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BackTable / OBGYN / Podcast / Episode #107

Multidisciplinary Approaches to Pelvic Floor Disorders

with Dr. Shannon Wallace, Dr. Anna Spivak, Dr. Mark Hoffman, Dr. Amy Park

Trouble with bowel or bladder function? It might be time to partner with a specialist. In this episode of BackTable OBGYN, hosts Dr. Amy Park and Dr. Mark Hoffman are joined by Dr. Shannon Wallace and Dr. Anna Spivak, experts from the Cleveland Clinic specializing in pelvic floor disorders. They dive into the complex world of combined colorectal and urogynecological issues, discussing the importance of a multidisciplinary approach to treat conditions such as rectal prolapse, constipation, and incontinence.

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Multidisciplinary Approaches to Pelvic Floor Disorders with Dr. Shannon Wallace, Dr. Anna Spivak, Dr. Mark Hoffman, Dr. Amy Park on the BackTable OBGYN Podcast
Ep 107 Multidisciplinary Approaches to Pelvic Floor Disorders with Dr. Shannon Wallace, Dr. Anna Spivak, Dr. Mark Hoffman, Dr. Amy Park
00:00 / 01:04

BackTable, LLC (Producer). (2026, February 23). Ep. 107 – Multidisciplinary Approaches to Pelvic Floor Disorders [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Mark Hoffman on the BackTable OBGYN Podcast

Dr. Mark Hoffman is a minimally invasive gynecologic surgeon at the University of Kentucky.

Dr. Amy Park on the BackTable OBGYN Podcast

Dr. Amy Park is the Section Head of Female Pelvic Medicine & Reconstructive Surgery at the Cleveland Clinic, and a co-host of the BackTable OBGYN Podcast.

Dr. Anna Spivak on the BackTable OBGYN Podcast

Dr. Anna Spivak is a female pelvic medicine and reconstructive surgeon practicing at the Cleveland Clinic in Cleveland, Ohio.

Dr. Shannon Wallace on the BackTable OBGYN Podcast

Dr. Shannon Wallace is a urogynecologist practicing at the Cleveland Clinic in Cleveland, Ohio.

Synopsis

The conversation covers detailed diagnostic methods like manometry and defecography, various surgical options, and the crucial role of pelvic floor physical therapy in patient recovery. They also provide insights into setting up effective multidisciplinary clinics and emphasize the need for teamwork and administrative support in delivering optimal patient care. This episode is a valuable resource for both specialists and generalists aiming to enhance their understanding and treatment of pelvic floor dysfunctions.

Timestamps

01:05 - Introduction
05:40 - Multi-Compartment Prolapse & Second Opinions
08:14 - Pelvic Floor Compartments Explained
10:36 - When Internal Prolapse Becomes Surgical
11:56 - Incomplete Emptying, Splinting, Fragmentation & Leakage
16:55 - Fluoro vs MRI and When to Order It
23:47 - Anorectal Manometry
26:56 - Physical Therapy, Biofeedback, Meds, Injections, & Motility Workup
29:08 - Robotic Mesh Repairs vs Vaginal/Perineal Approaches
34:43 - When (and Why) to Consider Biologics
36:46 - Resection Rectopexy
38:10 - Treating Ehlers-Danlos syndromes (EDS) & Eating Disorders
42:55 - Pelvic Floor PT After Surgery and Recovery Timelines
47:29- Perineal Prolapse Repairs (Altemeier vs Delorme)
49:53 - Symptom Improvement vs Retraining the 'New Normal'
52:20 - Fecal Incontinence & Sacral Neuromodulation
57:08 - Diarrhea-Driven Incontinence
58:56 - Building a Multidisciplinary Pelvic Floor Program
01:04:04 - Conclusion

Resources

Pelvic Floor Disorders Consortium (American Society of Colon & Rectal Surgeons) https://fascrs.org/Web/Web/My-ASCRS/Education/Pelvic-Floor-Disorders-Consortium.aspx

The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.

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