Our Practice is Unique

Your patients, who see us, will find a warm and caring "small office" environment, with a friendly but professional atmosphere. We are dedicated to compassionate care and unsurpassed quality. After building a large successful group practice and then joining the SMH First Physicians Group, we now feel we can use what we have learned to provide the best care available..

We have worked very hard to combine our expert training, long experience, continuing improvements and quality assurance programs to offer you a service unique in Southwest Florida. We have gained the confidence of thousands of loyal patients, and the area medical community with our exceptional standard of care.

For example, we are the first and only Gyn practice in Sarasota to be accredited in specialty ultrasound services. When Gyn or breast ultrasound is indicated, Dr. Swor will provide the testing in our clinic with superior quality. We have been certified and recertified through AIUM and Dr. Anna Parson's peer review program at USF, Tampa. Dr. Swor has been an assistant clinical professor at USF for several years, and has lectured in many venues to thousands of healthcare professionals.

Dr. Swor has 20+ years of Board-certified experience and was the first SW Florida gynecologist to join the advanced surgical educational group known as the Accreditation Council of Advanced Laparoscopy and Hysteroscopy. We are also affiliated with Sarasota's most prominent clinical research group, Physician Care Clinical Research, so we can offer our patients advanced treatments, not yet widely available.

Dr. Swor is best known as a pioneer in laparoscopic surgery, Gyn laser surgery and surgical robotics in Southwest Florida. In the early 1990's, with Dr. Irving Beychok, he co-founded the Center for Advanced Surgery at Sarasota Memorial Hospital and continues to develop new minimally invasive surgery techniques and alternative treatment options.

We also evaluate and treat Urogynecologic problems, working with patients of in conjunction with physicians, urologists and even other gynecologists. Problems we evaluate and treat include incontinence, urgency, frequency and pelvic support problems. Many tests are available in our clinic and treatment ranges from medical to non-invasive physical therapy to minimally-invasive surgery. We can help many women with decreased bladder function using simple exercise instruction, innovative devices, new medications, bladder training, electronic pelvic floor therapy and, if necessary, minimally-invasive outpatient surgery.

Our Specialty

Women's health issues are our specialty. Allison Smith, Beth Hinkelman, and Karen Collins are Advanced Nurse Practitioners (ARNP) and see patients for routine and general Gyn care. They are qualified to see patients for ongoing preventive care, cancer screening, evaluation of pain, bleeding, pelvic support, hormonal concerns, infertility and adolescent medicine. Any complex Gyn problems, surgical opinions, or ather advanced care is provided by Dr. Swor directly.

We evaluated and treated patients from all over the world, usually in cooperation with their primary care internists, family doctors, urologists, and current OBGYN providers. We are also open to assisting patients of non-traditional medical practitioners and believe in a practical approach to patient care considering all available options.

Advanced Surgery

Dr. Swor has special expertise in advanced laparoscopic and minimally invasive surgery. 95% of our major surgeries are done with these techniques. These include laparoscopic hysterectomies, LASH procedures, pelvic floor repair, myomectomy and endometriosis surgery. He has 20+ years of experience in these techniques, which are continuously updated and refined as new technology and ideas become available.

Please see our section on Advanced Surgery under Services Offered.

Pelvic Floor Support Problems and Incontinence

We provide a full range of services for the evaluation and treatment of urinary (and bowel) incontinence and other female pelvic support problems, such as prolapse, cystocele, rectocele and enterocele. We have the latest in-office urodynamic testing, Interstim therapy and electronic pelvic floor therapy and counselling services as an adjunct to our surgical options. We are trained in the latest and least invasive operative techniques including laparoscopic Burch, SurX urethropexy, Transobturator sling and laparoscopic pelvic floor repair. We often work with local urologists on more complex cases requiring urology expertise, but most patients can be effectively evaluated and treated through our office.

Breast Cancer Screening

We are committed to a comprehensive breast cancer screening and treatment program in the Sarasota area. At Swor Women's Care, we do breast cancer risk analysis, take a careful personal and family history, do appropriate clinical examination, refer for mammograms and other imaging and encourage and teach monthly self-breast examination. When advisable, we also offer Firstcyte NFA testing, breast ultrasound and FNA needle aspiration. We also work with local and regional breast cancer experts when a multispecialty approach is helpful.

Surgery Update

See our latest Gyn Surgery Update for patients and doctors...Click Here. This listing describes many traditional and more recently introduced procedures that are available through Swor Womens Care. We are specialists in advanced minimally-invasive techniques. Most of our surgical care is provided with laparoscopic or other "small-incision" instrumentation.

Dr. Swor is always happy to discuss any gynecologic issue with patients and providers and is available 24 hours a day at 941-330-8885.  Patient consultation, Gyn specialty clinical realtime ultrasound and urogynecology workups are done in our office at 1617 South Tuttle Ave in Sarasota. Most surgery cases are done at Cape Surgery Center and Sarasota Memorial Hospital.

"Natural forces within us are the true healers. Let your food be your medicine and your medicine be your food" --Hippocrates

GYN UPDATE FOR CLINICIANS 

Sept 2006

Clinical Research - Newsflash     

As of May 2007, we have launched Physician Care Clinical Research, located on Tuttle Avenue and Hyde Park. This is more or less a clinical research cooperative, where local docs can partix\cipate in clinical trials or simply refer patients for information on current trials. Most of what we do are women's health, GI and nutritional. This is also the site of the USF/IVF Gyn subspecialty clinic.

We are offering THREE new treatments related to HPV and precancerous changes in the cervix. We are offering participation in clinical studies to qualified patients, that treat CIN 2-3 / moderate or severe dysplasia with non-surgical therapy. We also offer new vaccines for PREVENTING infection with certain HPV strains and significantly reducing the future risk of cervical cancer. Please call for more info....

We also offer clinical trials in women's sexual dysfunction-low libido, new birth control pills, ulcerative colitis, vaginal infection, hot flashes, breast cancer and hormone therapy.

April 9, 2006

Newsflash- We have relaunched Sarasota-Manatee ObGyn Journal Club. This is a great venue for all area ObGyns to share ideas, case experience and learn from other specialists. We want to include other docs when appropriate, so please email me any topic ideas, suggestions, or sponsor leads.

Newsflash- We have officially launched our USF-Sarasota ObGyn affiliation. This includes graduate education programs, resident and fellow teaching, and outpatient clinical research. We also plan to open an ObGyn subspecialty clinic this summer. We just opened Physician Care Clinical Research for women’s health studies and body composition lab.

Menopausal Hormone Controversy- The pot is still boiling here. All patients deserve an individualized approach to care regarding menopausal changes. Many women find that hormone replacement of some kind is essential to healthy and satisfactory living. We suggest a careful analysis of a patient’s needs, risks and experience at least annually. Synthesized estrogen carries a potential risk of accelerating breast cancer growth, increasing thromboembolic risks, gall bladder risks and may increase EXISTING cardiovascular disease (synthetic progestins, especially Provera are believed by many to be the culprit in lipid change and CVD risk). Human identical female hormones definitely help bone strength, bladder and vaginal tissues and probably healthy vascular systems. If vasomotor or other symptoms are severe, then low dose progesterone and/or estrogen can be offered safely to most patients. There are several topical formulations that are excellent “power boosts” to atrophic vaginal tissues and help bladder urgency too. We prefer newer formulations that are human-identical (ie estradiol, estriol, progesterone). These are lower dose and theoretically safer that those used in the past. They are prescribed in a transdermal delivery to avoid “first liver pass”. Many women benefit from physiologic replacement of androgens for improved energy and libido.

Breast Cancer- We encourage a watchdog attitude in early breast cancer detection. Monthly self-breast exam, annual (or more) clinical exam and yearly mammogram starting at age 35-40. High risk patients need additional surveillance, which may include MRI, ultrasound or more frequent clinical exam. If the mammogram, the patient or the clinician finds an abnormality, then at the very least a short interval re-examination is done.  If any suspicion, then refer to a qualified breast surgeon.  We do an in-office clinician-performed breast ultrasound at the time of clinical exam if indicated. Breast cancers caught early are very effectively treated with lumpectomy and radiation therapy. In selected patients, Mammosite brachytherapy provides focused radiation treatment to the lumpectomy site. 

Newsflash- a new BLOOD TEST for breast cancer detection has been launched for patients...although it will initially be offered only in certain middle eastern countries. See BC SeraPro from Power 3 Medical.

Guardasil HPV Vaccine-  We recommend all girls and young women ages 9-26 receive the HPV vaccine against cervical cancer associated subtypes 16 and 18, and wart-related subtypes 6 and 11. This vaccine is safe and effective and if used appropriately, will reduce HPV-related disease dramatically. We would expect a 70% reduction in cervical cancer and high grade dysplasia. At a cost of $400, there are reimbursement issues, but the vaccine is available and should be offered.

PAP Testing Recommendations and Evaluation of Abnormal PAPs- recent changes in the recommended frequency of screening and algorithms for workup of abnormals is still confusing. Some patients do in fact qualify for less than yearly screening. These criteria include Medicare patients with a long history of normal PAPs, who can be tested every 2 years, and also “low risk” younger patients. Rather than grill patients on their sexual history, we believe in offering annual screening to all patients less than 65. Even post-hysterectomy patients benefit from PAP screening since cytology helps detect VAIN (vaginal intraepithelial neoplasia), vaginitis and urogenital atrophy. When a PAP reveals ASCUS (squamous atypia), either do reflex HPV testing to detect “high-risk” HPV or at least repeat a PAP in 3 months. If the high-risk HPV is positive, or the 3 month PAP is also positive, then PLEASE recommend colposcopy. PAP results clue us in, colposcopy gives the diagnosis. A significant number of these patients will have precancerous lesions. If any PAP reveals AGUS (glandular atypia), then the patient needs endocervical and endometrial evaluation. Send these patients to a Gyn. Appropriate follow-up for AGUS is vaginal ultrasound and biopsy as many of these patients will have a polyp or endometrial lesion. The other possibility is adenocarcinoma, especially in older patients.

Specialty Gyn Ultrasound- In our office, when indicated, we offer vaginal probe pelvic ultrasound test, done by the gynecologist. We were accredited by the American Institute of Ultrasound in Medicine in 1999 and peer-reviewed by fellow clinical staff at USF.  This specialized testing offers an immediate clinical correlation with exam findings that exceeds the quality of most pelvic ultrasound studies. We also offer a similar breast ultrasound test and fine needle aspiration for evaluating lumps and mammogram abnormalities.

Urinary Incontinence, Interstitial Cystitis and E-stim- A significant number of women, when asked, will complain of problematic bladder leakage or pain/frequency syndrome. There has been a new wave of interest in this area and associated testing, drug therapy and minimally-invasive procedures. We have in-office urodynamics, IC evaluation and related therapies that have provided many patients with successful outcomes for their bladder dysfunction. E-stim is our non-surgical electronic pelvic floor therapy for a variety of bladder and gynecologic problems. We consulted with urogynecology specialists at Mayo and have essentially tried to duplicate their program. Please ask patients pertinent questions about urine leakage, pelvic pain, bladder pain and frequency, and offer them the option of thoughtful workup and treatment from a Gyn specialist.

The LASH procedure- laparoscopic removal of part of the uterus, sparing the cervix. This is a minimally-invasive alternative to hysterectomy for many patients. The cervix is used to maintain or improve pelvic support and reduce the occasional problem of post-hysterectomy sexual dysfunction. After 12 years experience, most in the last 5 years, we have seen significant reduction in pain, healing time and functional disruption. Our practice quality data shows an average return to 80% function at one week post-op.  Patient satisfaction has been outstanding, and our 5 year results have been submitted for publication.

Endometrial Ablation- this is a type of hysterectomy alternative used ONLY for bleeding issues in a relatively “normal” uterus, where cautery or heated water is used to heat-treat the endometrium rendering it inactive and results in no period or, at least, decreased flow. It is a minor surgery similar to D&C in recovery time.

Augmented Vaginal Repair and Suburethral Slings- new technology and devices are the popular in Urogynecology and pelvic floor repair.  We have seen great outcomes with the Repliform human tissue graft material to bolster weak fascia tissues in anterior, posterior and paravaginal repairs of rectoceles, cystoceles, etc. Laparoscopic “lift” procedures can be done with fast recovery, and preservation of organs. Newer needle-placement techniques and smaller sizes in suburethral slings, allow for outpatient treatment, excellent outcomes and fast recovery.

Laparoscopic Surgery- As you probably are aware, we do almost all of our major Gyn surgeries via the laparoscope. The exception is the unusual situations such as more advanced Gyn cancers (and we now have our own local gyn oncologist, Jim Fiorica for those). Patients contemplating an “open” gyn surgery such as hysterectomy, fibroid or endometriosis surgery or pelvic repair, can consider other alternatives and another approach. Recovery from laparoscopic surgery is measured in days, not weeks, and excellent outcomes statistics are well-documented.

DaVinci Robotic Surgery-  We now have the robotic technology to assist with advanced laparoscopic surgery. DaVinci adds 3D visualization, improved instrumentation and reduced hand fatigue on complex gyn surgical procedures.

Physician Care Clinical Research- Located at 1931 South Tuttle Avenue at the corner of Hyde Park and Tuttle, the PCCR Center offers you and your patients additional options in treating a variety of conditions, such as abnormal PAP, sexual dysfunction and endometriosis. Patients can be referred to he center with a simple phone call to 941-954-2355. All patent care and treatment are provided at no cost to patients. The referring physician continues to provide regular care in conjunction with study treatment. There are opportunities for practicing physicians to be subinvestigators on current and upcoming studies. The time commitment is small, the educational aspect is rewarding and the reimbursement is excellent. See www.PCCRsarasota.com

In-Office Prescription Service- Now we can provide the care AND then provide the medicine to our patients. Medeon Florida sets you up with a simple turn-key prescription service, just like “the old days”, so you can provide low-cost high-quality prescription meds at prices that will please patients, and give them a reason to avoid Medicare Part D or offshore internet suppliers. See www.medeonmd.com

I hope this update has been informative. We are all on the same team with the goal of helping our patients and each other (and surviving the times). I am always available for quickie phone or email consults from other clinicians on any Gyn specialty care patient issues. We will see any clinician-referred patient on an urgent basis, if you believe it is important. Thank you for all your support over the years. Beth, Allison, Karen and I appreciate your confidence in our care and your commitment to quality.

                                      Michael Swor MD

Chairman, SMH Department of ObGyn

The #1 Gyn department in Florida (as ranked by US News and World Report 2006)

                                    Fellow American College of OBGYN

Fellow American College of Surgeons

Assistant Clinical Professor, Dept of OBGYN, University of South Florida

Affiliate Clinical Professor, Florida State University

Accreditation Council for Gynecologic Endoscopists- 1995 founding member

Accredited GYN Specialty Ultrasound