Expert pelvic surgery and ongoing holistic care with a knowledgeable and compassionate multidisciplinary team

No. While uterine fibroids and endometriosis are two of the most common conditions we treat, we also frequently treat adenomyosis, adenomyomas, ovarian cysts, hydrosalpinx, uterine septum, isthmocele (c-section scar defect), pelvic pain, abnormal uterine bleeding, endometrial polyps, abnormal paps, urinary incontinence, pelvic organ prolapse, and many others.

No. We see many patients with endometriosis symptoms that have not been surgically confirmed yet. In fact, we'd prefer your first surgery be with us. While many patients are worried that we won't find anything, we know that if you have pelvic pain, you have a 70% chance of having endometriosis, even if your ultrasound is normal! 

Dr. Winner and Dr. Kretzer are trained to recognize even the most atypical appearing or subtle endometriosis. As Dr. Winner tells patients, "I almost always find something."

The most common endometriosis symptoms include painful periods, painful intercourse, painful bowel movements, painful urination and pelvic pain. Other common symptoms include bloating, urinary frequency, hip, back, or sciatic pain and fatigue.

If you have significant symptoms like this that are affecting your quality of life, then it is very likely that you do have endometriosis!

Expert endometriosis surgeons always recommend excision for three reasons: 1) You are able to confirm the entire lesion is removed; 2) You can remove any surrounding fibrosis (hard or thickened tissue) which may contribute to pain; 3) You generate a tissue specimen which is sent off to the lab to confirm the diagnosis. 

Dr. Winner and Dr. Kretzer are endometriosis excision surgeons, and are trained to recognize even the most subtle lesions. Their goal is always to remove all visible endometriosis.

Too often, patients with uterine fibroids are told that hysterectomy is their only option.  This is simply not true. Depending on your symptoms, fertility goals and age, options can include treatment with medication, uterine fibroid embolization, radiofrequency ablation (Acesssa), myomectomy or hysterectomy. 

The good news is that almost all fibroids can be removed minimally invasively in the hands of a specially trained surgeon. If you have been told you are not a candidate for minimally invasive or fertility-sparing surgery due to the number or size of your fibroids, please reach out for a second option.

Some patients respond well to hormone therapy, and others do not. There is no "one size fits all" approach. We will discuss the options available, the pros and cons given your unique situation, and ultimately the decision is up to you. We typically do not use Lupron or Orlissa to treat endometriosis due to significant side effects, although there are some patients who have found these medications helpful as well.

We receive many referrals from our reproductive endocrinology and infertility (REI) colleagues, as it is known that excision of endometriosis, ovarian cystectomy for endometrioma, removal of submucosal uterine fibroids, incision of uterine septum (>1.5 cm) and removal of endometrial polyps can all improve natural fertility.

Additionally, removal of submucosal fibroids, hydrosalpinx (blocked/dilated fallopian tube), uterine septum >1.5 cm and endometrial polyps can all improve the success rate of subsequent in vitro fertilization (IVF).

Dr. Winner's practice is focused on surgical consultations. Dr. Kretzer also sees patients for surgical consultations, as well as ongoing gynecologic care. Dr. Winner trained Dr. Kretzer, and they perform all of their laparoscopic surgeries together. This means you have the benefit of having two board-certified surgeons who have worked closely with each other for years, in your surgery.

Patients with complex, chronic conditions often benefit from a holistic approach. Dr. Winner has spent the last several months seeking out, interviewing, learning from and brainstorming with pelvic floor physical therapists, acupuncturists, dieticians, and mental health counselors who are already experts in endometriosis, fertility, and women's health in our region. 

This team will continue to cross train with each other and meet regularly in order to provide you with the most integrated, knowledgeable and compassionate care. For complex endometriosis cases, Dr. Winner works closely with her colleagues in radiology, and was the first to bring endometriosis protocol MRI and dynamic ultrasound to her hospital system. 

In the operating room, Dr. Winner has formed close relationships with her colleagues in colorectal surgery, urology and general surgery to ensure the safest care possible.

Dr. Winner and Dr. Kretzer are out-of-network gynecologists and we are not contracted with any insurance companies. However, our biller can submit your receipt (superbill) to your insurance for you, so you may get reimbursed for a portion of the bill if you have out-of-network benefits.

Most PPO insurance plans do provide some out of network coverage. For patients with high deductible plans, seeing an out of network provider may be a similar cost to an in-network provider. Please contact your insurance provider for details about your specific plan.

We accept traditional credit cards, HSA (health savings account) or FSA (flex spending account) cards, or CareCredit (a credit card that can be used for medical expenses). We require payment for office consultations and surgeries at the time of scheduling.

Unfortunately, due to Washington State law, we are unable to see patients with Medicaid even if you are willing to pay out-of-pocket.

We partner with CareCredit to offer payment plans if necessary.

We do not offer refunds, however, if you need to reschedule and do so with more than 24 hours’ notice in advance of your appointment, there will be no fee to reschedule and any fee paid for the appointment or procedure will apply to the rescheduled appointment. If you reschedule with less than 24 hours’ notice from your appointment, there will be a $50 rescheduling fee and any fee paid for the appointment or procedure will apply to the rescheduled appointment.  If you cancel your appointment and do not reschedule or miss your appointment, there is no refund of fees paid.

If you need to reschedule your surgery and do so with 10 or more business days’ notice in advance of your scheduled surgery date, there will be no fee to reschedule and any fee previously paid for the surgery will apply to the rescheduled surgery. If you reschedule with less than 10 business days’ notice from your scheduled surgery date, there will be a 10% rescheduling fee from the fee previously paid for the surgery and any fee previously paid for the surgery will apply to the rescheduled surgery.

If you cancel your surgery with 10 or more business days' notice in advance of your scheduled surgery date, there will be a 25% cancellation fee from the fee previously paid for the surgery. You will be reimbursed the remainder of the fee previously paid for the surgery. If you cancel your surgery with less than 10 business days' notice in advance of your scheduled surgery date or if you miss your surgery, there will be a 50% cancellation fee from the fee previously paid for the surgery. You will be reimbursed the remainder of the fee previously paid for the surgery.

Yes. Contact your insurance company for specific details about your plan.

Yes. We partner with CareCredit to offer interest-free payment plans up to 6 months.

We frequently hear from patients that they are frustrated with long wait times, short appointments, and physicians who do not have specific training or surgical skills to treat complex gynecologic conditions. 

These issues stem, in part, from poor reimbursement from insurance companies for women's health, requiring OB/GYNs to see a large number of patients per day. Other factors include an emphasis on obstetrics (taking care of pregnant women and delivering babies) in OB/GYN residency training, and higher reimbursement for obstetrics than gynecology. 

This is all a reflection of how insurance companies and society as a whole values women and women's health (thanks patriarchy). This is why minimally invasive gynecologic surgeons, urogynecologists and menopause specialists are all in short supply with high demand.

In addition, physicians who are in-network have to employ a large number of staff to do battle with the insurance companies to get patients the care that they need (hours on hold on the phone to obtain preauthorizations, fighting denials, doctors spending their lunch breaks doing peer-to-peer calls explaining why a treatment is necessary even though it is already in the note, following up on unpaid bills, etc).  

Small independent gynecology practices suffer even more, as they do not have negotiating power with insurance companies to get fair contracts.  In fact, some insurances will not even partner with solo practitioners. This is why many private practices (even those that practice obstetrics) are going out of business (Google "Seattle OB/GYN" to hear one sad story of what should have been a very successful practice going out of business).

These issues are especially true for complex gynecologic surgery, which reimburses significantly lower than other surgical fields such as orthopedic surgery or urology. Again, this is all a reflection of how women's health is viewed and valued by insurance companies. 

In addition, endometriosis surgery procedure codes are outdated, so that a quick ablation of one spot of endometriosis reimburses the same as an extensive excision of endometriosis from multiple and/or tricky locations. For this reason, and all the reasons listed above, almost all private practice endometriosis excision surgeons are out of network.

To make a long story short: We would not be able to provide the personalized, subspecialized, high-quality, detail-oriented, and multi disciplinary care that we know patients need and deserve if we were contracted with insurance companies.  We are sorry.  We wish it was different.

• Access to highly sought-after, expert minimally invasive gynecologic surgeons

• No long waits for consultations or surgery

• Fewer delays due to prior authorizations or insurance denials

• Messaging and postoperative checks with your surgeon, not a physician's assistant

• Ongoing support from an integrated multidisciplinary care team including pelvic floor physical therapy, acupuncture, nutrition and mental health counseling

• Simple, transparent pricing and help with submitting your superbill to insurance

• Physician-owned, woman-owned practice

Yes! We know you love the convenience of not having to drive, find our office, park, etc. In fact, we prefer to see patients coming in for surgical consults virtually first, and then have you come into the office for an exam later, once any additional testing you may need has been done.

Yes. Many patients have traveled from other states or even other countries for surgery with Dr. Winner. She has operated on patients from Alaska, Hawaii, Oregon, California, Idaho, Montana, Illinois, Texas, Florida, New York and Canada. She has also seen patients from all across Washington State including central and eastern Washington, Kitsap County and the San Juans. 

Unfortunately, patients have to be physically in the state of Washington, even for virtual visits, as this is where our doctors have their medical licenses.

No. We see many patients coming in for a second-opinion without a referral.

We are located at 6204 8th Ave NW, Unit A, Seattle WA 98107.
We are happy to offer free easy parking in our parking lot, and there is also ample street parking.

Surgeries will be performed at Swedish Ballard Hospital and Swedish First Hill Hospital downtown.