How Do Our Consultations Work?
We focus our consultation services to the referring physician's needs and preferences as detailed below.
If you request our evaluation only, the patient receives a comprehensive evaluation of her incontinence as well as any pelvic floor defect. This evaluation includes clinical and, if indicated, further diagnostic testing as detailed below. We send you a letter reviewing the findings. In the letter, we make recommendations to you regarding both surgical and non-surgical therapeutic options.
If you request both our evaluation and management, we evaluate the patient as described above. Our letter to you reviews the findings and outlines our initial management. For patients who require reconstructive surgery, we send you a follow-up letter after the post-operative visit. If you have full operating privileges at the hospital where the surgery is performed, and choose to participate in the surgery, we will make all efforts to accommodate you. For patients who do not need surgery, we correspond with you regularly on the patient's progress.
In all cases, we inform your patient of the consultative nature of the referral, and clearly direct her back to you after the completion of our services.
What Does Our Consultation Service Involve?
At the patient’s first visit, we perform a complete history and physical, with emphasis on pelvic floor defects and disorders of the lower urinary tract. We also perform a preliminary urodynamic test (uroflowmetry).
If, after our clinical assessment, the diagnosis is relatively clear and the patient is not a surgical candidate, we will outline initial management without the aid of formal multi-channel urodynamics.
In more complex cases, where the etiology of her lower urinary tract symptoms is not clearly evident upon clinical evaluation, we have the patient come in for a second visit for urodynamic evaluation. (Urodynamic testing is also performed prior to surgery when indicated.) This session takes between 45 minutes to an hour. We see the patient at a third visit for post-procedure counseling and review of the results.
Our In-office Urodynamic Evaluation Includes the Following:
Urethral pressure profilometry
Measurement of abdominal leak point pressure
The patient may also require further testing such as urethrocystoscopy or imaging studies.
A description of these tests, in patient-friendly language, is available for your patients.