WHICH DIAGNOSTIC TESTS DO WE ROUTINELY PERFORM AT THE PELVIC CARE CENTER ?

WHICH TREATMENTS DO WE PROVIDE AT THE PELVIC CARE CENTER?

  • Dynamic MRI proctogram to identify defecation disorders and pelvic organs prolapse;

  • Endoanal Ultrasound to assess anal sphincters and perianal tissues by consultant Gastroenterologyst;

  • Lactulose breath test to identify various conditions such as slow transit constipation and bloating by Consultant Gastroenterologist

  • Abdominal, Pelvic, Duplex US scan by Consultant Gastroenterologist;

  • Obstetric and Gynecology US scan  by Consultant Obstetric and Gynecologist;

  • Pelvic US scan by consultant Urologyst;

  • Anal manometry and balloon expulsion test to assess anal sphincter function by Consultant Colorectal surgeon;

  • Advanced Urodynamic assessment for chronic urinary dysfunction and impaired voiding conditions;

  • Endoanal and superficial non-needle electromyography recruitment to assess electrical activity of anal sphincter, coordination of muscle of the pelvic floor and recruitment of antagonist muscles by Consultant Colorectal surgeon;

  • Endovaginal and superficial non-needle electromyography recruitment to assess electrical activity of vaginal muscle, coordination of muscle of the pelvic floor and recruitment of antagonist muscles by Consultant Urologyst;

  • Pelvic Neurophysiology electromyography end evoked potentials tests to assess electrical conductivity of Pudendal nerve by Consultant Urologist;

  • Complete Urodynamic tests to assess urinary conditions including incontinence urgency and voiding problems;

  • Peripheral Nerve Evaluation (PNE) to assess whether sacral nerve neuromodulation is effective and appropriate for certain condition such as anal incontinence and other lower urinary tract dysfunctions;

  • Sexual enhancement treatments for chronic age and non-age related sexual dysfunctions both in female and male

  • Vaginal Surgery for acute and chronic vaginal condition requiring surgical correction

  • Minimally invasive and advanced procedures for colo-proctology conditions such as hemorrhoids, anal fistula and non-surgical treatment for anal spasm and anal pain;

  • Routine and advanced endoscopy services including polypectomies, endoscopic mucosal resection and trans-anal resection;

  • Routine advanced laparoscopy for pelvic organ prolapse and other benign gynecologic and urologic conditions;

  • Routine and advanced endoscopic-urologic procedure for diagnosis and treatment con urinary tract and bladder diseases including stone disease;

  • Non-scalpel minimally invasive vasectomy;

  • Advanced treatments of chronic constipation and irritable bowel syndrome;

  • Peripheral nerve stimulation for chronic pelvic pain, functional anal and urinary conditions and some forms of anal and urinary incontinences;

  • Biofeedback and pelvic muscle retraining with and without electrical stimulation for various pelvic conditions such as incontinences, obstructed defecation, pelvic dyssynergia, chronic pelvic pain, voiding dysfunctions, etc.

  • Peripheral nerve anesthetic blocks under EMG guidance for chronic pelvic pain or anal spasm;

  • Peripheral nerve denervation for chronic pelvic pain with Pulsed Radiofrequency for chronic pelvic pain and other conditions;

  • Sacral Nerve Neuromodulation permanent implants for chronic pelvic conditions such as fecal and urinary incontinences;

  • Sexual enhancement treatments for chronic age and non-age related sexual dysfunctions both in female and male.

WHICH PATHOLOGIES / CONDITIONS WE TREAT IN THE PELVIC CARE CENTER?

We provide initial consultation assessment diagnosis and innnovative care option for :

  • Chronic Pelvic Pain

  • Pelvic Organs Prolapse

  • Chronic constipation

  • Complex colonic and rectal polyps

  • Common anorectal conditions

  • Anal & Fecal incontinence

  • Outlet type constipation and obstructed defecation syndromes

  • Urinary incontinence

  • Urinary retention and other voiding dysfunctions

  • Sexual dysfunction age and non-age related in both sexes

  • Advances Gynecologic screening modalities and disease prevention

  • Obstetric services and delivery assistance

TREATMENTS FOR CHRONIC PELVIC PAIN

Sacral Neuromodulation

Sacral neuromodulation is a well established therapy for patients with lower urinary tract dysfunction. This therapy has also been suggested to be useful in the treatment of chronic pelvic pain

Pudendal Peripheral Nerve Block

 

Pudendal nerve blocks are a minimally invasive, non-surgical treatment for chronic pain. These nerve blocks can help in the diagnosis of chronic pelvic pain conditions such as vaginal pain, penile pain, scrotal pain, or perineal pain. In addition, this pain management technique can also provide therapeutic relief by reducing pain signals originating from these nerves.

The pudendal nerve is prone to damage either by compression or stretch. Common scenarios where this may occur include trauma, prolonged/difficult/traumatic vaginal childbirth, or chronic straining during defecation caused by constipation. Pudendal nerve entrapment, also known as Alcock canal syndrome, is less rare and is associated with professional cycling or repetitive trauma on perineal area or wrong posture.

Systemic diseases such as diabetes and multiple sclerosis can also damage the pudendal nerve.

 

How It Works

A pudendal nerve block is performed with neurophysiology  guidance to increase the accuracy and safety of this procedure.

 

    You will be asked to lie on your stomach.

    Your lower back and buttocks will be cleaned with an antiseptic, and a sterile drape will be placed. 

    Your physician will direct a guide needle toward the intended target area under EMG ( C-MAP ) guidance. Bony landmarks will help facilitate safe placement of the needle.

    A local anesthetic and a steroid (cortisone) will be administered in close proximity to the nerve to block signals from reaching the brain. The cortisone serves as an anti-inflammatory under the assumption the nerve is  inflamed or irritated.     The needle is then flushed and withdrawn, and a dressing is placed over the point of needle entry.

 

Risks

This procedure is safe. However, with any procedure, there are side effects, risks, and possibility of complications. The most common side effect is temporary pain at the injection site. Other less common risks include bleeding, infection, or injection into blood vessels or vital organs. Fortunately, serious side effects and complications are uncommon. Injections of anti-inflammatory steroid medications along with local anesthetic

or local anesthetics alone can provide slow relief of nerve pain over three to four months. The bulk of nerve-pain patients respond to injections. Radio frequency ablation can be helpful as well.

Educational Leaflets

HOW CAN YOU BE REFERRED OR SEEN BY A PHYSICIAN AT THE HARLEY PELVIC CARE CENTER?

How can you be referred or seen by a physician at the Harley Pelvic Care Center?

  • If you have seen a physician elsewhere, he or she may refer you to a specific physician at the Pelvic Care Center according to your most prevalent symptom;

  • If you want to see a specific physician for what is your most prevalent symptoms you may do so;

  • If you are uncertain which physician is best for your initial consultation, our receptionist will book you to one physician initially according to your most prevalent symptoms;

  • Internal referrals and multidisciplinary care is activated whenever a case requires more than one specialist’s expertise; you don’t have to worry about that as it is an automatic and internal process.

HARLEY STREET MEDICAL CENTRE

POBOX 41 475

Villa No. A 20, A 21 and A 22,Marina Ring Road,Marina Village - Abu Dhabi - United Arab Emirates

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