by Kelsey Herbers
To meet the growing demand for specialized and comprehensive women’s care services, Vanderbilt’s Department of Obstetrics and Gynecology (OB-GYN) has opened three new clinics focusing on peripartum and perineal disorders, infertility and polycystic ovary syndrome.
The Perineal Clinic, which launched in December 2018, is mainly designed for women who have disorders of the perineum related to pregnancy and childbirth. Common conditions treated by the clinic include extensive (third or fourth degree) lacerations or tears that occurred during delivery, dyspareunia (pain during intercourse) due to delivery and urinary or fecal incontinence related to childbirth. Patients who have experienced these issues during past pregnancies are also evaluated during subsequent pregnancies to prevent future occurrences.
The clinic, located at the Vanderbilt Center for Women’s Health One Hundred Oaks, is led by Nicola White, MD, assistant professor of OB-GYN, in conjunction with Nicole Motzny, PT, DPT, a pelvic floor physical therapist. The pair also has a consultation service with Urogynecology in case complex surgical care is needed.
“This is the first time it’s going to be myself and one of the physical therapists working together in the clinic, so these patients can come get an evaluation, make sure their tear is healing correctly and see if they need surgical intervention or if they’re more amenable to going the physical therapy route,” said White.
“For patients who have had big tears, there’s research that shows having consistent and early follow-up can improve the healing process and identify any infections and problems earlier, which typically leads to better outcomes long-term.”
The launch of the Perineal Clinic follows the opening of the Vanderbilt Fertility Clinic, which began seeing patients in March 2018.
Operating inside the Vanderbilt Center for Women’s Health Cool Springs, the clinic offers services such as egg and sperm donations, gestational carrier, intrauterine insemination, fertility preservation through freezing eggs, embryos or semen, in vitro fertilization and embryo transfer, and ovulation induction.
“I see a very diverse group of patients — not just patients with infertility issues, but those with recurrent pregnancy loss, birth defects of the uterus that need to be surgically corrected and patients with genetic disorders, such as Turner Syndrome,” said Donna Session, MD, associate professor of OB-GYN and head of the Fertility Clinic.
“We’re building a program, and it’s been a great educational opportunity for our residents. We’re looking to add fellows in the near future, expand our research opportunities and also become more involved in services such as oncofertility. The most exciting part is the growth.”
Patients with polycystic ovary syndrome (PCOS), or who believe they may have PCOS, are able to receive care at Vanderbilt’s PCOS Clinic, directed by Michelle Roach, MD, assistant professor of OB-GYN, and Melissa Wellons, MD, associate professor of Medicine. Opening its doors in 2017 within the Vanderbilt Center for Women’s Health One Hundred Oaks, the PCOS Clinic helps patients manage symptoms such as irregular or abnormal bleeding, abnormal hair growth or loss, acne and infertility.
The clinic is conveniently located down the hall from the Vanderbilt Weight Loss Center and Vanderbilt Dermatology, to which patients can be referred for relevant symptoms.
“Most patients with PCOS need counseling and education on the different symptoms and treatment options, and physicians in other clinics may not always have the time to sit with the patient and discuss these things in depth, so this clinic provides a place for patients to get the answers and comprehensive care they need,” said Roach. “Many women may have never received appropriate counseling. We are able to provide complete care to patients with PCOS, which really can change lives. “
According to Ronald Alvarez, MD, chair of Vanderbilt’s Department of OB-GYN, collaborating with other departments within the Medical Center through specialized clinics helps provide VUMC patients with a more holistic approach to care.
“VUMC has the unique ability to pull together a team of multidisciplinary providers to help women who suffer from complex problems of the nature these clinics are addressing,” said Alvarez.
