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Center for Pelvic Physiology

The Center for Pelvic Physiology uses technology to evaluate patients with fecal and urinary incontinence, constipation, pelvic floor disorders, urinary tract disorders and anal and rectal tumors or fistulas. Established in 1995, we recently expanded our services and moved in 2004 into a new state-of-the-art facility. A specially trained nurse and board-certified colo-rectal surgeon or urogynecologist conduct comprehensive evaluations. Specialists in gastroenterology, urology and gynecology are available to assist our team.

In addition, we offer biofeedback therapy as well as innovative surgical therapies for fecal and urinary incontinence. Our patients who don't respond to conventional care may participate in clinical trials or research projects that test innovative, experimental therapies.

Procedures

Services offered at the center include:
  • Anorectal Manometry — Measures internal and external sphincter pressures, rectal sensation, rectal volume capacity and recto-anal inhibitory reflex (RAIR), which can confirm or exclude a diagnosis of Hirschsprung's disease

  • Cytoscopy — Evaluates the urethra and bladder for intrinsic lesions by direct visualization

  • Endoanal Ultrasound — Evaluates the integrity of internal and external sphincter for incontinence and fisula-in-ano

  • Endorectal Ultrasound — Evaluates the depth of rectal tumors for staging

  • Pudendal Nerve Testing — Evaluates the presence and response rate of the pudendal nerve, which may impact fecal incontinence

  • Puborectalis Muscle Fiber Recruitment — Measures neuromuscular activity that helps diagnose pelvic floor dysfunction

  • Urodynamic Testing includes:

    • Cystometrogram (CMG) — Pressure filling study used to evaluate bladder capacity, sensation and urinary incontinence
    • Urethral Pressure Profile (UPP) — Evaluates urethral closure pressure, a measure of severity of stress incontinence
    • Uroflometry/Voiding Pressure Study — Evaluates voiding mechanism and function

  • Biofeedback — Functional training of rectum, anal sphincter and pelvic floor muscles to treat fecal incontinence and constipation

Conditions

The following conditions are among those evaluated at the center:

Our Team

Dr. Madhulika G. Varma is director of the Center for Pelvic Physiology. Other staff members include Dr. Sharon Knight, director of Gynecologic Urology, and gynecologists Dr. Abner Korn and Dr. Leslie Subak. Nurse Susan Wong is the clinical assistant and a certified biofeedback specialist.

For more information, please contact:

Center for Pelvic Physiology
Medical Office Building
2330 Post St., Suite 219
San Francisco, CA 94115

Phone(415) 885-7673
Fax(415) 885-7678

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