Services 

​​​​Office Procedures


Catheterization: Use of a pediatric sized catheter to drain urine from the bladder. This may be done to determine if you empty your bladder appropriately, or to collect urine specimens to send to the lab. 


Cystoscopy: a procedure that involves placing a tiny camera though the urethra into the bladder to visualize thes areas


Urodynamic Testing: a bladder function test involving the use of a tiny catheter in the bladder and one in the vagina or rectum.  The bladder is filled with sterile fluid to assess the bladder and urethra muscles and nerves.  This test can help determine the reason for leakage of urine and/or the reason for inability to empty the bladder well. 



Conservative Treatment Options


Dietary Changes: A list of foods and drinks that are removed from the diet for a few days and then reintroduced to assess if that particular food or drink can aggravate bladder symptoms.  


Bladder Training: Training your bladder to hold urine longer by doing pelvic floor exercises when you have an urge to urinate and allowing that urge to pass prior to urinating.  The amount of time holding your urine increases incrementally over time. 


Pelvic Floor Muscle Rehabilitation:  An office procedure involving the placement of a small probe in the vagina and/or rectum to evaluate and train the pelvic floor muscles. This procedure can help patients identify the appropriate pelvic muscles and help them learn to strengthen and relax these muscles.  It is used to treat vaginal prolapse, urinary incontinence, fecal incontinence and pelvic floor weakness. 


Pelvic Floor Physical Therapy (PFPT):  Meeting with a pelvic floor physical therapist to better understand the exercises involved in strengthening the pelvic floor muscles.  PFPT treats many issues including vaginal prolapse, urinary incontinence, fecal incontinence, pelvic muscle weakness and pelvic pain.


Pessary: A ring that is placed in the vagina to support a vaginal prolapse and/or treat leakage of urine. A pessary fitting is done to determine which pessary may be right for you.  Sometimes you may need to try a few pessaries until you find the right pessary for you


Geneveve/Vaginal Rejuvenation: A small probe placed in the vagina for 25 minutes in the office to improve urinary incontinence, vaginal laxity, orgasms, lubrication and arousal.  






MInimally Invasive Treatments

Laparoscopic Surgery: A surgery that involves tiny incisions on the abdomen. 

Robotic Surgery: A laparoscopic surgery in which a robot holds and manipulates the instruments under the command of the surgeon


Periurethral Injections: A procedure done during a cystoscopy during which a tiny needle is used to inject a substance into the urethra to bulk up the urethra to reduce urinary incontinence that occurs with activity.


Slings: A surgical procedure in which a thin ribbon of mesh is placed through a vaginal incision near the urethra to reduce urinary incontinence that occurs with activity.  


Interstim: A procedure that involves implanting a small device in the area of where your hip pocket would be. This device gives off a signal to the bladder nerves to treat urge related urinary incontinence, frequent urination, incomplete bladder emptying and fecal incontinence. 


PTNS: An office procedure involving the placement of an acupuncture needle in the ankle and attaching the needle to a small battery to stimulate the nerves that go to the bladder.  This procedure gives off a signal to the bladder nerves to treat urge related urinary incontinence, frequent urination, incomplete bladder emptying and fecal incontinence.  It is repeated weekly for 12 weeks, and then monthly. 


Botox:​​ Injection of botox in the bladder during cystoscopy to relax the muscles of the bladder.  This treatment temporarily treats urge related urinary incontinence and frequent urination. It is periodically repeated to maintain efficacy. 


Labiaplasty/Labial Reduction: A surgical procedure to reduce the size of the labia minorato improve discomfort with activity.


Vaginoplasty: An in-office Geneveve® procedure, as above, to improve vaginal laxity, arousal, lubrication and urinary incontinence, or a surgical procedure to tighten the vagina and improve laxity. 

PREOP INSTRUCTIONS

Our surgery scheduler will contact you with instructions specific to your surgery.

DAY OF SURGERY

On the day of surgery, you will be asked not to eat or drink anything after midnight, unless otherwise instructed. 

HOSPITAL STAY

For patients who are admitted, the hospital stay is usually 23 hour observation.  You may, however, stay longer depending on your medical history and postoperative course. 

POSTOP INSTRUCTIONS

Our surgery scheduler will contact you with instructions specific to your surgery. 

AFTER SURGERY

Typically, you will be seen postoperatively at weeks 2 and 6 after surgery.  Patients requiring a voiding trial or incision check may be seen in the first couple of days postoperatively.  Your follow-up instructions will be finalized at the time of your discharge from the hospital or surgery center. 

Your Surgery

Call Us:     +1-703-293-5239

Specializing in Urinary Incontinence and Reconstructive Pelvic Surgery