First-of-its-kind opens in Southwest Orange

Orlando Health Dr. P. Phillips Hospital now has a new clinic on its campus. 

The first-of-its-kind clinic integrates the Orlando Health Colon and Rectal Institute and the Orlando Health Women’s Institute Center for Urogynecology to target pelvic health disorders. It is located at 7350 Sand Lake Commons Blvd., Suite 2225 in Medplex B, Orlando. 

“Many people silently struggle with functional problems related to going to the restroom — difficulty, discomfort, embarrassment — and they never seek help because it feels like a taboo subject,” said Dr. Antonio Caycedo, chief of colorectal surgery and medical director at Orlando Health Colon and Rectal Institute. “These are incredibly common problems, and the important message is that you do not have to live with them. This clinic was built precisely to help you, and we are here without judgment.” 

According to Orlando Health, one in four women older than 20 has at least one pelvic floor disorder, which makes this clinic the perfect place to stop by and get checked — whether by a urogynecologist, colorectal doctor or both.

“The pelvic floor is made up of many things, including but not limited to the bladder, vagina, reproductive organs, bowel, muscles, nerves, ligaments,” urogynecologist Dr. Samantha Margulies said. “Instead of siloing each organ, a combined clinic offering urogyn and colorectal (services) helps to diagnose and treat conditions that could be affecting more than one part of the pelvis.”

For example, Margulies said pelvic floor muscle dysfunction can affect both the bladder and bowel. Having a clinic with a multidisciplinary approach makes it easier for patients to seek the necessary care and prevents them from needing to schedule separate surgeries, undergo anesthesia twice and relieve some stress that comes with it. 

In addition to pelvic floor muscle dysfunction, the Orlando Health Colon and Rectal Institute and the Orlando Health Women’s Institute Center for Urogynecology treat several other disorders. 

Margulies’ expertise also includes urinary incontinence, recurrent urinary tract infections, urinary retention, vaginal cysts, vaginal reconstructive surgeries, urodynamics and more. 

“Many patients are too embarrassed to bring up these symptoms to their providers, and those that do bring up these symptoms many times are told these conditions are normal and (aren’t) offered treatment,” she said. “While these diagnoses are common, that does not mean that they are normal and does not mean women need to live like this. The toll these conditions take on someone’s quality of life is outstanding.” 

To decrease risk of pelvic floor dysfunction, Margulies recommends pelvic floor physical therapy. 

“There are physical therapists with a specific training in the pelvic floor,” she said. “They are incredible, and I can’t recommend them enough. I am thankful that I have joined a health care system that shares this sentiment and has many fabulous pelvic floor physical therapists.” 

On the colorectal side, Caycedo said the clinic treats colorectal and anal cancers, precancerous polyps, hemorrhoids, anal fissures, fistulas, diverticular disease, fecal incontinence, chronic constipation and more. 

“What truly sets us apart is our focused expertise in functional and complex conditions (such as) pelvic floor disorders, fecal incontinence, chronic constipation, and dysmotility—areas that are often underserved,” Caycedo said. “We work in close collaboration with urogynecology, and we also house a specialized High Resolution Anoscopy Program, which is quite unique in this region. There is really nothing else quite like this clinic in Orlando.” 

To avoid colorectal issues, Caycedo said it starts with maintaining a healthy diet and staying active. 

Beyond that, he recommends early screenings or getting a colonoscopy. 

“I know many people feel it is too invasive, but I always remind my patients that it is far more invasive to deal with cancer,” he said. “And please, do not ignore warning signs: rectal bleeding, a sudden change in bowel habits, constipation lasting several weeks, unexplained weight loss, or anemia are all reasons to speak with a doctor and ask about a colonoscopy.” 

Since the clinic’s opening, there have been many success stories, Caycedo and Margulies said. 

“When we perform surgery for colorectal cancer, we are in many cases saving a life right there in that operating room, and when we perform a colonoscopy and remove a precancerous polyp, we are preventing cancer before it even begins,” Caycedo said. “That is the extraordinary privilege of this work, and I share it with a truly exceptional group of surgeons and colleagues.” 

Margulies also feels privileged to work alongside surgeons and colleagues who have a passion for urogynecology and colorectal services. 

“I see success stories every day in clinic,” she said. “This ranges from finally eliminating the recurrent urinary tract infections, relieving symptoms of a vaginal bulge, decreasing number of pads used for incontinence. … Imagine a woman using five adult diapers per day because of urinary leakage. This is not an uncommon story I hear.” 

Margulies said diapers can put a financial burden on the woman or a family, cause vulvar skin irritation or embarrassment and even is associated with increased nursing home admission. 

“With different treatment options, we often can significantly reduce the number of diapers or pads a patient needs, significantly improving her health and quality of life,” she said. “Hearing that a patient was able to attend their grandson’s piano recital without mapping out every bathroom location in the building, being able to ace a pickleball match without leaking, being able to dance at their daughter’s wedding without feeling a bulge or pressure in their vagina, going on a cruise without antibiotics for fear of a UTI — it’s so great.” 

Both doctors are excited to be working at a clinic offering such critical services to the Southwest and West Orange communities. 

“Do not wait for a problem to become serious before you seek help,” Caycedo said. “Whether it is a screening colonoscopy, a concern you have been putting off or a functional issue you have been quietly living with, we are here, we are ready and we genuinely care about helping you.”