ValleyCare Health System | Health Ways | Spring 2014 - page 1

A
s a pelvic surgeon/urogynecologist,
Michael T. Margolis, MD, helps
women suffering from a variety of
problems involving the pelvis, including
but not limited to: urinary incontinence,
pelvic organ prolapse and vesicovaginal
and obstetric rectovaginal fistulas (small
holes or tears between the rectum and
vagina that can occur during childbirth)—
the same type that affected Sarah Benjamin
(see main story this page).
“There are a number of conditions
that can occur from complications and
failures from previous gynecologic surgery,
endometriosis, fibroids, congenital
abnormalities and birth trauma,”says
Dr. Margolis.“Unfortunately, Sarah’s was
from birth trauma when she had her
son at the young age of 16½. We used a
transvaginal approach and were able to
successfully correct Sarah’s fistula.”
FistulaRepair
Dr. Margolis has a high
success rate for these
repairs, 95 percent,
which are most
often accomplished
through a simple,
one-hour, transvaginal
approach. It is
considered outpatient
surgery and women
can return to normal, daily activities quickly.
Dr. Margolis is only one of a handful
of fellowship-trained pelvic surgeons
in the country, trained by the world-
renowned Johns Hopkins surgeon Clifford
Wheeless, MD. As such, Dr. Margolis has
performed thousands of pelvic surgeries
since completing his fellowship in 1991. In
addition, he has held faculty positions and
taught pelvic surgery/urogynecology at
four major U.S. universities and has taught
doctors internationally as well.
SurgicalMissionTrips
Near and dear to his heart are the
humanitarian surgical mission trips to South
America and Africa. He regularly participates
in these missions to developing countries
in cooperation withMedlendMissions and
Johns Hopkins medical schools.
“Fistulas are common in Africa due to the
young age of first-time mothers and the
lack of medical care during childbirth,”he
says.“In 1992, I went on my first mission trip
to Ghana,West Africa, to study the repair of
S
arah Benjamin, age 26, of Santa Cruz, had
lived with an obstetric stula since the birth
of her son in 2004, when she was 16½.
According to Michael T. Margolis, MD,
a Bay Area pelvic surgeon and
urogynecologist with clinic hours at
ValleyCare Health System in Pleasanton, an
obstetric stula is a small hole or tear between
the vagina and rectum that can occur due to
obstetric injury during childbirth.
NIGHTMARE
For Benjamin, it was a nightmare. “It’s
not only embarrassing, but also causes
limitations in your life,” she says. “Because
gas and minute fecal matter would pass
through the stula, I always had to be
near a bathroom. I love to hike and be
outdoors, and it limited my ability to go
places and travel.” Because of the fecal
matter and irritation, cleanliness is of
utmost importance, so Benjamin says
she used to have lots of wipes with her
to keep the area clean.
She also says it caused great
psychological distress. For example,
when attending UC Santa Cruz she’d be
sitting in a small classroom and was always
afraid of making a noise when gas would
pass through the hole. “I would be so fearful of
embarrassing myself and my classmates wouldn’t
understand. It was awful,” she says. “I would tense
up my body and pray I would get through class without
making a noise. Obviously, I had a hard time in social
From
Embarrassment
to
CRUSADER
settings.”
Knowing she had to get it xed, she saw a colorectal surgeon
in Santa Cruz who said he could repair it. A week following her
surgery, it failed and the hole was worse. It was larger and fecal
matter was more prevalent. The doctor tried to repair it a second
time. A week later, it failed again and the doctor said he couldn’t
do anything more to “help” her.
Convinced someone could help, she started doing research
online and found a doctor at UC San Francisco who was
experienced with stulas and also travels to Africa to do these
surgeries. Benjamin waited three months to see the doctor. On her
rst visit, upon learning about Sarah’s two previous surgeries that
failed, this gynecologist told her she couldn’t do anything more,
that it was too risky due to the prior surgeries. “I was devastated,
especially after waiting three months to see her and
having such high hopes that this doctor could give
me my life back,” she says.
Being persistent and not one to just stand by,
Benjamin continued her research and found a
colorectal doctor at Stanford who addressed these
issues and made an appointment. After two months
of waiting to see her, the doctor told Sarah they
could do surgery, but the success rate would be low.
This doctor also wanted her to have a temporary
colostomy bag for several months in order for the
area to heal and keep it clean, along with what is
called a gracilis ap (removing muscle and tissue
from the inner thigh). Because of the low success
rate and all that was involved, Benjamin said she
would have to think about it. “I could not see
myself going through all of that and being so
young,” she says. “I just didn’t believe that was my
last option.”
Fistula Repair Gives
Sarah Benjamin
a New Life
HELPING WOMEN
Get Their Lives Back
—Continued on page 4
—Continued on page 4
THE DOCTORS SHOW
One day while watching TV, she came upon an idea. “I thought
maybe I could write to a medical show on TV and see if anyone could
help,” she says. “I wrote to
The Doctors
show and much to my delight
and surprise, I heard from Chelsea Wright, the producer, about a
week later. She said my story was unique and one they wanted to
share with the world. They would y me down to L.A. to meet with
them. Though it is such an embarrassing topic, I decided to go for it
and tell my story and hoped they could nd a doctor to help.”
After meeting the team and having an exam by Dr. Lisa, a
gynecologist from the show, Benjamin was surprised when she
learned they found a doctor from the Bay Area who would take her
case. “I met Dr. Margolis a couple of weeks later, and he said he
could truly help me. I was so happy I literally cried, but also had
hundreds of questions for him,” she says. “He
was so patient and answered every single one
of them, and his con dence that he could
correct my problem gave me the con dence to
go ahead one more time.”
CELEBRATING THE REPAIR
In April of 2012, a time when Benjamin
was attending UC Santa Cruz full time, she
underwent surgery with Dr. Margolis at
ValleyCare Medical Center in Pleasanton.
“I remember waking up in recovery and Dr.
Margolis telling me everything looked good,
but we wouldn’t know for sure for a few
months yet, but I was smiling,” she says. “I had
high hopes that it was going to work this time.”
After a postop visit a couple weeks later,
Dr. Margolis told her that he was very
Sarah Benjamin with her son at her UC Santa Cruz graduation in 2013.
Spring 2014
SERV ING THE TR I VALLEY AND SURROUNDING COMMUNI TI ES WI TH MEDI CAL FAC I L I T I ES IN L I VERMORE, PLEASANTON AND DUBL IN
I N S I D E
2
Making an Impact
ValleyCare o ers ImPACT® concussion
testing for student athletes
3
Exemplary Performance
Our hospital has been recognized for
outstanding care
4
ExpandedHours
Our Urgent Care locations arenow
open later
Health
Ways
Sarah enjoys biking again.
Michael T.
Margolis, MD
1 2,3,4
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