The body takes nutrients from food and converts them to energy. After the body has taken the food and liquid that it needs waste products are left behind and must be eliminated and are filtered through the urinary system. The urinary system also keeps chemicals, such as potassium, sodium, and water in balance.
The Female Pelvic Medicine Institute uses the most state-of-the-art, research level LABORIE™ multichannel urodynamic testing. The gold standard to evaluate bladder function and maximize your comfort. This is used to evaluate the bladder itself as well as the urethra, pelvic muscles and nerves. Most testing includes assessment of bladder filling, emptying, continence as well as correlation with possible pain symptoms.
This test is the most objective way to determine the cause of bladder symptoms. It allows the assessment of the bladder, urethra, abdominal pressures, and pelvic muscles at the same time. This allows Dr. Guerette and his staff to accurately pick the best therapy options for you. Urodynamics can be particularly important if you have complex incontinence symptoms, difficulty emptying your bladder completely, prior bladder surgery, diabetes, or any neurological issues.
Testing is not painful; however it may cause some mild discomfort. An anesthetic gel solution is used to numb and lubricate the urethra. The catheters are very small. You will feel the urge to urinate at the end of the test.
Our urogynecology diagnostics testing will take approximately 15 minutes.
A cystoscopy is a simple in-office test that enables us to examine directly inside your bladder through our state-of-the art and very small, high precision WOLF™ flexible scope (less than the diameter of spaghetti). This allows us to directly examine the urinary tract, particularly the bladder, the urethra, and the openings of the ureters (tubes from the kidneys to the bladder). Cystoscopy can assist in identifying problems with the urinary tract, such as, infection, narrowing, obstruction, stones, growths, and bleeding. In addition to allowing visualization of the internal urethra and bladder, the cystoscope, if necessary, enables us to irrigate, suction, biopsy and access these structures with surgical instruments.
There is no significant preparation but we ask you to be well hydrated prior to the test. This shortens the duration of the test to aid in your comfort. We recommend you drink 36 ounces of fluid within 2 hours of the cystoscope.
To investigate and diagnose signs and symptoms of:
A cystoscopy is not painful; however it might cause some mild discomfort.
A cystoscopy will take 5 to 10 minutes.
FPMI uses, high-resolution, state-of-the-art, Laborie equipment to evaluate the rectum and anus. Anorectal manometry is an in-office procedure that tests your rectums ability to expand and contract. This is needed to assess fecal incontinence, types of constipation, pain and other problems associated to eliminating waste from your body. It is particularly useful for pre-surgical and post-surgical evaluation of the anal sphincter, anorectal pain, pelvic floor dysfunction, and dyssynergia (incorrect use of the pelvic floor muscles). With the anorectal manometry, Dr. Guerette and his staff will measure the pressures of your anal sphincter muscles, sensation in the rectum, and the neural reflexes that are needed for normal bowel movements.
Anorectal manometry provides us valuable information regarding anorectal function. It indicates the, types of treatment and prognosis of treatment, particularly sphincter injuries, and may be used in our biofeedback treatments.
Digestive healthcare is important to us, so we need to measure the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are needed for normal bowel movements.
Some of the common disorders anorectal manometry evaluates are:
No pain and no sedation is required; there is slight pressure as the tube is being inserted.
An anal manometry test will take only 5-10 minutes.
FPMI uses state-of the art pudendal nerve terminal motor latency testing which is the most common test to evaluate the external nerve that controls the pelvic floor muscles, urinary sphincters, and anal sphincter muscle. It may be done following an anorectal manometry.
Pudendal nerve is a sensory, autonomic, and motor nerve that carries signals to and from the genitals, anal area, and urethra.
No pain associated is with this procedure.
PNTML testing takes just 2 to 3 minutes.
With our LABORIE™ endoanal ultrasound we use sound waves to generate an image of soft tissues surrounding the anus and lower rectal canal. Dr. Guerette and his staff will use the ultrasound to establish if there are certain anatomic defects, or tears, in your anal sphincter muscles which are often clinically unrecognized and may be amenable to surgical repair.
Our Endoanal Ultrasound improves our ability to diagnose structural lacerations to the sphincter muscle. Significant nerve injury to a muscle can also be associated with muscle atrophy and volume loss. These findings are critical to counselling you on your treatment options.
No pain associated with this procedure.
An endoanal ultrasound takes just 1-2 minutes.
Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is a noninvasive medical test.
A Doppler ultrasound exam may be part of a pelvic ultrasound examination.
Doppler ultrasound is a special ultrasound technique that allows the physician to see and evaluate blood flow through arteries and veins.
With our GE™ 3D pelvic ultrasound, our probes are able to create detailed images of your pelvic floor structures. Our 3D ultrasound distinguishes your pelvic organs, muscle and fascial components. We can identify the urethra, levator ani muscle, pelvic organs, prolapse, and surgical implants used in continence procedures or pelvic reconstructive surgery. This is non-invasive technology that Dr. Guerette and his staff provides to elevate the standard of care for his patients.
In women, a pelvic ultrasound is most often performed to evaluate the:
Ultrasound examinations can help diagnose symptoms experienced by women such as:
And help identify:
A transvaginal ultrasound is usually performed to view the endometrium, the lining of the uterus, and the ovaries. Transvaginal ultrasound also provides a good way to evaluate the muscular walls of the uterus, called the myometrium. Sonohysterography allows for a more in-depth investigation of the uterine cavity. Three-dimensional (3-D) ultrasound permits evaluation of the uterus and ovaries in planes that cannot be imaged directly. These exams are typically performed to detect:
We also use 3-D ultrasound to visualize positions of pelvic organs, muscle defects, and foreign objects in the pelvis such as mesh from incontinence and pelvic organ prolapse procedures.
You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.
You may be asked to wear a gown during the procedure.
Ultrasound imaging may take just 5-15 minutes.
For most ultrasound exams, you will be positioned lying face-up on an examination table that can be tilted or moved.
After you are positioned on the examination table, the sonographer will apply a warm water-based gel to the area of the body being studied. The gel will help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body. The transducer is placed on the body and moved back and forth over the area of interest until the desired images are captured.
There is usually no discomfort from pressure as the transducer is pressed against the area being examined. However, if scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer.
Once the imaging is complete, the clear ultrasound gel will be wiped off your skin. Any portions that are not wiped off will dry to a powder. The ultrasound gel does not stain or discolor clothing.
Transvaginal ultrasound is performed very much like a gynecologic exam and involves the insertion of the transducer into the vagina after you empty your bladder. The tip of the transducer is smaller than the standard speculum used when performing a Pap test. A protective cover is placed over the transducer, lubricated with a small amount of gel, and then inserted into the vagina. Only two to three inches of the transducer end are inserted into the vagina. The images are obtained from different orientations to get the best views of the pelvic organs. Transvaginal ultrasound is usually performed with you lying on your back, possibly with your feet in stirrups similar to a gynecologic exam.
A clear water-based gel is applied to the abdomen. A transducer is moved back and forth over this area until the desired images are captured.
Ultrasound examinations are painless and easily tolerated by most patients.
Our PFT® Health Coaching is a unique program offered at The Female Pelvic Medicine Institute. Our Director of Rehabilitation, MaryAnne Snavely, works with women to develop proper lifestyle factors and decrease the risk of pelvic organs dropping—a common problem that can lead to issues such as urine leakage and incontinence.