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Female pelvic medicine and reconstructive surgery

Wichita's Ascension Medical Group adds specialist in female pelvic medicine

Native Wichitan Simon Patton, MD, recently joined Ascension Medical Group, providing services in a relatively new female-focused field of medicine. Dr. Patton is board-certified in the subspecialty of female pelvic medicine and reconstructive surgery, also known as urogynecology. The American Board of Medical Specialties approved the subspecialty in 2011 and the first doctors were board-certified in 2013, according to the American Urogynecologic Society (AUGS).

Like other urogynecologists, Dr. Patton has received additional training and experience in evaluating and treating conditions that affect the female pelvic organs and surrounding muscles and connective tissues. After an obstetrics/gynecology residency at Mercy Hospital in St. Louis from 2011-15, Dr. Patton completed a three-year fellowship in female pelvic medicine and reconstructive surgery at the University of South Florida in Tampa. He joined Wichita-based Ascension Medical Group in September 2018.

Like many physicians who care for expectant mothers, Dr. Patton enjoyed “taking care of women at such an exciting time of their life. I would tell people it's the only time people bring balloons to the hospital.”

But during his residency, he saw women devastated by another condition unique to the female body – that of pelvic floor disorders, or PFDs. He said he saw more women cry as they visited the OB/GYN department at Mercy Hospital for conditions related to PFD and other pelvic organ conditions than when they were diagnosed with gynecological cancers.

“It's a quality of life issue,” said Dr. Patton.

The symptoms of PFDs and pelvic organ conditions are not only embarrassing for women, but also can lead to serious health issues. The pelvic floor refers to the network of muscles, ligaments and connective tissue that support the bowel, bladder, uterus, vagina and rectum.

PFDs are relatively common, according to AUGS. One out of four women 20 years and older suffer with PFDs – most commonly pelvic organ prolapse, urinary incontinence and accidental bowel leakage, and more than half of women age 55 and older have one or more problems with PFDs, the society reports. Other PFDs include fistulas caused by pelvic organ damage and overactive bladder. Pelvic floor prolapse includes the so-called dropping and sometimes bulging of the vagina, uterus, cystocele and rectocele.

Risk factors including aging, heavy lifting, straining from constipation, chronic coughing and genetics. Childbirth is a major contributing factor, with one in three women who have given birth having prolapse, according to AUGS. Diseases that affect the nervous system, like Parkinson's disease, can also increase a woman’s risk for PFDs.

Because of its prevalence and because many women may find it uncomfortable to discuss symptoms of PFDs, general practitioners and other physicians may need to take a more active role in talking to patients about the conditions, said Dr. Patton.

“A lot of women experience this and don't want to talk about it,” he said.

As a new doctor in a relatively new field, Dr. Patton has been visiting with physicians in private practice and in clinics outside of Wichita. “I’m finding they’re pleased to learn that they have a resource for more complex or complicated cases as well as for issues outside their area of comfort or expertise,” said Dr. Patton.

There are a variety of nonsurgical and surgical treatment options, depending on a woman's condition and diagnosis, Dr. Patton said.

Nonsurgical options include physical therapy, using a silicone, diaphragm-like pessary device to hold up prolapse, and even lifestyle and dietary modifications, he said. For example, a 5-10 percent weight loss can reduce urinary issues by half, Dr. Patton cited. Avoiding bladder irritants such as caffeinated beverages and spicy or citrus-laden food can also help, as can a more diligent bathroom break schedule. Eating more fiber can help reduce constipation and straining.

Surgical options can include reconstruction of the pelvic floor support structure by using a portion of the patient's uterosacral or sacrospinous ligaments, Dr. Patton explained. Another option is the grafting of a mesh implant. The use of transvaginal mesh has declined since the FDA issued warnings of its failure in 2011, but mesh implanted through the abdomen can still be a viable option, Dr. Patton said.

“The key is figuring out the right treatment plan for the patient.”

For referrals or consultations with Dr. Patton about screening and treatment options of pelvic floor disorders, call 316-636-1550.