Evaluations, Tests and Treatment Options

Advanced Diagnostic Testing and Treatment

Urodynamic Testing

Urodynamic testing is a computerized evaluation of how the bladder, urethra and sphincters are working. The test uses thin, flexible tubes called catheters. It is not a painful procedure, but it may be uncomfortable. Please come to the test with a full bladder and be prepared to spend at least one hour in the office. You will be able to drive after this procedure and do not need to be accompanied.

At the beginning of the study you will empty your bladder into a machine that measures how fast your urine flows. Two small catheters will be placed: one vaginally or rectally, and one into the urethra. The catheters measure how much pressure is exerted on your bladder during the study. Your bladder will be slowly filled with sterile water. You will be asked to indicate fullness at various times during the filling process. You will also be prompted to cough and bear down to reproduce circumstances that provoke leaking. Once the bladder is full, you will be asked to empty your bladder into a special funnel with the catheters in place.

Cystourethroscopy

A cystourethroscopy is a procedure during which we insert a small lens into the urethra and bladder, looking for abnormalities that may contribute to your urinary symptoms. Your doctor will be inspecting the walls of your bladder and urethra and ureteral orifices.

An anesthetic gel to numb the area will be applied to the inside of the urethra. The procedure is usually not painful, but you may feel some discomfort. Be prepared to spend at least 30 minutes in the office for this test. You will be able to drive after this procedure and do not need to be accompanied.

Treatment Options, including Laser Therapy and Robotic Surgery

We offer a full range of treatments, from surgical to non-surgical options, including:

  • Minimally invasive urethral slings
  • Robotic/laparoscopic surgery
  • Vaginal surgery
  • Intravesical Botox
  • Management of mesh complications
  • Tibial neuromodulation (Urgent PC)
  • Sacral neuromodulation (interstim)
  • Urethral bulking injections
  • Pessary care
  • Pelvic floor physical therapy

Laser therapy is a new and innovative treatment option, ideal for women who have mild to moderate stress urinary incontinence (leaking). It is a non-hormonal, non-surgical therapy that helps alleviate the symptoms of urinary incontinence. The procedure is done in the office setting and typically takes less than 20 minutes with little to no down time.

Our surgeons are at the forefront of the adoption of robotic surgery for urogynecologic procedures, and were amongst the first to routinely offer robotic surgery to their patients with prolapse. Our state-of-the-art robotic system allows your surgeon to perform procedures such as a sacrocolpopexy, the "gold standard" repair for advanced pelvic organ prolapse, using a minimally invasive technique.

The robotic approach uses small incisions in the abdomen and the robot provides more dexterity, precision and control than standard laparoscopic surgery. When compared to an open approach, robotic surgery typically results in:

  • less pain after surgery
  • less blood loss and need for transfusions
  • less risk of infection and scarring
  • a shorter hospital stay (typically overnight) and recovery time
  • a quicker return to normal activities

Treatments offered also include non-surgical options, including:

  • Laser therapy
  • Biofeedback and pelvic muscle rehabilitation
  • Medications
  • Periurethral injections
  • Neuromodulation (Interstim)