New Integrated, Multidisciplinary Pelvic Health Program

AdventHealth Launches Integrated, Multidisciplinary Pelvic Health Program

AdventHealth recently launched a new integrated Pelvic Health Program that brings together a team of multidisciplinary pelvic health physicians, pelvic floor therapists and pelvic health nurse navigators to provide patients suffering from pelvic floor disorders with more supportive, cohesive and seamless care.

Pelvic floor disorders, including urinary incontinence, fecal incontinence and pelvic organ prolapse, affect approximately one in four women in the United States. Aging and obesity are both associated with increased incidence. In fact, pelvic floor disorders affect about 30% of women age 50-59, 40% of those age 60-69, and 50% of women 80 and older. As a result of the aging population and obesity epidemic in the U.S., the prevalence of pelvic floor disorders is expected to increase over the next decade.

AdventHealth has cared for patients with pelvic floor disorders for many years. However, the increasing prevalence and complexity of these conditions, including the need for both urogynecological and colorectal physician care, led AdventHealth urogynecologist Nathan Kow, MD, to establish the Pelvic Health Program with a focus on enhancing coordination, streamlining communication, and leveraging systemwide resources to improve the patient experience and meet growing community needs.

“Pelvic floor conditions can occur together and caring for these patients requires a multitude of services and specialists,” explains Dr. Kow who serves as the Program Director. “Patients may require care or surgery from both urogynecologic and colorectal physicians as well as imaging, testing and pelvic floor therapy. By integrating our services through this new program, we are better able to identify and care for even the most complex cases, including operating together to correct all abnormalities in a single surgical procedure.”

Treatment for Complex Pelvic Health Disorders

Because pelvic floor disorders can occur concurrently, they often require advanced treatment and surgery from a multidisciplinary care team that can include urogynecology, urology, colorectal surgery, gastroenterology, and pelvic rehabilitation therapy. The AdventHealth Pelvic Health Program provides care for even the most complex cases, including the following disorders:

• Urinary incontinence
• Fecal incontinence
• Voiding dysfunction
• Anal stenosis
• Anismus
• Pelvic floor dysfunction
• Pelvic organ prolapse (cystocele, rectocele, uterine and vault prolapse)
• Rectal prolapse
• Rectovaginal fistula
• Recurrent urinary tract infections
• Urethral diverticulum
• Urinary retention
• Vaginal mesh complications
• Vesicovaginal fistula

The Pelvic Health Program’s medical team employs a range of surgical treatments, including vaginal, laparoscopic and robotic minimally invasive techniques, to reduce patient discomfort and shorten recovery time. The program also offers pelvic floor physical therapy from board-certified physical therapists with specialized training in treating bowel and bladder function, pelvic pain, abdominal/organ conditions and other pelvic floor dysfunctions.

Enhanced Care Coordination

One of the new services provided through the Pelvic Health Program is care coordination by a pelvic health nurse navigation team. Nurse navigators can enhance communication, reduce delays in care and improve quality of life for patients with complex chronic conditions and disease states.

The AdventHealth Pelvic Health Program utilizes a Women’s Nurse Navigator as well as two specially trained, registered nurse, Pelvic Health Care Coordinators who serve as a single point of contact for pelvic floor disorder patients and help to manage their care, including assistance with:

• Finding the right care provider(s)
• Scheduling appointments
• Coordinating care amongst multiple providers and facilities
• Answering pelvic health care questions
• Providing pre- and post-operative counseling and education

“Our nurse navigators are the hallmark of this new program,” shares Dr. Kow. “While cancer programs have successfully employed nurse navigators for more than two decades to help integrate services and address fragmented care systems, this approach has not really been applied before to treating pelvic floor disorders. We saw this as a tremendous opportunity to build relationships with our patients, and we believe our nurse navigators are critical to providing them with personalized, timely, whole-person care.”

In addition to care coordination, the Pelvic Health Program has instituted a structured framework for bi-monthly, multidisciplinary pelvic health conferences that bring together pelvic health providers from throughout the system to discuss complex cases.

Looking Ahead

Dr. Kow hopes to expand Pelvic Health Program services to additional locations in the coming years with the goal of enhancing reach and access so patients can get the care they need closer to home. His team is also exploring new targeted services, including specialized pelvic health care for new mothers as well as caring for women’s pelvic health needs after gynecological surgery. In addition, the Pelvic Health Program is creating infrastructure that will allow for benchmarking the program’s progress in reducing delays of care and enhancing patient satisfaction and quality of life.

“We are at the forefront and pushing the boundaries of what a pelvic health program can achieve,” he said.

To refer a patient to the AdventHealth Pelvic Health Program, call Call855-843-8424 or to learn more, visit PelvicHealthExperts.com.

About Nathan Kow, MD

AdventHealth Pelvic Health Program Director Nathan Kow, MD, is an OB/GYN and urogynecologist who cares for women with complex pelvic floor issues, including pelvic organ prolapse, urinary incontinence, fecal incontinence, vesicovaginal and rectovaginal fistulas, disorders of the lower urinary tract and mesh complications. Board certified in obstetrics and gynecology as well as female pelvic health and reconstructive medicine, he uses both non-surgical and surgical options, including vaginal, laparoscopic and robotic pelvic reconstructive procedures.

After graduating from Emory University, Dr. Kow earned his medical degree from Mercer University School of Medicine in Georgia and completed an obstetrics and gynecology residency at Tufts Medical Center in Boston as well as a three-year fellowship in female pelvic medicine and reconstructive surgery at the Cleveland Clinic in Ohio. He serves as a member of the American Urogynecologic Society, American College of Surgeons, American College of Obstetricians and Gynecologists, and the Society of Gynecologic Surgeons. Dr. Kow has authored many original research papers in urogynecology and serves as an editorial board member for the International Academy of Pelvic Surgery. He also frequently teaches in regional and national surgical skills labs focused on reconstructive pelvic surgery

AdventHealth Pelvic Health Program Physician Team

Nathan Kow, MD, Director

Urogynecologist

Link to bio: Nathan Kow, MD | OBGYN | Orlando, FL | AdventHealth)

Elizabeth Sherlock, PA-C

Physician Assistant, Urogynecology

Link to bio: Elizabeth Sherlock, PA | Urogynecology | Orlando, FL | AdventHealth

Jeremy Drake, MD

Colorectal Surgeon

Link to bio: Jeremy M. Drake, MD | Colon and Rectal Surgery | Kissimmee, FL | AdventHealth

Karoline Neumann, APRN, NP-C

Nurse Practitioner, Colorectal Surgery

Link to bio: Karoline Neumann, ARNP, NP-C | Colon and Rectal Surgery | Orlando, FL | AdventHealth

Teresa deBeche-Adams, MD, FACS, FASCRS

Colorectal Surgeon

Link to bio: Teresa H. deBeche-Adams, MD | Colon and Rectal Surgery | Orlando, FL | AdventHealth

Daniel Hoffman, MD

Urologist

Link to bio: Daniel Hoffman, MD | Urogynecology | Altamonte Springs, FL | AdventHealth

Daniel Galante, DO, FACS

Colorectal Surgeon

Link to bio: Daniel Galante, DO | Colon and Rectal Surgery | Oviedo, FL | AdventHealth

Lindsay Kissane, MD

Urogynecologist

Lindsay Kissane, MD | OBGYN | Orlando, FL | AdventHealth

Julie Schneider, MD

Urogynecologist

Link to bio: Julie Schneider, MD | Urogynecology | Ormond Beach, FL | AdventHealth

AdventHealth Pelvic Health Program Navigation Team

Doreen Forsythe, BSN, RN

Women’s Health Navigator

Kathryn Ong, RN

Pelvic Health Care Coordinator

Amy Royer, RN

Pelvic Health Care Coordinator