Women s PeRsonAL health Chesapeake Urology Associates, P.A.

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1 Women s PERsonAL health

2 Welcome to Chesapeake Urology s Urodynamics Services. Urinary incontinence keeps millions of people from enjoying a full life, but today, many treatments are available to help. To assist your physician in determining the source of your urinary incontinence symptoms and the best course of treatment, urodynamics may be recommended. What is Urodynamics? Urodynamics refers to a series of diagnostic tests that evaluate the function of the bladder and urethra. These tests may be recommended if you have urinary incontinence (leakage of urine), recurrent bladder infections, slow or weak urinary stream, incomplete bladder emptying, or frequent urination. How to prepare for Urodynamics Prior to your appointment, you may be asked to fill out a questionnaire or voiding diary. Please bring this with you to the appointment. At the beginning of the test you will be asked to provide a urine sample so please arrive for the study with a relatively full bladder. You may eat or drink anything prior to the study. Take your medications as normally scheduled, unless otherwise directed by your doctor. The tests typically take about 60 minutes and are generally painless, so no anesthesia is necessary. Your friends and family are welcome to accompany you but will be asked to remain in the waiting area. You will be able to resume all previous activities, including driving, at the completion of the urodynamics studies. A catheter (soft, hollow tube) or special sensor will be carefully placed in your urethra and sometimes your rectum to perform the study. Your physician will decide which of the following tests need to be performed to help diagnose and treat your condition. Uroflow This test measures the speed and amount of urine you void. You should come to the test feeling as though you need to urinate. Try not to empty your bladder one hour before your test. You will be asked to urinate into a commode with a funnel attached to a computer that measures your urine flow. Cystometrogram This study evaluates how your bladder holds urine, measures your bladder capacity, and also determines how well you can control your bladder. Through a catheter your bladder is filled with fluid. In order to reproduce your bladder symptoms, you should report any sensations you feel during the study. In addition, you may be asked to cough, bear down, stand or walk in place during the test. At the end of the study, you will be asked to urinate. EMG This test measures how well you can control your sphincter (outlet) muscles and determines if they are working in coordination with your bladder. Electrodes may be placed near the rectum to record muscle activity. Pressure Flow Study This test determines if there is an obstruction. After your bladder is filled through a catheter, you will be asked to urinate as you normally would. This test may be done sitting on a commode or standing. The study simultaneously records the bladder pressure and urine flow rate. Videourodynamics This study is a combination of the above tests with the addition of video pictures. If this study is prescribed, the doctor will be present to explain each step of the process. Your bladder will be filled with contrast fluid, and X-ray video pictures are taken to see your bladder in motion during filling and emptying. After the procedure, the doctor will discuss the study results with you. A detailed report will be sent to your physician including a summary of results, diagnosis, and suggestions for treatment. After reviewing the report, your doctor will talk to you about the findings and your options for treatment. Instructions Your urodynamics study will take approximately 60 minutes. Please arrive 15 minute before your appointment time to complete the necessary forms. Arrive with a comfortably full bladder. Procedure Details 1. You will empty your bladder into an uroflowmeter that automatically measures the amount of urine and flow rate. 2. The urodynamics specialist will then perform a post-void residual. This involves placement of a thin tube in your bladder to measure the amount of urine remaining. 3. The urodynamic study will then be performed. This study will evaluate: 1) how much your bladder can hold; 2) how much pressure builds up inside your bladder as it stores urine and 3) how full it is when you feel the urge to urinate. 4. The results will be received by your physician and reviewed with you during your next visit.

3 PERSONAL CARE FOR WOMEN S UNIQUE AND INTIMATE HEALTH NEEDS WOMEN S PERSONAL HEALTH AT CHESAPEAKE UROLOGY Urology is not just about men s health issues. In fact, Chesapeake Urology is the only women s urological health program in the region dedicated to caring for women s most intimate healthcare needs. We understand that women s needs are different than men s. From our fellowship-trained physicians in all areas of women s urological health to innovative treatment options and therapies, the specialists at Chesapeake Urology offer unmatched expertise in women s personal health, coupled with the understanding and compassionate care women want, and expect. WHY CHOOSE CHESAPEAKE UROLOGY FOR WOMEN S PERSONAL HEALTH CARE? Chesapeake Urology offers one of the most comprehensive and specialized women s personal health programs in the Mid-Atlantic region, with exceptional, compassionate care provided by the region s leading experts in female urology and urogynecology. Our specialists are sensitive to the unique needs of women and are available to see patients in convenient locations throughout the greater Baltimore area. CHESAPEAKE UROLOGY S WOMEN S PERSONAL HEALTH SERVICES INCLUDE COMPREHENSIVE CARE FOR THE FOLLOWING CONDITIONS: Women s urinary incontinence issues including: - Medical, surgical and non-surgical treatment options for stress urinary incontinence and overactive bladder - Physical therapists who specialize in women s incontinence and pelvic floor conditions - A urodynamics team for diagnosing incontinence conditions - Specialists in neurourology and complex bladder cases - A patient navigator dedicated to incontinence patients Female pelvic health conditions including: - Diagnosis and treatment of pelvic organ prolapse, interstitial cystitis (painful bladder syndrome), chronic pelvic pain, uterine fibroids and chronic UTIs - Physical therapy for pelvic floor muscle strengthening and rehabilitation - Dedicated pessary specialists Women s bladder conditions including: - Diagnosis and treatment of chronic urinary tract infections (UTIs) as well as interstitial cystitis (painful bladder syndrome) - Diagnosis and treatment of bladder cancer - Diagnosis and treatment of complex neurogenic bladder cases by leading fellowship-trained urologists - A urodynamics team for comprehensive diagnostic procedures Kidney conditions including: - Diagnosis and treatment of kidney stones and kidney cancer - Medical management of kidney stones - Complete metabolic evaluation and care plan for the prevention of kidney stone formation Female Sexual Enhancement performed by Dr. Karen Boyle, the region s foremost expert in female sexual enhancement and intimate surgical procedures including: - Labiaplasty, labia majora remodeling - Vaginal rejuvenation - Hymenoplasty and clitoral hood reduction - Other female genital cosmetic surgery, helping women of all ages look and feel their best More information on back...

4 CHESAPEAKE UROLOGY S HIGHLY-TRAINED PHYSICIANS AND WOMEN S PERSONAL HEALTH CARE TEAM INCLUDES: Fellowship-trained physicians in urinary incontinence and female pelvic conditions Fellowship-trained physicians in complex neurogenic conditions of the bladder and pelvic area A urogyncologist who specializes in pelvic health conditions, pelvic reconstruction and minimally invasive GYN surgery A women s health nurse practitioner who works with Chesapeake Urology s urogynecology patients A fellowship-trained physician and leading expert in female sexual health and aesthetic surgery Specialists in the areas of kidney stone disease and kidney and bladder cancers Physical therapists specially trained to focus on pelvic floor dysfunction and urinary incontinence Pessary specialists for treatment of pelvic organ prolapse Urodynamics services for diagnostic testing An incontinence patient navigator who guides patients through every step of their condition, from diagnosis to treatment A clinical trials program that provides patients access to the latest medications and treatments before they are available on the market Chesapeake Urology s women s personal health program is specially designed to meet the unique health needs of women with a focus on exceptional care, overall well-being, compassion and comfort. Our specialists are dedicated to returning all women to a better quality of life.

5 COMPREHENSIVE DIAGNOSIS & TREATMENT FOR OVERACTIVE BLADDER (OAB) WHAT IS OVERACTIVE BLADDER (OAB)? Overactive Bladder (OAB), also known as urge incontinence, is the name of a group of urinary symptoms. The most common symptom of OAB is the gotta go feeling, or the frequent and/or sudden urge to urinate that cannot be controlled. Risk factors for developing OAB symptoms include: Aging Neurological conditions including multiple sclerosis, Parkinson s disease, stroke, cerebral palsy and spinal cord injury Diabetes Certain gastrointestinal conditions such as irritable bowel syndrome (IBS) Menopause Pregnancy and childbirth; endometriosis; abdominal surgeries Medications such as diuretics, sedatives and antidepressants Caffeine, alcohol and spicy foods can irritate the bladder and make OAB symptoms worse Obesity and being overweight Bladder control problems such as overactive bladder (OAB) are common in women of all ages. In fact, more than 30 million Americans are living with OAB. The incontinence specialists at Chesapeake Urology have helped restore countless women living with OAB to a better quality of life. HOW IS OVERACTIVE BLADDER DIAGNOSED? The incontinence specialists at Chesapeake Urology will perform a comprehensive medical exam in addition to a urinalysis and blood work. Physicians often ask patients to keep track of urinary symptoms in a bladder diary. Additional testing may be required including: A pelvic ultrasound A post void residual test (PVR) Cystoscopy Urodynamic testing CONSERVATIVE TREATMENTS FOR OAB Chesapeake Urology incontinence specialists may recommend one or more of the following lifestyle modifications as first line treatments: Physical therapy, including pelvic floor muscle exercises (Kegels) and techniques such as timed urination, bladder training or delayed voiding Fluid and diet management Bladder diary Medications such as anticholinergics or Beta-3 agonists (usually used in combination with other conservative treatment options) ADVANCED TREATMENTS FOR OAB Botox injections, which relax the bladder muscles. Treatments need to be repeated every six to nine months. Neuromodulation therapy, which works by addressing the communication lapse between the brain and the nerves that control the bladder utilizing an implantable neurotransmitter device, includes: - Urgent PC This therapy uses percutaneous tibial nerve stimulation (PTNS) to treat OAB symptoms. The slight electrical impulses inhibit frequent contractions of the pelvic floor and bladder muscles for better urinary control and less frequent urinary urges. - InterStim therapy This implanted device stimulates the sacral nerves with mild electrical pulses to modulate the communications signals with the brain. This treatment is safe and effective and a viable option for patients who have not had success with lifestyle changes and conservative therapies for OAB. More information on back...

6 MEET CHESAPEAKE UROLOGY S PELVIC HEALTH SPECIALISTS: St. Agnes office Conrad Duncan, M.D., F.A.C.O.G., F.A.C.S. Certified by the American Board of Obstetrics and Gynecology Board-certified in Urogynecology Fellow of the American Congress of Obstetricians and Gynecologists Areas of specialty: Urogynecology including minimally invasive GYN surgery including robotic surgery, female urinary incontinence, overactive bladder, pelvic organ prolapse, fecal incontinence, abnormal uterine bleeding/fibroids, interstitial cystitis, chronic pelvic pain, and vaginal birth injuries Franklin Square office Kannan Manickam, M.D. Fellowship trained in female urology, urodynamics, pelvic floor and urinary reconstruction, and sacral neural modulation Areas of specialty: Female incontinence and pelvic prolapse conditions Kaiser Robertson III, M.D., F.A.C.S. Areas of specialty: urinary incontinence and pelvic reconstructive surgery Maple Lawn office Lisa Hawes, M.D. Areas of specialty: Female urologic conditions including incontinence, pelvic prolapse, urinary tract infections and interstitial cystitis; kidney stone disease and conditions Kelly Johnson, M.D. Fellowship trained in female urology, neurourology and urinary tract reconstruction American Board of Urology Board Eligible Glen Burnie office Owings Mills & Westminster office Andrew Shapiro, M.D., F.A.C.S. Director, Chesapeake Urology Center for Continence and Pelvic Floor Dysfunction of Chesapeake Urology; Fellowship trained in female urology, neurourology and urinary tract reconstruction Areas of specialty: Urinary incontinence, pelvic prolapse, voiding dysfunction, neurourology and complex neurogenic bladder cases Owings Mills & Towson office Areas of specialty: Female urology, neurourology, pelvic reconstructive surgery, urinary incontinence, pelvic prolapse, chronic pelvic pain, interstitial cystitis and complex neurogenic bladder cases Victoria Staiman, M.D., F.A.C.S. Kenneth F. Langer, M.D., F.A.C.S. Fellowship of the American College of Surgeons Maple Lawn office Areas of specialty: Female incontinence and pelvic prolapse, urinary tract infections, hematuria, voiding dysfunctions and kidney stone disease Franklin Square & St. Agnes office Areas of specialty: Female voiding dysfunction and incontinence Sondra Beth Barker, CRNP, MS, RN Working with urogynecologist Dr. Conrad Duncan, Sondra is a women s health nurse practitioner who specializes in urogynecology. Areas of specialty: Incontinence services including management of stress urinary incontinence and overactive bladder treatment programs, tibial nerve stimulation, urodynamics studies and medication management, management of chronic pelvic pain and interstitial cystitis, bladder instillations, vaginal pessary fitting and placement, medical therapy for pelvic organ prolapse, and sexual dysfunction Clinton office Burkhardt H. Zorn, M.D. Chief of Urology, MedStar Southern Maryland Hospital Center Areas of specialty: bladder dysfunction evaluation and treatment to include neurogenic bladder, incontinence, pelvic prolapse, interstitial cystitis, recurrent cystitis, stone disease, evaluation and treatment of hematuria

7 COMPREHENSIVE DIAGNOSIS AND TREATMENT FOR STRESS URINARY INCONTINENCE (SUI) WHAT IS STRESS URINARY INCONTINENCE (SUI)? Stress Urinary Incontinence (SUI) is the involuntary loss or leakage of urine that occurs during physical activity such as exercise, laughing, coughing and sneezing. 1 in 3 adult women have Stress Incontinence, which is the most common type of bladder control problem among women of all ages. What causes SUI? A number of factors influence SUI including: Pregnancy and childbirth Neurological conditions including multiple sclerosis, spina bifida and spinal cord injuries Obesity Chronic cough, oftentimes caused by smoking Certain medications, excessive alcohol consumption and caffeine Menopause Pelvic surgery or radiation treatment Bladder control problems such as stress urinary incontinence (SUI) are very common in women of all ages. In fact, one in three adult women has stress incontinence. The incontinence specialists at Chesapeake Urology understand how bladder control issues can affect a woman s lifestyle and confidence. Our doctors are committed to helping restore patients quality of life. HOW IS STRESS URINARY INCONTINENCE DIAGNOSED? The incontinence specialists at Chesapeake Urology will perform a comprehensive medical exam in addition to a urinalysis and blood work. Physicians often ask patients to keep track of urinary symptoms in a bladder diary. Additional testing may be required including: A pelvic ultrasound Stress test A post void residual test (PVR) Cystogram Cystoscopy Urodynamic testing WHAT ARE THE TREATMENT OPTIONS FOR SUI? While there are currently no medications approved in the U.S. to treat SUI, a Chesapeake Urology incontinence specialist may recommend one or more of the following lifestyle modifications as first line treatments, or surgical procedures to minimize symptoms: Physical therapy, including pelvic floor strengthening exercises Weight loss and quitting smoking Fluid and diet management A urethral sling, which is the most common and effective surgical intervention Urethral bulking Secondary surgical treatments may include: Retropubic suspension surgery (Burch procedure) Autologous pubo-vaginal sling Radiofrequency bladder neck suspension More information on back...

8 MEET CHESAPEAKE UROLOGY S PELVIC HEALTH SPECIALISTS: Conrad Duncan, M.D., F.A.C.O.G., F.A.C.S. Certified by the American Board of Obstetrics and Gynecology Board-certified in Urogynecology Fellow of the American Congress of Obstetricians and Gynecologists Areas of specialty: Urogynecology including minimally invasive GYN surgery including robotic surgery, female urinary incontinence, overactive bladder, pelvic organ prolapse, fecal incontinence, abnormal uterine bleeding/fibroids, interstitial cystitis, chronic pelvic pain, and vaginal birth injuries Lisa Hawes, M.D. Areas of specialty: Female urologic conditions including incontinence, pelvic prolapse, urinary tract infections and interstitial cystitis; kidney stone disease and conditions Kelly Johnson, M.D. Fellowship trained in female urology, neurourology and urinary tract reconstruction American Board of Urology Board Eligible Areas of specialty: Female urology, neurourology, pelvic reconstructive surgery, urinary incontinence, pelvic prolapse, chronic pelvic pain, interstitial cystitis and complex neurogenic bladder cases Kannan Manickam, M.D. Fellowship trained in female urology, urodynamics, pelvic floor and urinary reconstruction, and sacral neural modulation Kaiser Robertson III, M.D., F.A.C.S. Areas of specialty: urinary incontinence and pelvic reconstructive surgery Andrew Shapiro, M.D., F.A.C.S. Director, Chesapeake Urology Center for Continence and Pelvic Floor Dysfunction of Chesapeake Urology; Fellowship trained in female urology, neurourology and urinary tract reconstruction Areas of specialty: Urinary incontinence, pelvic prolapse, voiding dysfunction, neurourology and complex neurogenic bladder cases Victoria Staiman, M.D., F.A.C.S. Areas of specialty: Female incontinence and pelvic prolapse, urinary tract infections, hematuria, voiding dysfunctions and kidney stone disease Burkhardt H. Zorn, M.D. Chief of Urology, MedStar Southern Maryland Hospital Center Areas of specialty: bladder dysfunction evaluation and treatment to include neurogenic bladder, incontinence, pelvic prolapse, interstitial cystitis, recurrent cystitis, stone disease, evaluation and treatment of hematuria Areas of specialty: Female incontinence and pelvic prolapse conditions Sondra Beth Barker, CRNP, MS, RN Working with urogynecologist Dr. Conrad Duncan, Sondra is a women s health nurse practitioner who specializes in urogynecology. Areas of specialty: Incontinence services including management of stress urinary incontinence and overactive bladder treatment programs, tibial nerve stimulation, urodynamics studies and medication management, management of chronic pelvic pain and interstitial cystitis, bladder instillations, vaginal pessary fitting and placement, medical therapy for pelvic organ prolapse, and sexual dysfunction

9 UROGYNECOLOGY SERVICES FOR WOMEN S PERSONAL HEALTH CARE NEEDS UROGYNECOLOGY AT CHESAPEAKE UROLOGY Urogynecologist Dr. Conrad Duncan and women s health nurse practitioner Sondra Beth Barker focus on women s overall care, well-being and comfort. They are dedicated to restoring women s good health and returning patients to a better way of life. Dr. Duncan now is accepting new patients for urogynecology conditions at our new office located conveniently on the campus of St. Agnes Hospital 3407 Wilkins Avenue Suite 210 Baltimore, MD For the treatment of women s pelvic health conditions and personal health issues, Chesapeake Urology s experienced urogynecologist, Conrad Duncan, M.D., is a leading expert in minimally invasive GYN surgery including pelvic reconstructive surgery and robotic surgery as well as female pelvic health conditions. Dr. Duncan specializes in the diagnosis and treatment of female pelvic disorders including: Female urinary incontinence Pelvic organ prolapse Fecal incontinence Interstitial cystitis (painful bladder syndrome) Chronic pelvic pain Chronic urinary tract infections (UTIs) Vaginal birth injuries Dyspareunia (painful sex) Pelvic floor myalgia MEET OUR UROGYNECOLOGY SPECIALISTS Conrad Duncan, M.D., F.A.C.O.G., F.A.C.S. Certified by the American Board of Obstetrics and Gynecology Board-certified in Urogynecology Fellow of the American Congress of Obstetricians and Gynecologists Areas of specialty: Urogynecology including minimally invasive GYN surgery including robotic surgery, pelvic reconstructive surgery, female urinary incontinence, pelvic organ prolapse, fecal incontinence, interstitial cystitis, chronic pelvic pain, and vaginal birth injuries. Speak with Chesapeake Urology s urogynecology specialists today Call or visit us on the web at womenshealth. chesapeakeurology.com. Sondra Beth Barker, CRNP, MS, RN Areas of specialty: Incontinence services including management of stress urinary incontinence and overactive bladder treatments, tibial nerve stimulation, urodynamics studies and medication management, pelvic floor disorder services including management of chronic pelvic pain and interstitial cystitis, bladder instillations, vaginal pessary fitting and placement, medical therapy for pelvic organ prolapse, and sexual dysfunction

10 URODYNAMICS SERVICES AT CHESAPEAKE UROLOGY URODYNAMICS AT-A-GLANCE Urodynamics refers to a series of diagnostic tests that evaluate the function of the bladder and the urethra. These tests may be recommended for patients with urinary incontinence, recurrent bladder infections, slow or weak urinary stream, incomplete bladder emptying, or frequent urination. See back for our seven convenient locations. WHY CHOOSE CHESAPEAKE UROLOGY FOR URODYNAMICS SERVICES? Chesapeake Urology s urodynamicists work closely with a patient s physician while guiding and supporting patients through the urodynamics studies. Our urodynamicists are highly-trained specialists who are dedicated to ensuring that each patient is comfortable both physically and psychologically. The urodynamicists at Chesapeake Urology play an important role in the patient care team. CHESAPEAKE UROLOGY S HIGHLY-TRAINED URODYNAMICSTS PERFORM THE FOLLOWING TESTS: Uroflow: This test measures the speed and amount of urine a patient voids Cystometrogram: This study evaluates how the bladder holds urine, measures the bladder capacity, and also determines how well a patient can control their bladder EMG: This test measures how well a patient can control the pelvic floor muscles and determines if they are working in coordination with the bladder Pressure Flow Study: This test determines if there is an obstruction in the bladder or urethra Videourodynamics: This study is a combination of the above tests with the addition of video pictures Continued on back...

11 CHESAPEAKE UROLOGY URODYNAMICISTS Betty Hall, CMA Director, Urodynamics The urodynamicist is an important member of the highly trained patient care team at Chesapeake Urology. Working closely with each patient s urologist, our urodynamicists play an essential role, guiding and supporting patients through their urodynamics studies. Our urodynamicists are not only highly trained specialists who treat our patients with kindness, respect and sensitivity, they are dedicated to making sure that each patient is comfortable both physically and psychologically with their testing. They are equipped with knowledge about the testing process and will thoroughly educate patients in the procedures being performed. Our urodynamicists will do whatever they can to make each patient s study go as smoothly as possible. Urodynamicist Betty Hall, CMA, is the manager of Chesapeake Urology s Urodynamics program and works with patients with overactive bladder as a patient navigator. She is a certified medical assistant who is also certified in urodynamics and the interpretation of urodynamics. She has a wealth of experience, having worked in the field of urology for more than 16 years. A graduate of Medix School in Towson, she completed her externship at Johns Hopkins Medicine at Greenspring Station, and continued to work there for three years in the urogynecology division. She has been with Chesapeake Urology as a urodynamicist and surgical technician since Rhonda Cantu, RMA Lindsay Dugent, MA Nancy Kozlowski, MA Lakyna Williams, MA Cindy Woodward, CMA See back for office locations

12 TWELVE CONVENIENT LOCATIONS Bel Air 201 Plumtree Road Suite 210 Bel Air, MD Brandywine Brandywine Medical Center 7704 Matapeake Business Drive Suite 310 Brandywine, MD or Columbia/Maple Lawn Midtown Medical Building 7625 Maple Lawn Blvd. Suite 210 Fulton, MD Franklin Square Hospital 6820 Hospital Drive Suite 210 Baltimore, MD Good Samaritan Hospital 5601 Loch Raven Blvd. The Smyth Building Suite 307 Baltimore, MD Hanover, MD 7580 Buckingham Blvd. Suite 100 Hanover, MD Owings Mills The Continence Center 21 Crossroads Drive Suite 220 Owings Mills, MD Silver Spring 3801 International Drive Suite 205 Silver Spring, MD St. Agnes Hospital 3407 Wilkens Avenue Suite 200 Baltimore, MD Towson 8322 Bellona Avenue Suite 202 Towson, MD Westminster 410 Malcolm Drive Suite A Westminster, MD Woodholme/Pikesville Woodholme Medical Center 1838 Greene Tree Road Suite 450 Pikesville, MD

13 CHESAPEAKE UROLOGY ASSOCIATES The Region s Leading Experts in Diagnosis and Treatment of Bladder Cancer CHESAPEAKE UROLOGY S BLADDER CANCER EXPERTS Bladder cancer is highly treatable in the early stages of the disease, which is why it s important for patients to be referred to an experienced urologist when exhibiting any unusual bladder symptoms. Our physicians are on the leading edge of the most sophisticated technology, diagnostic and minimally invasive surgical procedures, as well as clinical trials. Chesapeake urology s team of cancer specialists not only deliver the most advanced medical, surgical and oncologic care, but do so with compassion, so you can feel confident that your patients are in the very best hands. At Chesapeake Urology, our physicians are leading experts in the diagnosis and treatment of bladder cancer. Our team of cancer professionals is dedicated to delivering the most advanced, compassionate and personalized care to ensure the best possible outcomes for patients. DIAGNOSING BLADDER CANCER Chesapeake Urology s bladder cancer specialists are experienced in the most advanced diagnostic techniques that can identify bladder cancer quickly and accurately. In addition to a comprehensive medical exam, additional diagnostic testing may include: Urine cytology, Intravenous pyelogram (IVP) or CT urography Cystoscopy Tumor marker tests Flourescence in Situ Hybridization (FISH) TREATING BLADDER CANCER A Chesapeake Urology bladder cancer specialist will develop a personalized and comprehensive treatment plan that best meets the individual needs of the patient and coordinate care with the patient s primary care physician. Surgical treatment is often recommended for patients with bladder cancer. Some patients will receive radiation, chemotherapy or immunotherapy in addition to, or instead of, surgery. Surgical and other therapeutic approaches include: Transurethral resection (TUR) Radical cystectomy Radiation therapy Chemotherapy Immunotherapy More information on back...

14 MEET THE CHESAPEAKE UROLOGY SPECIALISTS IN ADVANCED BADDER CANCER: Geoffrey N. Sklar, M.D., F.A.C.S., Chief of Urology, Baltimore Washington Medical Center Chief of Genitourinary Oncology, Baltimore Washington Medical Center Chief Medical Officer, Chesapeake urology Associates Dr. Geoffrey Sklar, Chesapeake Urology s Chief Medical Officer, is a local leader in bladder cancer treatment as well as continent urinary diversion and neobladder. Named an Innovator in Urology, Dr. Sklar has participated in numerous clinical trials and his clinical research interests include bladder cancer and kidney cancer. Dr. Sklar is a leading physician in Maryland and has been recognized as a Top Doctor by Baltimore magazine in 2011 and 2012 and by Annapolis Lifestyle magazine as a Top Doctor in 2010 and He also serves as Chief of Urology and Chief of Genitourinary Oncology at Baltimore Washington Medical Center. Rian Dickstein, M.D. Cancer Liaison Physician, University of Maryland Baltimore Washington Medical Center Clinical Assistant Professor - Dept. of Surgery at University of Maryland School of Medicine Dr. Dickstein is a urologic oncologist who trained at the world-renowned MD Anderson Cancer Center in Houston, Texas. Dr. Dickstein focuses on all urologic cancers and specializes in open, laparoscopic and robotic surgeries. His expertise includes the treatment of bladder cancer (noninvasive and locally advanced), kidney cancer (small or locally advanced tumors), and prostate cancer (including primary and salvage surgery for complex cases). He has published numerous articles on urologic cancers in multiple medical journals and has presented at national meetings on subjects primarily related to bladder and penile cancers. Bishoy A. Gayed, M.D. American Board of Urology Board Eligible Languages: Fluent in English and Arabic; Experienced in French Director, Urologic Oncology, Saint Agnes Hospital Dr. Bishoy Gayed is the director of urologic oncology at Saint Agnes Hospital. He completed his fellowship training in urologic oncology at the University of Texas Southwestern. Dr. Gayed specializes in the treatment and management of kidney, prostate, bladder, ureteral, testicular, penile, and adrenal cancers, including the use of robotics, laparoscopy, focal therapy, and open surgical techniques. He also focuses on urinary diversion (continent and incontinent.

15 AN INTEGRATED APPROACH TO TREATING CHRONIC PELVIC PAIN WHAT IS CHRONIC PELVIC PAIN? Many women experience chronic pelvic pain but have no known cause, resulting in feelings of frustration and even depression. The female urology specialists at Chesapeake Urology understand that although the cause of pelvic pain may not be easily pinpointed, the pain is real and, in many cases, can be effectively treated. DID YOU KNOW? Some 5% to 14% of women in the U.S. are affected by chronic pelvic pain. Chronic pelvic pain is an integrated problem that requires a coordinated approach to diagnosis and treatment. The physicians at Chesapeake Urology perform a comprehensive work-up and extensive testing to rule out other pelvic conditions that may be causing a patient s pain. CHRONIC PELVIC PAIN MAY BE ASSOCIATED WITH OTHER PELVIC CONDITIONS INCLUDING: Interstitial cystitis (IC) or painful bladder syndrome Endometriosis Chronic bladder infections Pelvic adhesions or scar tissue from a prior abdominal surgery Dysmenorrhea, or painful menstrual cramps Levator Ani Syndrome, which causes increased tension of the pelvic floor Vaginismus, or excessive tightness of the pelvic floor muscles around the opening of the vagina TREATING CHRONIC PELVIC PAIN While finding an exact cause of pelvic pain may prove difficult, Chesapeake Urology specialists can either treat a known medical condition that is causing pelvic pain or treat the pain on its own. Physical therapy A specially trained physical therapist can perform soft tissue mobilization of pelvic floor muscles as well as relaxation techniques, pelvic floor muscle exercises and suggest exercises to improve poor posture If a diagnosis has been made, such as interstitial cystitis, endometriosis, a bladder condition or other cause of pain, the physician will prescribe the appropriate treatment for the diagnosed condition If no known cause of pain has been diagnosed, the physician may begin treatment with pain medication including: - Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen - Tri-cyclic antidepressants - Oral contraceptives to help reduce menstrual pain and pain associated with endometriosis Depending on the cause or origin of the pain, hysterectomy to relieve chronic pain may be recommended in individual cases

16 MEET OUR SPECIALISTS: Conrad Duncan, M.D., F.A.C.O.G., F.A.C.S. Certified by the American Board of Obstetrics and Gynecology Board-certified in Urogynecology Fellow of the American Congress of Obstetricians and Gynecologists Areas of specialty: Urogynecology including minimally invasive GYN surgery including robotic surgery, pelvic reconstructive surgery, female urinary incontinence, pelvic organ prolapse, fecal incontinence, interstitial cystitis, chronic pelvic pain, and vaginal birth injuries. Lisa Hawes, M.D. Areas of specialty: Female urologic conditions including incontinence, pelvic prolapse, urinary tract infections and interstitial cystitis; kidney stone disease and conditions Kelly Johnson, M.D. Fellowship trained in female urology, neurourology and urinary tract reconstruction American Board of Urology Board Eligible Areas of specialty: Female urology, neurourology, pelvic reconstructive surgery, urinary incontinence, pelvic prolapse, chronic pelvic pain, interstitial cystitis and complex neurogenic bladder cases Andrew Shapiro, M.D., F.A.C.S. Director, Chesapeake Urology Center for Continence and Pelvic Floor Dysfunction of Chesapeake Urology; Fellowship trained in female urology, neurourology and urinary tract reconstruction Areas of specialty: Urinary incontinence, pelvic prolapse, voiding dysfunction, neurourology and complex neurogenic bladder cases Sondra Beth Barker, CRNP, MS, RN Working with urogynecologist Dr. Conrad Duncan, Sondra is a women s health nurse practitioner who specializes in urogynecology. Areas of specialty: Incontinence services including management of stress urinary incontinence and overactive bladder treatment programs, tibial nerve stimulation, urodynamics studies and medication management, management of chronic pelvic pain and interstitial cystitis, bladder instillations, vaginal pessary fitting and placement, medical therapy for pelvic organ prolapse, and sexual dysfunction

17 CHESAPEAKE UROLOGY ADVANCED BLADDER AND KIDNEY CANCER SPECIALISTS: Geoffrey N. Sklar, M.D., F.A.C.S., Dr. Geoffrey Sklar, Chesapeake Urology s Chief Medical Officer, is a local leader in bladder cancer treatment as well as continent urinary diversion and neobladder. Named an Innovator in Urology, Dr. Sklar has participated in numerous clinical trials and his clinical research interests include bladder cancer and kidney cancer. He also serves as Chief of Urology and Chief of Genitourinary Oncology at Baltimore Washington Medical Center. WOMEN S PERSONAL HEALTH PHYSICIANS AND CARE PROVIDERS Glen Burnie Landmark Drive, Ste. 118, Glen Burnie, MD Rian Dickstein, M.D. Dr. Dickstein is a urologic oncologist who trained at the world-renowned MD Anderson Cancer Center in Houston, Texas. Dr. Dickstein focuses on all urologic cancers and specializes in open, laparoscopic and robotic surgeries. His expertise includes the treatment of bladder cancer, kidney cancer, and prostate cancer. Glen Burnie Landmark Drive, Ste. 118, Glen Burnie, MD Bishoy A. Gayed, M.D. American Board of Urology Board Eligible Dr. Bishoy Gayed is the director of urologic oncology at Saint Agnes Hospital. Dr. Gayed specializes in the treatment and management of kidney, prostate, bladder, ureteral, testicular, penile, and adrenal cancers, including the use of robotics, laparoscopy, focal therapy, and open surgical techniques. He also focuses on urinary diversion (continent and incontinent.) St. Agnes Wilkens Ave., Ste. 210, Baltimore, MD Maple Lawn/Columbia Maple Lawn Blvd., Ste. 210, Fulton, MD METABOLIC EVALUATION AND TREATMENT OF KIDNEY STONE DISEASE SPECIALISTS: Julio Davalos, M.D. Areas of specialty: kidney stone disease and surgical and medical management of kidney stones, metabolic evaluations to prevent and treat kidney stone formation, and treatment for kidney cancer. He specializes in providing comprehensive surgical, medical and preventive care for kidney stones with the treatment goal of rendering patients 100% stone free Glen Burnie Landmark Drive, Ste. 118, Glen Burnie, MD Marnie Robinson, M.D. Areas of specialty: kidney stone disease and surgical and medical management of kidney stones, metabolic evaluations to prevent and treat kidney stone formation with the goal of rendering patients 100% stone free Pikesville Greene Tree Road, Ste. 460, Pikesville, MD Jonathan Rubenstein, M.D., F.A.C.S. Areas of specialty: kidney cancer, minimally invasive surgery, metabolic evaluation and treatment of kidney stones Towson/Ruxton Professional Center Bellona Avenue, Ste.202, Towson, MD URINARY INCONTINENCE AND PELVIC HEALTH PHYSICIANS Conrad Duncan, M.D., F.A.C.O.G., F.A.C.S. Certified by the American Board of Obstetrics and Gynecology Board-certified in Urogynecology Fellow of the American Congress of Obstetricians and Gynecologists Areas of specialty: Urogynecology including minimally invasive GYN surgery including robotic surgery, female urinary incontinence, overactive bladder, pelvic organ prolapse, fecal incontinence, abnormal uterine bleeding/fibroids, interstitial cystitis, chronic pelvic pain, and vaginal birth injuries St. Agnes Wilkens Ave., Ste. 210, Baltimore, MD Lisa Hawes, M.D. Areas of specialty: Female urologic conditions including incontinence, pelvic prolapse, urinary tract infections and interstitial cystitis; kidney stone disease and conditions Maple Lawn/Columbia Maple Lawn Blvd., Ste. 210, Fulton, MD Kelly Johnson, M.D. Fellowship trained in female urology, neurourology and urinary tract reconstruction American Board of Urology Board Eligible Areas of specialty: Female urology, neurourology, pelvic reconstructive surgery, urinary incontinence, pelvic prolapse, chronic pelvic pain, interstitial cystitis and complex neurogenic bladder conditions for patients with multiple sclerosis, Parkinson s disease, spinal cord injury and birth defects such as spina bifida Towson/Ruxton Professional Center Bellona Avenue, Ste.202, Towson, MD The Continence Center - 21 Crossroads Drive, Ste. 200, Owings Mills, MD Kenneth F. Langer, M.D., F.A.C.S. Fellowship of the American College of Surgeons Areas of specialty: Female voiding dysfunction and incontinence Kannan Manickam, M.D. Fellowship trained in female urology, urodynamics, pelvic floor and urinary reconstruction, and sacral neural modulation Areas of specialty: Female incontinence and pelvic prolapse conditions Franklin Square Hospital Drive, Ste. 210, Baltimore, MD Kaiser Robertson III, M.D., F.A.C.S. Areas of specialty: urinary incontinence and pelvic reconstructive surgery Glen Burnie Landmark Drive, Ste. 118, Glen Burnie, MD Andrew Shapiro, M.D., F.A.C.S. Director, Chesapeake Urology Continence Center; Fellowship trained in female urology, neurourology and urinary tract reconstruction Areas of specialty: Urinary incontinence, pelvic prolapse, voiding dysfunction, neurourology and complex nneurogenic bladder conditions for patients with multiple sclerosis, Parkinson s disease, spinal cord injury and birth defects such as spina bifida The Continence Center - 21 Crossroads Drive, Ste. 200, Owings Mills, MD Malcolm Drive, Ste. A Westminster, MD CONTINUED ON INSIDE womenshealth.chesapeakeurology.com

18 URINARY INCONTINENCE AND PELVIC HEALTH PHYSICIANS CONT. PELVIC HEALTH PHYSICAL THERAPISTS Victoria Staiman, M.D., F.A.C.S. Areas of specialty: Female incontinence and pelvic prolapse, urinary tract infections, hematuria, voiding dysfunctions and kidney stone disease Maple Lawn/Columbia Maple Lawn Blvd., Ste. 210, Fulton, MD FEMALE SEXUAL ENHANCEMENT AND AESTHETIC SURGERY NURSE PRACTITIONER, UROGYNECOLOGY Burkhardt H. Zorn, M.D. Chief of Urology, MedStar Southern Maryland Hospital Center Areas of specialty: bladder dysfunction evaluation and treatment to include neurogenic bladder, incontinence, pelvic prolapse, interstitial cystitis, recurrent cystitis, stone disease, evaluation and treatment of hematuria 7501 Surratts Rd # 308, Clinton, MD Jodi Berger, MPT Director, Pelvic Health Physical Therapy Program In Balance Physical Therapy 21 Crossroads Drive, Suite 210 Owings Mills, MD Sarah Bury, PT Pelvic Health Physical Therapist Life Fitness Physical Therapy 658 Kenilworth Drive Towson, MD Shayna Roberts, PT Pelvic Health Physical Therapist Life Fitness Physical Therapy 9110 Philadelphia Road, Suite 104 Rosedale, MD Lindsay Rothermel, DPT Pelvic Health Physical Therapist Life Fitness Physical Therapy 658 Kenilworth Drive Towson, MD Karen Boyle, M.D., F.A.C.S. Areas of specialty: Female sexuality, female aesthetic surgical procedures including tumescent liposuction and liposculpting, Laser Vaginal Rejuvenation (LVR), Designer Laser Vaginoplasty (DLV), labiaplasty, and hymenoplasty GBMC - Physicians Pavilion North, 6535 N. Charles Street, Ste. 625, Baltimore, MD 2120 Sondra Beth Barker, CRNP, MS, RN Working with urogynecologist Dr. Conrad Duncan, Sondra is a women s health nurse practitioner who specializes in urogynecology. Areas of specialty: management of stress urinary incontinence and overactive bladder treatment programs, tibial nerve stimulation, urodynamics studies and medication management, management of chronic pelvic pain and interstitial cystitis, bladder instillations, vaginal pessary fitting and placement, medical therapy for pelvic organ prolapse, and sexual dysfunction St. Agnes Wilkens Avenue, Ste. 210, Baltimore, MD Franklin Square Hospital Drive, Ste. 210, Baltimore, MD Carla Carpenter-Breeding, MPT Pelvic Health Physical Therapist Central Maryland Rehabilitation Services 844 Washington Road, Suite 101 Westminster, MD Kerry Kress, PT Pelvic Health Physical Therapist In Balance Physical Therapy 21 Crossroads Drive, Suite 210 Owings Mills, MD Stephanie Stover, PT Pelvic Health Physical Therapist Life Fitness Physical Therapy 658 Kenilworth Drive Towson, MD PESSARY SPECIALISTS Ally Gordon, P.A.-C Ally works with prolapse patients to provide custom fit vaginal pessaries to treat pelvic organ prolapse. She also teaches women how to care for and maintain the pessary for optimal results. The Continence Center - 21 Crossroads Drive, Ste. 200, Owings Mills, MD Sondra Barker, CRNP, MS, RN, Urogynecology Sondra works with prolapse patients to provide custom fit vaginal pessaries to treat pelvic organ prolapse. She also teaches women how to care for and maintain the pessary for optimal results. St. Agnes Wilkens Avenue, Ste. 210, Baltimore, MD Franklin Square Hospital Drive, Ste. 210, Baltimore, MD URODYNAMICS SERVICES Betty McVicker-Hall, CMA/Urodynamicist Certified in performance and interpretation of urodynamics/video urodynamics Areas of specialty: Neurologic conditions and disorders (multiple sclerosis, spinal cord injuries, diabetes, and Parkinson disease), incontinence, voiding dysfunction, and neurogenic bladder Silver Spring, Clinton, Maple Lawn, Glen Burnie INCONTINENCE PATIENT NAVIGATOR Sue Spurlock, RN, CURN Certified by the Board of Urology Nurses and Associates As a patient navigator, Sue works closely with Chesapeake Urology s incontinence physicians and patients to provide a continuum of care, guiding women through diagnostic procedures, setting appointments and scheduling testing, as well as answering all questions and/or concerns related to their condition and subsequent treatment options. The Continence Center - 21 Crossroads Drive, Ste. 200, Owings Mills, MD Sondra Barker, CRNP, MS, RN St. Agnes, Franklin Square Lindsay Dugent, MA Franklin Square, St. Agnes, Glen Burnie Nancy Kozlowski, MA Bellona, Bel Air, Woodholme Cindy Woodward, CMA Continence Center-Owings Mills, Westminster womenshealth.chesapeakeurology.com

19 CHESAPEAKE UROLOGY ASSOCIATES The Region s Leading Experts in Diagnosis and Treatment of Kidney Cancer CHESAPEAKE UROLOGY S KIDNEY CANCER EXPERTS Renal cell carcinoma (RCC) is the most common type of adult kidney cancer and is a mass that grows in the urine producing portion of the kidney. Affecting about 32,000 Americans each year, this cancer usually responds well to treatment when caught early. Our physicians are on the leading edge of the most sophisticated technology, diagnostic and minimally invasive surgical procedures, as well as clinical trials. Chesapeake urology s team of kidney cancer specialists not only deliver the most advanced medical, surgical and oncologic care, but do so with compassion, so you can feel confident that your patients are in the very best hands. At Chesapeake Urology, our physicians are leading experts in the diagnosis and treatment of kidney cancer. Our team of cancer professionals is dedicated to delivering the most advanced, compassionate and personalized care to ensure the best possible outcomes for patients with renal cell carcinoma. DIAGNOSING RENAL CELL CARCINOMA Chesapeake Urology s kidney cancer specialists are experienced in the most advanced diagnostic techniques that can identify renal cell carcinoma quickly and accurately. In addition to a comprehensive medical exam, diagnostic tests may include: CT Scan, MRI or ultrasound Urinalysis Blood tests X-ray or bone scan to determine if cancer has spread to the lungs or bones Needle biopsy of the kidney mass, in rare circumstances TREATING RENAL CELL CARCINOMA Chesapeake Urology physicians have extensive experience in the most advanced treatments for kidney cancer including minimally invasive surgery, which provides patients with a quicker recovery, less pain and fewer surgical complications. Treatment will depend on a number of factors, including a patient s age and overall health and the extent to which the cancer has spread. Surgery - the standard treatment for renal cell carcinoma, the following procedures can be performed laparoscopically or robotically: - Nephrectomy - Radical nephrectomy - Partial nephrectomy Cryosurgery Radiofrequency ablation Targeted therapy More information on back...

20 MEET THE CHESAPEAKE UROLOGY KIDNEY CANCER SPECIALISTS: Geoffrey N. Sklar, M.D., F.A.C.S., Chief of Urology, Baltimore Washington Medical Center Chief of Genitourinary Oncology, Baltimore Washington Medical Center Chief Medical Officer, Chesapeake urology Associates Dr. Geoffrey Sklar, Chesapeake Urology s Chief Medical Officer, is a local leader in bladder cancer treatment as well as continent urinary diversion and neobladder. Named an Innovator in Urology, Dr. Sklar has participated in numerous clinical trials and his clinical research interests include bladder cancer and kidney cancer. Dr. Sklar is a leading physician in Maryland and has been recognized as a Top Doctor by Baltimore magazine in 2011 and 2012 and by Annapolis Lifestyle magazine as a Top Doctor in 2010 and He also serves as Chief of Urology and Chief of Genitourinary Oncology at Baltimore Washington Medical Center. Rian Dickstein, M.D. Cancer Liaison Physician, University of Maryland Baltimore Washington Medical Center Clinical Assistant Professor - Dept. of Surgery at University of Maryland School of Medicine Dr. Dickstein is a urologic oncologist who trained at the world-renowned MD Anderson Cancer Center in Houston, Texas. Dr. Dickstein focuses on all urologic cancers and specializes in open, laparoscopic and robotic surgeries. His expertise includes the treatment of bladder cancer (noninvasive and locally advanced), kidney cancer (small or locally advanced tumors), and prostate cancer (including primary and salvage surgery for complex cases). He has published numerous articles on urologic cancers in multiple medical journals and has presented at national meetings on subjects primarily related to bladder and penile cancers. Bishoy A. Gayed, M.D. American Board of Urology Board Eligible Languages: Fluent in English and Arabic; Experienced in French Director, Urologic Oncology, Saint Agnes Hospital Dr. Bishoy Gayed is the director of urologic oncology at Saint Agnes Hospital. He completed his fellowship training in urologic oncology at the University of Texas Southwestern. Dr. Gayed specializes in the treatment and management of kidney, prostate, bladder, ureteral, testicular, penile, and adrenal cancers, including the use of robotics, laparoscopy, focal therapy, and open surgical techniques. He also focuses on urinary diversion (continent and incontinent.

21 MICROSURGICAL VASECTOMY REVERSAL AND MALE INFERTILITY EXPERTS THE MID ATLANTIC S LEADING MICROSURGICAL VASECTOMY REVERSAL AND MALE INFERTILITY EXPERTS Karen Boyle, MD, David Fenig, MD, and Brad Lerner, MD, make up the expert physician team at the Vasectomy Reversal Center of America (VRCA). The Mid- Atlantic s leading vasectomy reversal center is the only practice in the country with three fellowship-trained microsurgeons. The center s physician team is in an elite group of only two percent of boardcertified urologists with special microsurgical and male infertility fellowship training, resulting in vasectomy reversal success rates of more than 90%. MICROSURGICAL VASECTOMY REVERSAL A microsurgical vasectomy reversal is a delicate and complex surgical procedure, which, when performed by a highly skilled microsurgeon, can allow a couple to conceive a child naturally no matter how many years have passed since a man s vasectomy. Drs. Karen Boyle, David Fenig and Brad Lerner, male infertility and microsurgical vasectomy reversal specialists at The Vasectomy Reversal Center of America (VRCA), offer patients a number of distinct advantages: Fellowship training in microsurgery and male infertility Expertise performing vasovasectomy and the more complex epididymovasostomy, a blockage in the epididymis Access to the most advanced microsurgical tools aided by the powerful magnification of a Zeiss operating microscope in the VRCA s dedicated microsurgical suite Vasectomy reversal success rates of over 90% More than 30 years of collective microsurgical experience MALE FACTOR INFERTILITY About 15% of all couples are infertile and up to 50% of these infertile couples will have a male factor component. And, 30% of couples will not be able to conceive solely because of a male factor. As male infertility specialists, the VRCA physicians take a thorough approach to evaluating and treating men for infertility including: A comprehensive medical exam and laboratory testing Varicocele diagnosis and repair About 30% of men who have infertility have varicoceles, which are the number one reason why men have secondary infertility Removal of blockages - The surgeons perform a delicate microsurgical procedure to remove blockages and restore sperm production and transport More information on back... To learn more about Microsurgical Vasectomy Reversal and Male Infertility visit MensHealth.ChesapeakeUrology.com.

22 MEET THE MICROSURGEONS: Karen Elizabeth Boyle, M.D., F.A.C.S. Board Certified, American Board of Urology Fellow, American College of Surgeons Dr. Boyle is a nationally recognized expert in microsurgical vasectomy reversal and a leading physician in the field of male fertility, reproductive medicine and sexual health. Consultative Office: Greater Baltimore Medical Center Physician Pavilion North 6535 North Charles Street, Suite 640 Towson, MD KBoyle@cua.md David Fenig, M.D., F.A.C.S. Board Certified, American Board of Urology Fellow, American College of Surgeons Dr. Fenig is a highly experienced male infertility and sexuality specialist. He has a strong research background in male infertility and is on the leading edge of this specialty. Consultative offices: Ruxton Professional Center 8322 Bellona Ave., Suite 202 Towson, MD Midtown Medical Building 7625 Maple Lawn Blvd., Suite 210 Fulton, MD DFenig@cua.md Brad Lerner, M.D., F.A.C.S. Board Certified, American Board of Urology Fellow, American College of Surgeons Dr. Lerner is a leading physician in the field of male infertility, reproductive medicine and male sexuality, having practiced male infertility for more than 20 years. He was the first physician in the state of Maryland to provide male infertility and microsurgical vasectomy reversal services. Consultative offices: Union Memorial Hospital 3333 N. Calvert St., Suite 600 Baltimore, MD Plumtree Road, Suite 210 Bel Air, MD BLerner@cua.md

23 PERSONAL CARE FOR WOMEN S SEXUAL HEALTH ISSUES AND FEMALE AESTHETIC SURGERY EXPERT CARE FOR WOMEN S SEXUAL HEALTH The female body goes through many changes throughout a woman s life. At Chesapeake Aesthetic Surgery, Karen Boyle, M.D., works with women who wish to explore genital aesthetic surgery to enhance their appearance and restore natural genital function that may have been damaged by aging, pregnancy, childbirth, or weight gain and loss. Satisfaction with one s intimate appearance is a very personal issue for women. Dr. Boyle provides understanding and expertise for women s most intimate sexual health issues. Dr. Karen Boyle, who heads Chesapeake Aesthetic Surgery, is a leading sexual health expert and genital cosmetic surgeon who provides women with compassionate care and surgical excellence. Dr. Boyle works with women to educate and explain the delicate genital surgical procedures she performs, addressing both function and improvement to genital appearance and form. Dr. Boyle treats a wide array of aesthetic and reconstructive concerns of the female genitalia including: Labiaplasty Clitoral hood reduction / clitoropexy Vaginal rejuvenation Labia majora remodeling Fat transfer to the labia majora Hymenoplasty Pubic lift and liposuction Female sexual enhancement In addition, Dr. Boyle addresses issues of female sexual dysfunction including: Anorgasmia - orgasmic disorder Hypoactive sexual desire disorder - low sexual desire Sexual pain disorders such as: Dyspareunia, Vaginismus, Vestibulitis, Vulvodynia, Pelvic pain As the founder of Chesapeake Aesthetic Surgery and also The Laser Vaginal Rejuvenation Institute of Baltimore and Washington, D.C., Dr. Karen Boyle understands that sexual health and genital cosmetic surgery are very personal issues for the women who turn to her for help. Greater Baltimore Medical Center Campus Physicians Pavilion North 6535 N. Charles Street, Suite 640 Towson, MD To learn more about women s sexual health issues and female aesthetic surgery, visit ChesapeakeAestheticSurgery.com.