Sexual medicine is a medical specialty that focuses on your sexual and pelvic health. This specialty encompasses diagnosing, assessing, and treating all aspects that relate to sexuality, including sexual health counseling. The Fosnight Center for Sexual Health can also provide specialty urological healthcare, which often overlaps with your sexual health. We work collaboratively with other local providers to meet all of your care needs.
Take the first step toward better health and confidence—explore the sexual health conditions we treat and discover personalized solutions designed for you.
Vulvoscopy is procedure performed in the office to aid in a more detailed pelvic examination of the female external genitalia.
This device allows the provider to see those structures in a magnified capacity through a special microscope, bringing out architecture that is not always visible with the eye. A special solution may be applied to the vulva during the vulvoscopy to help differentiate abnormal cells from normal ones.
If a questionable area is seen during the vulvoscopy, a vulvar biopsy may be performed at the same time.
A duplex Doppler ultrasonography not only allows the provider to visualize the vascular structures within the pelvis, but ultrasonography also allows for evaluation of the pelvic floor musculature.
This can aid in diagnostic of pelvic floor disorders and treatment options.
Trigger point injections are recommended as a treatment option for patients with pelvic floor muscle spasms that often cause pelvic pain and/or difficulties with sexual function.
The injections are performed in the office and the majority of the time are used with ultrasound guidance in order to increase the effectiveness of the injection. Injection medications can include a local anesthetic, steroid, and/or neurotoxin agents.
A series of injections in conjunction with pelvic floor physical therapy and/or Softwave shockwave therapy can maximize the effectiveness of the treatment and will be determine individually with the patient.
Evaluation of pelvic and penile tissues can aid in treatment options for those patients with erectile ability concerns.
A penile doppler ultrasonography allows the provider and the patient to visualize blood flow to the pelvis and penile structures, isolating the cause for decreased vascularization.
This is an in-office procedure and is performed in conjunction with an artificial erection injection.
There are several neurologic diagnostic testing essential for evaluation of pelvic pain.
These include magnetic resonance imaging (MRI), nerve blocks, and electromyography (EMG).
Not all of these diagnostic tests will be required for each patient, however, a more focused, individual plan will be discussed and determined collaboratively with the provider and patient.
During a pelvic exam, the provider may perform a cotton swab test on the genitals to diagnose sexual health or pain concerns.
The test involves the use of a cotton swab placed on various sites on the genitals and the patient sensations are recorded.
This test is extremely helpful in diagnosing certain conditions. The provider will discuss with you in great detail the test before the exam begins.
Sacral neuromodulation has been FDA approved to treat urge incontinence, fecal incontinence, and incomplete bladder emptying.
A nerve evaluation test will first be performed in the office and if results are successful, we will discuss next best steps with the implantable device.
Percutaneous Tibial Nerve Stimulation (PTNS) is a minimally invasive neuromodulation therapy used to treat overactive bladder (OAB) symptoms, including urinary urgency, frequency, and urge incontinence. PTNS works by stimulating the tibial nerve near the ankle using a small needle electrode, which sends mild electrical impulses to the sacral nerve plexus, responsible for bladder control. This therapy is typically administered in weekly 30-minute sessions over 12 weeks and can help improve bladder function without the need for surgery.
Evaluation of pelvic and penile tissues can aid in treatment options for those patients with erectile ability concerns.
A penile doppler ultrasonography allows the provider and the patient to visualize blood flow to the pelvis and penile structures, isolating the cause for decreased vascularization.
This is an in-office procedure and is performed in conjunction with an intracavernosal injection.
This is a specialized in office procedure to investigate symptoms associated with interstitial cystitis.
A small scope will be inserted through your urethra with local anesthesia to look at your bladder and distend the bladder with fluid.
A modified cystohydrodistention can be both diagnostic and therapeutic, helping to alleviate some of the pelvic pain associated with interstitial cystitis.
Bladder instillations are specialized medication blends administered directly into the bladder during an in-office procedure.
We use a variety of medication combinations to meet the individual need of each patient. Bladder instillations can be used for patients with pelvic pain, interstitial cystitis, radiation cystitis, recurrent urinary tract infections, and other medical conditions.
Bladder chemodenervation is a treatment for overactive bladder (OAB) that involves injecting botulinum toxin (Botox or Dysport) into the bladder muscle to reduce excessive contractions. This procedure helps relax the bladder, increasing its capacity and decreasing urgency, frequency, and urge incontinence. It is typically performed in a clinic under local anesthesia and provides long-lasting relief, with effects lasting several months before repeat treatment may be needed.
Chemodenervation of the pelvic floor muscles involves injecting botulinum toxin (Botox or Dysport) into overly tight or hypertonic pelvic floor muscles to reduce excessive muscle tone and spasms. This treatment helps alleviate pelvic pain, pelvic floor dysfunction, and symptoms such as urinary urgency, urinary retention or painful intercourse. The procedure is performed under local anesthesia and provides temporary relief, with effects lasting several months before repeat treatment may be necessary.
A series of injections in conjunction with pelvic floor physical therapy and/or Softwave shockwave therapy can maximize the effectiveness of the treatment and will be determine individually with the patient.
Subcutaneous pellet hormone therapy involves the administration of hormones through small implants beneath the skin. This method provides a steady release of hormones, helping to alleviate symptoms of hormonal imbalances such as fatigue, mood swings, low libido, and other endocrine-related issues.
This safe and simple procedure can be performed in the office with a local anesthetic every 3-6 months.
Evaluation of pelvic and penile tissues can aid in treatment options for those patients with erectile ability concerns.
A clitoral doppler ultrasonography allows the provider and the patient to visualize blood flow to the pelvis and clitoral structures, isolating the cause for decreased vascularization.
This is an in-office procedure and is performed in conjunction with an oral or topical vasodilator.
One of the most effective treatment options for men with Peyronie’s has been intralesional injections. This allows for direct treatment of the plaque, resulting in reduction of the lesion size and decreased penile curvature.
These injections are performed in the office under ultrasound guidance for optimal plaque visualization. Medications used include verapamil, interferon, and collagenase clostridium histolyticum (Xiaflex).
A series of injections in conjunction with stretching and modeling exercises maximizes the effectiveness of the treatment.
Other treatment modalities recommended include pelvic floor physical therapy, Softwave shockwave therapy, and oral medications, and will be determined individually with the patient.
Cystoscopy is a minimally invasive in-office procedure used to examine the inside of the bladder and urethra. A thin, flexible tube with a camera (cystoscope) is inserted through the urethra, allowing the provider to assess for abnormalities such as inflammation, stones, or tumors. The procedure is performed under local anesthesia and takes only a few minutes, with minimal discomfort and little to no downtime. Occasionally urethral dilation is required.
A vulvar biopsy is a diagnostic procedure performed in the office to determine the cause of vulvar symptoms including irritation, lesion, suspected malignancy, auto-immune disorders, skin pigment changes, and conditions that are not resolving with standard treatment.
A local anesthetic is used prior to taking a biopsy of the area and may require a suture for closure.
Follow up will be scheduled to ensure proper wound healing, discuss biopsy results, and determine best course of treatment including referral to collaborating providers in the area.
Penile injections are a safe and effective method to improve blood flow to the penis.
There are many health diseases that can impair the blood flow to the pelvic and penile tissues, limiting arousal and erections. These injections allow for dependable erections for sexual play.
Education around how to perform self injections is vital to the safety and efficacy of the medications, and instructions will be provided to the patient in the office.
