. Because certain drugs can affect libido, Dr. Kressin also reviews medications.

Psychological Evaluation
When a woman contacts the WISH program for a sexual health concern, she is encouraged to see Medical College of Wisconsin psychologist Laura Liguori, PhD. Dr. Liguori is experienced in sex therapy and relationship issues, including couples therapy.

Incontinence (an involuntary leakage of urine or feces) and pelvic organ prolapse (a disorder in which the vagina, bladder and/or uterus fall or bulge) are common in women. These conditions often coexist, and both can affect quality of life.

Medical College of Wisconsin obstetrician/gynecologists Sumana Koduri, MD, and Julianne Newcomer, MD, specialize in urogynecology – a subspecialty of obstetrics and gynecology – and treat women with incontinence, prolapse and other pelvic floor disorders.

“For women, sex and emotions are intertwined, and the importance of sexuality is different for each woman,” Dr. Liguori said. “I talk to women about the emotional side of sexuality and what they can do to enhance self image and arousal.”

Dr. Liguori shares her evaluation with Dr. Kressin and Elizabeth Malak, MPT, physical therapist, so they can incorporate the information into the woman’s overall treatment. “We discuss each patient to make sure we’re all on the same page,” Dr. Kressin said.

Dr. Liguori helps women separate emotional issues of sexuality from medical issues, which Dr. Kressin addresses. “The team approach is very effective in this program,” Dr. Liguori said. “We try to make this a place where women can feel safe.”

“We encourage spouses to be involved, but leave it up to each woman,” Dr. Kressin said. “Sometimes a man needs to hear from a third party – a professional – about what his wife is experiencing. We want them to reach their goals together.”

In addition to a psychological evaluation, treatment for sexual health issues may include medication (for low libido or pain during or after intercourse), hormonal therapy and physical therapy.

“Women don’t talk about these issues, and sometimes they’re told they just have to live with them. But their quality of life is very important,” Dr. Koduri said. Because Dr. Koduri only performs surgeries for incontinence and prolapse, she has seen a wide range of these conditions. “I perform surgery every week – more than a regular gynecologist does – and have the experience to deal with complications,” she said.

Medical College of Wisconsin urologists Michael Guralnick, MD, and R. Corey O’Connor, MD, also treat women for female incontinence and voiding disorders. Because they have specialized (fellowship) training in reconstructive and female urology, they can handle the most complex cases. “It’s not normal to leak urine or have other pelvic problems,” Dr. O’Connor said. “With state-of-the-art diagnostic tools and surgical techniques, we offer many options to fit each individual. We have the expertise to treat all types of incontinence and voiding dysfunction conditions.”

The WISH Program offers expertise in all of these complex issues. If you suffer from one of them, don’t hesitate to ask about your options.

Visit froedtert.com/wish for more information. For an appointment, call 414-805-3666 or 800-272-3666.

 

 

Source: Froedtert Today

Date: March 2008

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