Urogynecology Services

Incontinence, or the loss of bladder control, is an uncomfortable, embarrassing problem that is far more common than most people realize. An estimated 20% of people over 65 and large numbers of younger people suffer from periodic or chronic incontinence.

 

But the good news is they don't have to.

 

Thanks to modern diagnostic and treatment methods available at the our office, people who experience incontinence or other urinary problems can find successful ways to cure or manage their disorders.

 

Helping Women with Bladder Problems - Diagnosis

Among the many sophisticated diagnostic procedures we use are computerized monitoring devices to measure bladder pressure, urinary flow, and sphincter muscle strength. Called urodynamic testing, these tests are essentially painless and are conducted in a comfortable, private, dignified atmosphere.

 

Once our team of experts carefully analyzes your condition, we take the time to fully explain our findings to you and to your family. Because our doctors also maintain full-service urological and gynecological practices, we have a myriad of treatment modalities to offer. We make an individual treatment plan for each patient.

 

Initial Evaluation

When a woman first presents with a bladder or prolapse problem, she first meets with me in my office and we go over all of the symptoms. Is there a problem of urinary leakage, bulging of the bladder or uterus, waking up at night, urinating too frequently?

 

We then proceed to the examination room where I perform a complete exam often including a painless catheterization for a sterile urine sample.

 

If prolapse is immediately apparent, a pessary may be recommended. This is usually a silastic disc that forms an internal frame for the prolapsed uterus or vagina to sit on for immediate relief. This can be fit on the spot and give relief while other options are explored.

 

A bladder diary or Urologue is recommended in most cases to see how the bladder functions in normal life circumstances. You will be given a receptacle that fits under the toilet seat to measure your urine each time you go, we don't keep the urine, just measure it and record it on the sheet given to you at your visit. 2 days is all I ask along with how much, what, and when you are drinking fluids. It is an easy, and low cost way to learn a lot about your bladder function.

 

Cystoscopy a painless look in the bladder with a small telescope can be performed when indicated in our offices with only a local gel anesthetic required.

 

If bladder dysfunction is apparent, a further treatment plan will be developed. This may include medication, surgery, or any of the many non invasive treatments and testing modalities available at the Pacific Continence Center.

 

  1. Urodynamic testing: A high tech option that displays on a computer exactly what is going on in the bladder when the leaking or urgency is occurring.
  2. Computer assisted biofeedback: Enhanced pelvic floor exercise that is covered by most insurance programs and Medicare.
  3. Neuromodulation: to stimulate muscles when there is nerve damage
  4. Bladder retraining
  5. Behavior Modification
  6. Dietary counseling as it pertains to several bladder conditions
  7. Bladder instillations of medication for painful bladder conditions

 

The Urogynecology Team

I work with a team of practitioners to deliver comprehensive care for all bladder related problems. Members of the team include:
-Roberta Yates, RNNP who sees all patients with pessaries and follows up on lab tests and treatment follow up.
-Maria Diaz, RNNP who is at the Pacific Continence Center and performs the urodynamic testing, patient counseling, and biofeedback.
-The Harbor-UCLA fellow, a fully trained gynecologist who sees patients alongside me in my office and assists on most surgeries along with my partners when appropriate.

 

Surgery

If surgery is chosen as the best option for your problem, it will be scheduled by Cynthia Cabalka, our office manager who is in charge of all scheduling. Cynthia also schedules the Urodynamic testing and can be reached at (310) 394-3690

 

A Gynecologic/Urologic Medical Group

In 1991 Drs. Amy Rosenman and Leslie Kaplan developed the Pacific Continence Center to combine the best of urogynecology and urology for the treatment of patients with bladder problems. Dr Rosenman combines the facilities available in her gynecology office with the extra offerings of the Pacific Continence Center to give all patients state of the art care.

 

At the Pacific Continence Center, we offer the same comprehensive testing and treatments found at a university or research medical center combined with the personal, caring services of expert gynecologists and urologists. This type of service is unavailable in most centers.