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Diagnosis

Diagnostic Tests

The diagnosis of female pelvic prolapse conditions is usually made first by a urologist using one or more of the following methods:

Pelvic Examination & Pelvic Floor Strength Test: When a woman seeks medical care for any type of pelvic prolapse, the initial investigation of her symptoms typically includes a pelvic exam.  During this examination, the physician will test the strength of the pelvic muscles by asking the patient to bear down as if she were having a bowel movement.  The patient may also be asked to tighten and contract the pelvic muscles as if controlling a stream of urine and both tests may be performed while the patient is lying down on her back and while standing up.

Bladder Function Test: This is also called a "Voiding Cystourethrogram" and involves a series of x-ray images captured during urination.  These images show the shape of the bladder which helps the doctor identify any factors that may be standing in the way of the normal flow of urine.

Imaging Studies: Though rarely needed to diagnose a prolapse condition, the physician may find something during the physical examination that requires further investigation.  He or she may order one or two common imaging studies including X-ray, MRI and Ultrasound.  These tests can help determine the size of the bulging or prolapse organ as well as how it may be affecting the surrounding organs and their normal functions.

Cystoscopy: This is a direct visual examination of the urethra and bladder.  Usually, a small flexible endoscope is placed into the urethra and advanced into the bladder.  During this exam, the urologist evaluates the integrity of the urethra and inner lining of the bladder.  Visual examination of the bladder is also important to rule out other disease processes that may produce symptoms similar to prolapse.  These can include bladder cancer, bladder stones, urethral diverticulum, or overactive bladder.

Urodynamics: In this study, a small catheter is placed in the bladder via the urethra and another is placed in the vagina or the rectum.  These catheters are pressure transducers.  They measure the amount of pressure inside and outside the bladder as the bladder is slowly filled with sterile fluid.  Furthermore, small sensors are also placed on the skin near the pelvic muscles that can detect pelvic muscle activity.  Urodynamic study is essential in the detection of disease processes that lead to urinary and pelvic symptoms.  This study can help differentiate pelvic prolapse from other conditions such as neurologic disorders of the bladder and overactive bladder syndrome.

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