Dr. Peter M. Lotze, MD

Dr. Peter M. Lotze, MD Urogynecologist and Pelvic Reconstructive Surgeon

Dr. Peter M. Lotze, MD, FACOG, is a board-certified urogynecologist and reconstructive pelvic surgeon. He evaluates and treats pelvic floor disorders, urinary incontinence, bladder dysfunction, pelvic organ prolapse, fecal incontinence, and complications related to previous pelvic surgery.

His training includes an obstetrics and gynecology residency followed by a three-year fellowship in female pelvic medicine and reconstructive surgery. Dr. Lotze established his Houston urogynecology practice in 2002 and was among the first physicians to receive subspecialty certification in female pelvic medicine and reconstructive surgery when certification became available in 2013.

Patients may see Dr. Lotze for urine leakage, a vaginal bulge, pelvic pressure, difficulty emptying the bladder, bowel-control problems, recurring urinary symptoms, or concerns following an earlier pelvic procedure.

A consultation does not automatically lead to surgery. Depending on the diagnosis, treatment may involve pelvic floor therapy, bladder training, medication, a pessary, an office procedure, continued monitoring, or reconstructive surgery.

About Dr. Peter M. Lotze

Dr. Lotze focuses on female pelvic medicine and reconstructive surgery, a subspecialty often called urogynecology.

His areas of care include:

• Pelvic organ prolapse
• Stress urinary incontinence
• Urgency urinary incontinence
• Overactive bladder
• Difficulty emptying the bladder
• Urinary retention
• Fecal incontinence
• Pelvic floor weakness
• Bladder and urethral fistulas
• Complications after previous pelvic surgery
• Vaginal and pelvic reconstructive surgery
• Minimally invasive gynecologic surgery
• Robotic, laparoscopic, and vaginal procedures

Current practice information describes experience with complex pelvic conditions and patients whose earlier treatment did not provide an acceptable result.

Patients comparing women’s health professionals can review other gynecology specialists through Doctiplus.

Professional Background

Dr. Lotze was the first fellowship-trained urogynecologist to establish a dedicated practice in Houston, beginning in 2002.

He previously served as director of a urogynecology fellowship program at the Women’s Pelvic Restorative Center and as a clinical assistant professor in the Department of Obstetrics and Gynecology at UTHealth Houston. His professional background also includes medical education, published urogynecology research, and service as a board examiner for the American Board of Obstetrics and Gynecology.

His academic work has included research involving:

• Pelvic organ prolapse repair
• Sacral colpopexy
• Uterosacral ligament suspension
• Sling procedures
• Pelvic nerve injuries
• Complex vaginal and pelvic conditions

Research experience does not determine which treatment is appropriate for an individual patient. Recommendations still depend on symptoms, examination findings, test results, previous operations, health history, and personal treatment goals.

Education and Medical Training

Training area	Institution	Details
Undergraduate education	Texas A&M University	Bachelor of Science in Microbiology, 1990
Medical education	Baylor College of Medicine	Doctor of Medicine, completed in 1994
Internship	Baylor College of Medicine	Transitional and postgraduate training, 1994 to 1995
Residency	Baylor College of Medicine	Obstetrics and gynecology, 1995 to 1999
Fellowship	Women’s Continence Center of Greater Rochester and Strong Memorial Hospital	Female pelvic medicine and reconstructive surgery, 1999 to 2002
Board certification	American Board of Obstetrics and Gynecology	Obstetrics and gynecology
Subspecialty certification	American Board of Obstetrics and Gynecology	Female pelvic medicine and reconstructive surgery

Dr. Lotze completed medical school and OB-GYN residency training at Baylor College of Medicine. He then undertook advanced fellowship training in Rochester, New York, focusing specifically on pelvic floor disorders, bladder conditions, and pelvic reconstructive surgery.

Board Certification and Professional Credentials

Dr. Lotze is publicly listed as board-certified in:

• Obstetrics and gynecology
• Female pelvic medicine and reconstructive surgery

His professional credentials include:

• MD, meaning Doctor of Medicine
• FACOG, meaning Fellow of the American College of Obstetricians and Gynecologists
• Residency training in obstetrics and gynecology
• Fellowship training in female pelvic medicine and reconstructive surgery
• Experience in urogynecologic education and research
• Experience with vaginal, laparoscopic, and robotic pelvic reconstruction

Board certification is separate from medical licensing. A medical license permits a physician to practice, while board certification reflects specialty education, supervised training, and professional assessment.

Dr. Lotze’s individual National Provider Identifier is 1639171903, with urogynecology and reconstructive pelvic surgery listed as his primary professional classification.

What a Urogynecologist Does

A urogynecologist is a physician with advanced training in gynecology, bladder function, pelvic floor disorders, and reconstructive pelvic surgery.

The pelvic floor is a group of muscles, ligaments, connective tissues, and nerves that supports the:

• Bladder
• Urethra
• Uterus
• Vagina
• Rectum

Pregnancy, childbirth, aging, menopause, surgery, chronic constipation, repeated heavy strain, and certain medical conditions can affect this support system.

A urogynecologist may help when symptoms involve more than one pelvic organ. For example, a patient may have vaginal prolapse together with urinary leakage, difficulty emptying the bladder, constipation, or bowel-control problems.

Dr. Lotze’s practice states that he works with referring primary care doctors, gynecologists, and urologists rather than replacing their wider preventive or general medical care.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when weakened muscles and connective tissues allow one or more pelvic organs to move downward toward the vagina.

The condition may involve the:

• Bladder, called a cystocele
• Rectum, called a rectocele
• Uterus
• Top of the vagina after hysterectomy
• Small intestine in selected cases

Possible symptoms include:

• A vaginal bulge
• Pelvic pressure or heaviness
• A pulling sensation
• Difficulty emptying the bladder
• Difficulty completing a bowel movement
• Urine leakage
• Lower-back discomfort
• Symptoms that worsen after standing
• Discomfort during physical activity or intercourse

Some prolapse is visible during examination but causes few symptoms. Treatment is usually based on how the condition affects comfort, bladder or bowel function, activity, and quality of life rather than appearance alone.

Nonsurgical Prolapse Treatment

Surgery is not required for every patient with pelvic organ prolapse.

Nonsurgical choices may include:

• Monitoring
• Pelvic floor physical therapy
• Treatment of constipation
• Changes to lifting or straining habits
• Weight-related health support when appropriate
• A vaginal pessary

A pessary is a removable support device placed inside the vagina. It may reduce pressure and support the affected organs without changing the pelvic anatomy through surgery.

A pessary must be selected, fitted, cleaned, and monitored properly. Some patients manage the device themselves, while others return to the office for removal and care. Dr. Lotze’s practice identifies pessary treatment as a nonsurgical option for selected prolapse patients.

Pelvic Reconstructive Surgery

Surgery may be considered when prolapse causes substantial symptoms, interferes with bladder or bowel function, or remains difficult to manage with nonsurgical treatment.

Dr. Lotze’s official procedure information includes:

• Vaginal prolapse repair
• Laparoscopic prolapse repair
• Robot-assisted prolapse repair
• Suspension of the uterus or vaginal canal
• Sacral colpopexy
• Uterosacral ligament suspension
• Prolapse correction with or without graft material
• Colpocleisis
• Hysterectomy when medically appropriate

The operation selected depends on:

• Which organs have moved
• Whether the uterus remains
• Previous pelvic operations
• Tissue quality
• Bladder and bowel symptoms
• General health
• Future sexual activity
• Personal preferences
• The risks and benefits of mesh or graft use

Dr. Lotze’s practice lists vaginal, laparoscopic, and robotic approaches, but not every patient is suitable for every technique.

Stress Urinary Incontinence

Stress urinary incontinence causes urine to leak when pressure increases around the bladder.

Leakage may happen during:

• Coughing
• Sneezing
• Laughing
• Running
• Jumping
• Lifting
• Exercise
• Standing from a chair

Stress incontinence commonly involves weakness or reduced support around the urethra and pelvic floor.

Evaluation may consider pregnancy and delivery history, menopause, earlier pelvic surgery, prolapse, medication, weight changes, and activities that trigger leakage.

Treatment may include:

• Pelvic floor muscle training
• Physical therapy
• A pessary or support device
• Activity changes
• Urethral bulking treatment
• Sling surgery
• Burch urethropexy in selected cases

Pelvic floor exercises can help strengthen muscles involved in bladder and bowel control, although patients may benefit from professional guidance to ensure they are exercising the correct muscles.

Sling Surgery

A sling supports the urethra to reduce stress-related urine leakage.

Different sling materials and surgical approaches may be available. The choice may depend on:

• Previous pelvic surgery
• Prolapse
• Bladder-emptying ability
• Earlier sling treatment
• Tissue health
• Personal preferences
• The surgeon’s assessment

Dr. Lotze’s practice lists vaginal sling surgery among its treatments for urinary incontinence.

Before choosing surgery, patients should ask:

• Which type of sling is proposed?
• What material will be used?
• Why is this approach preferred?
• Could urination become temporarily difficult?
• What restrictions will apply after surgery?
• What is the chance of continuing or recurring leakage?
• Could urgency symptoms remain after the procedure?

Temporary difficulty urinating, slower urine flow, discomfort, infection, bleeding, or a need for additional treatment can occur following incontinence surgery.

Overactive Bladder and Urgency Incontinence

Overactive bladder may cause:

• A sudden strong need to urinate
• Frequent bathroom visits
• Waking repeatedly during the night
• Leakage before reaching a toilet
• Difficulty delaying urination

Overactive bladder is different from stress incontinence, although some patients experience both.

Evaluation may include:

• Urine testing
• Medication review
• Bladder diary
• Pelvic examination
• Measurement of urine remaining after voiding
• Urodynamic testing
• Cystoscopy when another bladder condition is suspected

Treatment may involve:

• Bladder training
• Pelvic floor therapy
• Changes in fluid timing
• Treatment of constipation
• Medication
• Bladder injections
• Nerve stimulation
• Sacral neuromodulation

The appropriate sequence depends on symptom severity, earlier treatment, medication tolerance, bladder-emptying ability, and the patient’s preferences.

Sacral Neuromodulation

Sacral neuromodulation uses a small implanted device to send electrical signals to nerves involved in bladder and bowel control.

It may be discussed for selected patients with:

• Urgency urinary incontinence
• Overactive bladder
• Urinary retention without a correctable blockage
• Fecal incontinence

Treatment commonly begins with a testing stage to assess whether symptoms improve enough to justify placement of a longer-term device.

Dr. Lotze’s practice provides patient guidance for sacral neuromodulation systems, indicating that this treatment is part of its pelvic health services.

Patients should ask about device maintenance, activity restrictions, battery life, MRI compatibility, follow-up, and what happens when treatment does not provide the expected improvement.

Difficulty Emptying the Bladder

Some patients can urinate but cannot empty the bladder completely. Others may have a weak stream, need to strain, or feel that urine remains afterward.

Possible causes include:

• Pelvic organ prolapse
• Nerve problems
• Medication
• An earlier incontinence procedure
• Weak bladder muscle activity
• Urethral narrowing
• Constipation
• Another form of obstruction

Assessment may involve measuring the amount of urine left in the bladder after urination, urine testing, examination, urodynamics, or cystoscopy.

Sudden inability to pass urine requires prompt medical assessment. Untreated retention may contribute to infection, bladder injury, or kidney complications.

Fecal Incontinence and Bowel-Control Problems

Fecal incontinence means stool or mucus escapes unexpectedly.

Possible contributing factors include:

• Childbirth-related muscle injury
• Pelvic floor weakness
• Nerve damage
• Chronic constipation
• Diarrhea
• Rectal prolapse
• Earlier anal or pelvic surgery
• Neurologic conditions

A urogynecology assessment may consider both bladder and bowel symptoms because the same pelvic floor muscles and nerves contribute to control of several organs.

Treatment depends on the cause and may involve:

• Changes in stool consistency
• Constipation or diarrhea treatment
• Pelvic floor therapy
• Bowel training
• Medication
• Sacral neuromodulation
• Referral to a colorectal specialist

Dr. Lotze’s current practice profile identifies fecal incontinence as one of his clinical areas.

Pelvic Fistulas

A fistula is an abnormal connection between two structures.

Pelvic fistulas may develop between:

• The bladder and vagina
• The urethra and vagina
• The rectum and vagina
• Other nearby pelvic structures

Possible symptoms include:

• Continuous urine leakage
• Repeated infection
• Air or stool passing through the vagina
• Irritation
• Unusual drainage
• Symptoms following surgery, childbirth, radiation, or injury

Evaluation may involve examination, dye testing, cystoscopy, imaging, or review of previous surgical records.

Dr. Lotze’s procedure list includes laparoscopic and robotic correction of selected bladder and urethral fistulas.

Patients with a suspected fistula should bring previous operative reports, hospital records, imaging, and information about when the leakage or drainage began.

Cystoscopy

Cystoscopy uses a narrow instrument with a camera to examine the inside of the urethra and bladder.

It may be considered when a patient has:

• Blood in the urine
• Repeated urinary infections
• Bladder pain
• Difficulty urinating
• An earlier pelvic operation
• Suspected bladder injury
• A possible fistula
• Symptoms that remain unexplained

Cystoscopy is not required for every patient with urine leakage. Dr. Lotze’s office states that testing is selected according to the patient’s symptoms and initial examination.

Urodynamic Testing

Urodynamic testing assesses how the bladder and urethra store and release urine.

The study may measure:

• Bladder pressure
• Urine flow
• Bladder capacity
• Urgency
• Leakage during coughing or straining
• Muscle coordination
• Ability to empty

Testing may be useful when symptoms are complex, earlier treatment has failed, surgery is being considered, or examination findings do not fully explain the problem.

Dr. Lotze’s first-visit information identifies urodynamics as one of the tests that may be ordered after the initial assessment.

Hysterectomy and Pelvic Surgery

A hysterectomy removes the uterus. It may be included in treatment for selected prolapse or gynecologic conditions, but it is not automatically necessary for every prolapse repair.

Dr. Lotze’s practice lists:

• Vaginal hysterectomy
• Laparoscopic hysterectomy
• Robot-assisted hysterectomy
• Uterus-preserving suspension procedures

Patients can ask:

• Does the uterus need to be removed?
• Is a uterus-preserving repair possible?
• Will the cervix remain?
• Will the ovaries remain?
• How will removing or preserving the uterus affect the repair?
• Will treatment address bladder symptoms at the same time?

The decision should reflect the diagnosis, uterine health, previous screening, surgical anatomy, future health needs, and patient preference.

Complex or Repeat Pelvic Surgery

A repeat pelvic operation can be more complicated because scar tissue and altered anatomy may affect the bladder, ureters, bowel, vagina, nerves, and blood vessels.

Patients may seek another opinion because of:

• Recurrent prolapse
• Continuing incontinence
• Difficulty urinating after surgery
• Pelvic pain
• Mesh or graft concerns
• A previous repair that did not last
• A suspected fistula
• Several earlier abdominal or vaginal operations

Dr. Lotze’s current practice profile specifically identifies complex management of previous surgical problems as part of his work.

A second opinion may confirm the original recommendation or identify another reasonable approach.

Who May Benefit From Seeing Dr. Lotze

A consultation may be appropriate for patients who:

• Leak urine while coughing, exercising, or lifting
• Have a sudden urge followed by leakage
• Urinate very frequently
• Wake repeatedly to urinate
• Feel a bulge or pressure in the vagina
• Have difficulty emptying the bladder
• Experience recurring urinary symptoms
• Have bowel-control concerns
• Have been diagnosed with pelvic organ prolapse
• Need a pessary assessment
• Have symptoms after previous pelvic surgery
• Need another opinion before reconstructive surgery
• Have been advised to consider a sling or prolapse repair

Patients searching for another healthcare professional can use Doctiplus to find doctors by specialty.

What Patients Can Expect During an Appointment

Dr. Lotze’s practice describes the first visit as a detailed assessment that begins with medical history, vital signs, and discussion of the patient’s concerns.

The examination may include:

• Abdominal assessment
• Pelvic examination
• Evaluation of vaginal support
• Pelvic muscle strength testing
• Assessment of nerve function
• Review of earlier surgical scars
• Measurement of urine remaining after voiding

Depending on the findings, additional testing may include:

• Urinalysis
• Urine culture
• Urodynamics
• Cystoscopy
• Bladder diary
• Imaging
• Review of previous operative records

Not every test is performed during the first visit. Testing is selected according to the condition being evaluated.

Preparing for the Appointment

Patients can prepare by bringing:

• A complete medication list
• Allergy information
• Previous pelvic surgical reports
• Bladder or prolapse procedure records
• Implant, sling, or mesh information
• Urine-test results
• Imaging reports
• Earlier urodynamic results
• Cystoscopy records
• Gynecology records
• Pregnancy and delivery history
• Insurance and referral documents
• Written questions

A short symptom record can also be useful. It may include:

• When leakage happens
• How often the patient urinates
• How often nighttime urination occurs
• Whether pads are used
• Whether a vaginal bulge is present
• Difficulty starting or completing urination
• Constipation or bowel leakage
• Treatments already attempted
• How symptoms affect work, exercise, sleep, or travel

Patients should mention their most disruptive symptom near the beginning of the consultation.

Questions to Ask Dr. Lotze

Patients may consider asking:

• What is causing my symptoms?
• Do I have more than one pelvic floor condition?
• Is additional testing necessary?
• Could pelvic floor therapy help?
• Would a pessary be suitable?
• Are medications available?
• Why is surgery being considered?
• Can the uterus be preserved?
• Which surgical approach would be used?
• Would mesh or graft material be involved?
• What are the alternatives?
• Could urinary symptoms improve or worsen after prolapse repair?
• What recovery restrictions should I expect?
• How likely is recurrence?
• Could another procedure be needed later?
• Would a second opinion be reasonable?
• Which symptoms require urgent assessment?

Recovery After Pelvic Surgery

Recovery depends on the exact procedure and the patient’s health.

Follow-up may include:

• Incision or vaginal healing assessment
• Bladder-emptying checks
• Catheter care when temporarily required
• Pain-management review
• Treatment of constipation
• Activity and lifting restrictions
• Pelvic floor rehabilitation
• Review of urine leakage or urgency
• Monitoring for infection
• Gradual return to exercise and intercourse

Patients preparing for an operation can read about follow-up care during surgical recovery. Pelvic reconstructive procedures will still require in-person assessment when examination or bladder testing is needed.

Practice and Appointment Information

Dr. Lotze practices through the Pelvic Health, Wellness & Aesthetic Center, previously identified in professional records as the Women’s Pelvic Restorative Center.

Houston Medical Center Office

7900 Fannin Street
Suite 3300
Houston, TX 77054

The Woodlands Office

9180 Pinecroft Drive
Professional Building 4, Suite 250
Shenandoah, TX 77380

Primary appointment phone:
713-512-7810

Additional contact number:
833-764-5105

The practice lists Houston office hours from 8:30 a.m. to 5:00 p.m., Monday through Friday. The Woodlands office currently lists Friday hours from 8:30 a.m. to 2:00 p.m. Patients should confirm the suite and location because the HCA directory displays a different Houston suite number.

Hospital and Surgical Affiliations

Dr. Lotze’s current practice website lists affiliations that include:

• The Woman’s Hospital of Texas
• Houston Methodist Hospital
• Houston Methodist The Woodlands Hospital
• Memorial Hermann The Woodlands Medical Center
• Memorial Hermann Surgery Center The Woodlands
• Fannin Surgicare Center

The HCA physician directory specifically confirms The Woman’s Hospital of Texas. Hospital participation and the facility used for a procedure may depend on current privileges, insurance, surgical needs, and scheduling.

Languages and Communication

Current HCA information lists:

• English
• Spanish
• Spanish interpreter availability

Patients should confirm whether the physician, a staff member, or a qualified interpreter will provide communication in Spanish for the full consultation and consent discussion.

Insurance, New Patients, and Telehealth

Insurance participation may differ among the physician, hospital, surgical center, laboratory, imaging provider, and pelvic floor therapist.

Before scheduling, patients should ask:

• Is Dr. Lotze included in my current network?
• Is a referral required?
• Does urodynamic testing require authorization?
• Are cystoscopy and office procedures billed separately?
• Is pelvic floor therapy covered?
• Is a pessary and its follow-up covered?
• Is the planned hospital or surgery center in network?
• Are new patients currently being scheduled?
• Is telehealth available for follow-up?
• Which records should be sent before the consultation?

Current official information does not clearly confirm routine telehealth availability. Result reviews or selected postoperative discussions may sometimes be suitable for remote care, but prolapse, incontinence, bladder-emptying concerns, and new pelvic symptoms commonly require an in-person examination.

When Pelvic or Bladder Symptoms Require Urgent Care

Patients should not wait for a routine appointment when symptoms are severe or worsening quickly.

Urgent assessment may be needed for:

• Sudden inability to urinate
• Heavy vaginal or urinary bleeding
• Blood in the urine with clots
• Severe pelvic or abdominal pain
• Fever with pelvic pain
• Repeated vomiting
• Fainting
• New severe weakness
• A painful prolapse that cannot be returned to a comfortable position
• Tissue becoming dark, pale, or severely swollen
• Serious symptoms following pelvic surgery
• Increasing redness or foul-smelling drainage
• An incision that opens
• Severe difficulty breathing or chest pain after surgery
• One-sided leg swelling after an operation

Patients can review general guidance about when immediate medical attention is necessary, but symptoms suggesting urinary retention, serious bleeding, infection, or a postoperative complication require prompt assessment.