The Center for Colorectal and Pelvic Floor Disorders

The Center for Colorectal and Pelvic Floor Disorders at USC is staffed by academic colorectal and pelvic floor surgeons, who combine advanced diagnostic and imaging techniques with innovative surgical approaches to evaluate and treat patients suffering from benign and malignant disorders of the colon, rectum, anus, and pelvic floor. A central theme of the unit is multidisciplinary collaboration with colleagues from other specialties. This collaboration allows for state-of-the-art care that crosses traditional referral boundaries.

Our primary division offices are located at the Doheny Eye Institute adjacent to USC University Hospital. The University Hospital Anorectal Physiology Laboratory is located in the Center for Colorectal and Pelvic Floor Disorders medical suite.

Specialties

Physicians at the Center for Colorectal and Pelvic Floor Disorders have clinical expertise in treating patients with pelvic floor dysfunction, as well as expertise in a variety of benign and malignant diseases of the colon, rectum, and anus including cancer, ulcerative colitis, constipation, incontinence, diverticulitis, and common anorectal disorders (including hemorrhoids, anal fissures, fistulae, abscesses).

Diagnostics & Imaging - The University Hospital Anorectal Physiology Laboratory provides comprehensive anorectal physiology testing. Anorectal physiology is the study of the function of the lower bowel, the anus and the anal sphincter mechanism. The imaging equipment in the Anorectal Physiology Lab is utilized to look at the anal canal anatomy for anal sphincter tears, chronic anal infections, rectal/anal tumors, staging of rectal/anal cancers, follow-up for cancer recurrence, evaluation of loss of bowel control, and other disorders.

We are one of a few sites to offer the advanced imaging techniques of the Falcon 2101, 3-D Ultrasound. This equipment provides clear data acquisition with the advantage of easy manipulation of data cubes for viewing 3-D images from different angles. An added benefit of this equipment is further precision in directing ultrasound guided biopsy for suspicious rectal and perirectal lesions.

Cancer - Patients with colon, rectal, or anal cancer will be treated by a multidisciplinary team of experts including colorectal surgeons, radiation oncologists, medical oncologists, gastroenterologists, enterostomal therapists, and nurse specialists. High-risk patients and their families have the opportunity to meet with genetic counselors to assess risk and discuss genetic testing if desired. In consultation with the patient and referring physicians, the optimal treatment plan for eradication and management of cancer is discussed and planned. Treatment plans may include neoadjuvant chemo and radiation therapy for rectal cancer, advanced techniques in anal sphincter preservation with rectal reconstruction, and participation in clinical trials offering the latest advances in chemotherapeutic agents. Postoperative care may be augmented by pelvic floor physical therapy to hasten functional recovery.

Pelvic Floor Disorders - The effects of childbirth, aging, menopause, and chronic straining on the female pelvic floor have led to a national epidemic of pelvic floor disorders. Symptomatic patients experience loss of bowel/urinary control, pelvic organ prolapse, rectal prolapse, chronic pelvic pain, constipation, sexual dysfunction.

Obesity is an additional risk factor for pelvic floor disorders. Excessive body weight adds extra strain to the pelvic floor resulting in pelvic floor dysfunction. Dr. Kaufman has special interest in researching the effects of morbid obesity on the pelvic floor. He is a member of the USC Bariatric Surgery Program, offering open and laparoscopic surgical options for patients suffering from morbid obesity.

Inflammatory Bowel Disease (IBD) - Ulcerative colitis and Crohn's disease are the most common forms of inflammatory bowel disease. These conditions cause chronic inflammation of the digestive tract, which can result in diarrhea, frequent bowel movements, bloody bowel movements, and abdominal pain. Crohn's disease may occur at any location in the digestive tract and involves the full thickness of the intestinal wall. This disease pattern can result in bowel obstruction from scarring, painful inflammatory masses in the abdomen, abscesses, and fistulae (communication between structures that should not be connected). Alternatively, ulcerative colitis usually affects the mucosa (lining) of the colon and rectum and presents with bloody diarrhea. Medical therapy is the initial treatment for both types of IBD. For Crohn's disease, new drugs such as Remicade may delay surgical management, or it can used in association with surgery.

Bowel Control - Loss of control of bowel movements or gas can be embarrassing and socially debilitating. Our colorectal specialists work with patients to find the causes of this condition, which may include disorders of the colon and rectum, the anus, and/or the pelvic floor. Treatment depends on the cause and severity of loss of bowel control, and may include medication, dietary changes, biofeedback and exercise programs to strengthen anal and pelvic muscles, or surgery may be required. In addition to evaluation of the muscles and nerves of the anus and rectum, we offer the latest therapies available in clinical trials for patients who have failed traditional types of therapy.

Anorectal Disorders - Hemorrhoids, fissures, pilonidal disease, and other similar anorectal disorders are also treated by our specialists.

Colorectal Cancer Screening

Colorectal cancer is curable with early detection. In randomized clinical trials, screening for colorectal cancer has proven to decrease mortality. Routine tests such as colonoscopy, flexible sigmoidoscopy, and barium enema with contrast, are used to detect early development of colorectal cancer. Unfortunately, most individuals are not screened due to either fear or lack of adequate education regarding the benefits.

Recommendations for screening begin at age 50 for the average risk population, and at 40 years of age (or younger) for higher risk groups.

Colonoscopy - This short preventative procedure allows physicians to look inside the large intestine using a colonoscope in order to look for early warning signs of colon or rectal cancer. If anything abnormal is seen such as a polyp or inflamed tissue, the physician can remove all or part of it using tiny instruments passed through the scope. That tissue (biopsy) is then sent to a lab for testing. Colonoscopy takes 30 to 60 minutes.