The Woman’s Center for Advanced Pelvic Surgery is the premier center in Arizona dedicated to treating female pelvic floor disorders such as urinary and fecal incontinence, bladder and bowel dysfunction, and pelvic organ prolapse. The center provides state-of-the-art diagnostic and treatment options for women with pelvic floor disorders.

Ryan R. Stratford, MD founded this uniquely specialized center for female pelvic floor disorders. Kelly Kantartzis, MD recently joined this busy practice. Together with Andrea Levkowitz, DPT, a highly trained Physical Therapit, they are experienced clinicians who provide treatment for all types of pelvic floor disorders. They are parents and community volunteers. They work together with one clear goal: to improve the quality of life for women suffering from pelvic floor disorders.

Pelvic Floor Muscle Weakness or Pain

Pain during Intercourse

Urinary Incontinence

Fecal Incontinence

Awaking at Night to Urinate

Constipation

Pelvic Organ Prolapse or “Bladder Falling”

Pelvic Injuries after Vaginal Delivery

Overactive bladder

Pelvic Floor Physical Therapy

PFD is often undertreated because women delay seeking treatment for reasons such as embarrassment, not knowing that effective treatment exists, not knowing where to turn for help, or believe it is a natural part of aging. At The Woman’s Center for Advanced Pelvic Surgery, we are committed to advancing treatment options with a team centered approach.

Treatment options for pelvic floor dysfunction include:

Biofeedback Therapy  Behavioral Therapy

Pharmacotherapy          Electrical Stimulation

Pessary Management    Dietary Management

Women with pelvic floor dysfunction (PFD) benefit from pelvic floor therapy and rehabilitation. Pelvic floor therapy and rehabilitation is a non-surgical approach to improving the function and strength of the pelvic floor muscles. Advancements in technology allow for evaluation, diagnosis, and treatment of PFD. Types of PFD commonly treated with non-surgical intervention include:

Pelvic floor therapy and rehabilitation for PFD is well supported by research and is validated by positive patient outcomes.

Services Offering - Testing

Cystoscopy: Cystoscopy is a diagnostic procedure designed to examine the bladder and urethra. Cystoscopy can assist in identifying problems with the urinary tract, such as early signs of cancer, infection, strictures (narrowing), obstruction, and bleeding. To perform cystoscopy, a small camera, called a cystoscope, is inserted into the urethra and advanced into the bladder. This allows the physician to evaluate the inside of the bladder and urethra on a monitor where you will also be able to follow along if you chose.

Urodynamics: The Woman’s Center for Advanced Pelvic Surgery is a leader in the field of complex urodynamics testing and interpretation. These studies are conducted to evaluate causes for leaking urine, difficulty emptying the bladder, frequent urination, and loss of bladder support. To understand your bladder function in every detail, a specialized catheter is placed in your bladder which measures function during bladder filling, during activities performed with a full bladder, and during voiding. Instructions on how to prepare for your testing are provided.

Endoanal ultrasound: Endoanal ultrasound is a procedure that evaluates the muscles of the anal canal, looking for abnormalities that may have been caused by delivery of a baby. This can be useful in the evaluation of fecal incontinence or complicated pelvic floor injuries that occurred with childbirth. A small probed that emits sound waves is placed in the rectum and images are transmitted to a screen. No ionizing radiation (x-ray) is involved in ultrasound imaging.

Bladder Retraining – This treatment for urge incontinence involves teaching a patient to urinate according to a timetable rather than when she feels an urge. Gradually, the scheduled time between trips to the bathroom is increased as the patient’s bladder control improves. Commonly, bladder retraining is combined with pelvic floor muscle rehabilitation.

Pessaries –Pessaries are devices made out of silicon that are used to hold up vaginal prolapse. They can also be used to provide support underneath the bladder and urethra and help in the treatment of stress incontinence. Several types and sizes are available. Choosing the right size and shape makes their use easy, comfortable and manageable.

Tension-free Vaginal Tape (TVT) / Mid-urethral Sling – A special type of sling that has become the standard of care for most types of urinary stress incontinence. A ribbon-like piece of permanent mesh is placed underneath the urethra to provide support to the urethra and prevent urinary stress incontinence. It is minimally invasive with excellent long-term outcomes.

Periurethral Injections – This procedure involves an injection of material next to urethra to prevent stress incontinence.

Sacral Neuromodulation (Interstim) – This approach treats overactive bladder, urinary retention, urinary frequency, and fecal incontinence. Electrodes are placed near the nerves that control the bladder. First a test electrode is placed and trialed. If significant improvement is found then the electrode is left for long-term treatment.

Cystoscopic Botox injections: A newer therapy for overactive bladder involves injection of Botox directly into the bladder muscle