Our Programs

Urostym Program

Pelvic floor disorders such as urinary or bowel incontinence, pelvic organ prolapse, uterine prolapse, urinary urgency and frequency, and bladder or pelvic pain can be frustrating and troublesome for many women. Our comprehensive Urostym program provides complete care for weakened pelvic muscles. With a targeted Urostym evaluation, we are able to identify pelvic floor strength or endurance deficits allowing us to prescribe the most effective individualized treatment.

Vaginal Botox and Rehab Program

Our multidisciplinary team of physicians and physical therapists believe that pelvic pain disorders are, simply put, treatable. In many cases they can be cured and that is one reason we are passionate about treating them. While some physicians shy away from addressing these issues, we welcome women with this problem and are excited to offer them meaningful treatment options using pelvic floor physical therapy. In the minority of cases that are not responsive to physical therapy, pelvic floor Botox injections (in office or using brief anesthesia) are used to achieve cure of sexual and pelvic pain. We are confident in our ability to treat pain problems because we understand them and utilize a close collaborative approach with physical therapists which we believe is key to achieving a cure.

UTI Treatment Program

Urinary tract infections (UTIs) are very common among women of all ages and they can occur for many different reasons. In teenagers they may result from incomplete bladder emptying. Once young women become sexually active, they can be related to sexual intercourse. After women go through menopause they can be at increased risk as well. We provide easy access to treatment for women who suffer from urinary tract infections (UTIs) as well as decrease risk factors that contribute to such infection and improve quality of life.

Neurogenic Bladder Treatment

Neurological conditions like spinal cord injury, Parkinson’s and multiple sclerosis (MS) can all affect the bladder. In the Pacific Northwest, MS is more common. Treatments have greatly improved for this condition and patients are living longer and more functional lives. It is now more important than ever for women to receive contemporary and effective urinary tract care. We ensure women with neurological conditions that affect their bladders are offered all available treatment options including those traditionally used for women without neurogenic bladder conditions.

Vaginal Mesh Program

With the increasing awareness around the potential for surgical complications related to vaginal mesh implant surgery, our surgeons are dedicated to adhering to best practice guidelines and providing the best outcomes for our patients choosing a surgical care path. We provide appropriate, safe care of patients needing vaginal mesh surgery implant, revision, or removal to treat incontinence, prolapse, and pelvic floor dysfunction.

Teen & Young Adult Treatment

Our Adolescent Program was founded by Dr. Mia Swartz in order to address the unmet needs of this forgotten population. As if the adolescent years are not hard enough, issues of incontinence, voiding dysfunction, pelvic pain, painful sex and constipation affect some younger girls just as much as adult women. We treat common pelvic complaints that occur in girls aged 10-19 years of age in a safe, comfortable environment.

Stress Incontinence Program

We provide contemporary incontinence care that covers the entire treatment spectrum beginning with non-surgical options and progressing to surgical management where desired.

Elder Continence Program

Urinary incontinence and the unwanted leakage of urine happens more frequently as women age and can be due to a number of preventable and treatable causes. About half of women over 50 years old have some daily bother with bladder control and the numbers affected only increase as women age. The Elder Continence Program assesses each individual woman’s risks for incontinence and tailors a program that will be acceptable to her and her caregivers.

Overactive Bladder Program

We identify treatable causes of overactive bladder (frequency, urgency with urine leakage) using holistic approaches and where medication or procedures are needed the full spectrum of options are offered.

Pelvic Pain Treatment

Pelvic pain and dyspareunia (pain with intercourse) in women is not a rare problem and is treatable in many cases.  Our aim is to find treatable causes of pelvic pain and often the source of this problem is as simple as tight pelvic floor muscles. When a woman or girl comes to us with a complaint of pelvic pain, a careful anatomical evaluation is undertaken which includes urine cultures and a pelvic ultrasound to make sure there are no issues with reproductive organs.

Prolapse Treatment

Pelvic organ prolapse is a weakness in the fibrous tissue (fasciae) as well as ligaments that can lead to bulging of pelvic organs. For the most part, pelvic organ prolapse is not dangerous, but can have a significant impact on a woman’s quality of life. Each patient seen for possible prolapse treatment undergoes a thorough evaluation to determine the exact nature of her symptoms and what is bothering her the most.

Our Services

Things We Treat

• Adolescent incontinence and other urinary symptoms in girls 10-19 years of age
• Adult urinary incontinence
• Bed wetting in all ages
• Bladder stones
• Bladder tumors
• Cloacal anomalies
• Constipation
• Elder urinary incontinence
• Endoanal sphincter defects
• Fecal incontinence (all ages)

• Fistula involving the rectum, urinary and anal tracts
• Groin and pelvic injuries
• Hematuria and blood in the urine
• Interstitial cystitis (IC)
• Kidney stones
• Labial asymmetry
• Labial enlargement
• Menopause changes in tissue “atrophic vaginitis”
• Nocturia which is frequent urination at night time interrupting sleep

• Overactive bladder
• Pain with intercourse “dyspareunia”
• Pain with tampon placement
• Pelvic floor muscle dysfunction (both low and high tone)
• Pelvic pain
• Pudendal nerve injuries
• Radiation associated injuries or dysfunction
• Ureter stones
• Urethral and bladder diverticulum

• Urethral strictures
• Urethral tumors
• Urinary incontinence (all types)
• Urinary retention and incomplete emptying
• Urinary tract infections (UTIs)
• Vaginal dryness
• Vaginal injury with deliveries
• Vaginismus
• Vesico-ureteral reflux
• Vulvodynia

Procedures We Perform

• Bladder chemotherapy instillations
• Bladder tumor removal and surveillance
• Botox bladder injections
• Botox pelvic floor muscles
• Botox urinary sphincter
• Bowel-vaginal fistula repairs
• Cystoscopy
• Diverticulectomy (bladder as well as urethra)
• Endometrial biopsy
• Fibroidectomy – removal of fibroids

• Genital skin revisions and correction of congenital defects
• Hidradenitis skin treatment and surgical care
• Hydrodistention of bladder
• Hysterectomy
• Labial contouring and restoration
• Laparoscopic gynecologic reconstructive surgery
• Mesh removal surgery (slings, other vaginal mesh) and revision for mesh complications
• Mid-urethral slings (mesh, biological, native tissue)

• Neuromodulation (PTNS, SNS, Interstim)
• Oophorectomy – removal of ovaries or ovarian benign lesions
• Removal of ovaries
• Repair of obstetrical and vaginal injuries
• Robotic gynecologic reconstructive surgery
• Sacrocolpopexy
• Skin biopsy
• Transvaginal mesh implant surgery

• Urethral bulking to treat incontinence
• Urethral reconstruction
• Urinary-vaginal fistula repairs
• Urodynamics
• Vaginal cyst removal
• Vaginal prolapse repairs (all forms of surgery offered from robotic to vaginal, mesh graft and natural tissue repairs)
• Vaginal reconstruction and restoration – mommy makeover
• Vaginal suspensions for prolapse