Urodynamics & PTNS Specialist

Femina Careo

Elias Moukarzel, MD

OBGYN & Urogynecology located in El Centro, CA & Carlsbad, CA

If you’ve ever sneezed or coughed so hard that you experienced bladder leakage, help is available. Women throughout southern California get the relief they need for bladder issues by visiting with Elias Moukarzel, MD. As a double board-certified OB/GYN and female pelvic medicine expert, Dr. Moukarzel offers urodynamics and percutaneous tibial nerve stimulation (PTNS) treatments. With two convenient locations in El Centro and Carlsbad, California, Femina Careo and Dr. Moukarzel can help you take control of bladder pain and leakage, so you can start feeling like yourself again. Call the office, or book your appointment online today.

Urodynamics & PTNS

What is urinary incontinence?

Urinary incontinence includes a series of conditions that affect your bladder. You may lose some urine or have difficulty making it to the bathroom in time. Symptoms of urinary incontinence include:

Inability to fully empty your bladder
Feeling like your bladder is always full
Pain while urinating
Lower abdominal pain

These could be warning signs of chronic bladder conditions, including interstitial cystitis and overactive bladder.

What is the role of Urodynamics in Bladder Incontinence?

Urodynamic testing to diagnose bladder issues is typically most effective, since it lets your doctor know how your bladder is functioning. Urodynamic testing evaluates the bladder function, identifies the issues, and guides in management of urinary incontinence. You should arrive at your urodynamics appointment with a full bladder. During your procedure, you sit in a specialized chair that allows you to urinate.

The first part of the test involves emptying your bladder into a container. As you “go,” the system measures your urine volume and the rate at which you empty your bladder. Your practitioner then inserts a tiny flexible tube, or catheter, into your bladder. This tube helps measure the volume of any remaining urine, which is called post-void residual (PVR).

Lastly, Dr. Moukarzel will fill your bladder again by sending water through the catheter. Let him know when you feel the urge to urinate, so he can measure your bladder volume before you feel that sensation.

In some cases, he may also attach electrodes near your anus to measure your muscle activity as your bladder fills. By the end of your urodynamics session, Dr. Moukarzel can tell you how your bladder is functioning and start any necessary treatment.

Does percutaneous tibial nerve stimulation improve overactive bladder symptoms?

Studies show that percutaneous tibial nerve stimulation, or PTNS, treatments improve bladder issues up to 80% of the time. PTNS involves inserting a slim needle electrode near your tibial nerve in your ankle and transmitting mild electrical sensations to the nerve.

These impulses travel to your sacral nerve plexus at the base of your spine, which is the nerve grouping responsible for bladder function. Each time you have a PTNS session, the gentle electrical impulses continue to change the signals sent to your bladder and pelvic floor muscles.

Over time, you will gain better control of your bladder and have less leakage. Most women need about 12 weekly 30-minute sessions to start. Once your treatment plan is complete, Dr. Moukarzel can re-evaluate your bladder function and schedule maintenance PTNS sessions, if necessary.

What we offer