Urology Wellness Center

The Urology Wellness Center specializes in the non-surgical treatment of urinary incontinence, interstitial cystitis, impotence, urinary urgency/frequency (overactive bladder), vulvodynia, post-prostatectomy urinary incontinence, chronic constipation and other conditions of the bladder and bowel.

Urinary Incontinence (Leakage) Urinary Incontinence (Leakage)

Interstitial Cystitis (Painfull Bladder) Interstitial Cystitis (Painful Bladder)

Vulvodynia (Painful Vulva) Vulvodynia (Painful Vulva)

Urinary Urgency/Frequency (Overactive Bladder) Urinary Urgency and Frequency (Overactive Bladder)

Post Prostatectomy Incontinence Post Prostatectomy Incontinence

Impotence (Sexual Dysfunction) Erectile Dysfunction - E.D.

What is a Nurse Practitioner? What is a Nurse Practitioner?

Who Are We At UWC? Who Are We At UWC?

Office Locations & Phone Numbers Office Locations and Phone Numbers

Links to Related Sites Links to Related Sites

Billing or Insurance Questions Billing or Insurance Questions

To Request Brochure or Further Info To Request Brochure or Further Info

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Urinary Incontinence
(UI) - This condition is signified by the involuntary leakage of urine. The Agency for Health Care Policy and Research in the Guidelines for the Treatment of Urinary Incontinence in Adults says that the initial treatment of choice for Urinary Incontinence should be non-surgical behavior modification techniques. The Guidelines also state that these techniques are successful in 70% of the patients.

Initially, an evaluation of the patient's general health history and the history of the condition is necessary. Then, a physical examination should be performed to check the patients abdomen, back, pelvic area and reflexes for information pertaining to the condition and function of the bladder and bowel. Once this information is obtained, it is possible to decide what type of incontinence the patient has and to initiate specific treatment.
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The types of urinary incontinence are:

Stress Urinary Incontinence - This type of Urinary Incontinence occurs when the patient is under physical stress and the pressure inside the abdomen is greater than the pressure that closes the urethra (urine tube from the bladder to the outside of the body). This causes urine leakage which occurs when the patient coughs, sneezes, picks up something heavy, jumps up and down, etc. It may be caused by a "dropped" bladder or by weakness of the urethral closing mechanism. It can be treated by special exercises, diet, special devices to support the bladder, medications, and/or surgery. The non-surgical treatments should be tried first according to the Guidelines for the Treatment of Urinary Incontinence in Adults (AHCPR).
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Urge Urinary Incontinence - This kind of Urinary Incontinence is associated with a strong need to urinate and an inability to prevent urination until the appropriate time and place is reached. Urge Urinary Incontinence occurs when the bladder contracts without the person's permission. People who have this problem find that when they get home and put the key in the door, they may have an extreme need to urinate and may leak urine. Some people find they leak a little urine on the way to the bathroom, when they turn on the shower or when they put their hands in water. It may be caused by bladder irritants such as certain foods or drinks, medications, constipation etc. It can also be caused by a neurological condition such as back injury, multiple sclerosis, congenital causes, stroke, etc.
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Overflow Urinary Incontinence
- This type of Urinary Incontinence occurs because of the bladder's inability to empty itself completely. When the bladder fills and can not empty, it frequently mounts a contraction that squirts out small amounts of urine at a time. This can be caused by obstruction of an enlarged prostate or a "fallen bladder", neurological conditions, some medications, spasms of the pelvic floor, uncoordination of bladder/sphincter (muscle that closes the urethra) mechanism, etc. It can be treated by treating the cause, ie. surgery to remove obstruction, changing medications, lifting the bladder either by surgery or pessary, etc. Sometimes it is treated by self catheterization to remove the excess urine.
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Functional Urinary Incontinence
- In this type of Urinary Incontinence there is nothing wrong with the bladder. This type of incontinence is caused by the patients inability to get to the bathroom in time. This may be caused by mobility problems from injury or arthritis. It may be caused by dementia or alzheimer's disease that causes the patient to forget where the bathroom is. Medication may also cause a person to miss the cues to toilet. There may be obstacles in the way. There may be unavailable caregivers, etc.
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Interstitial Cystitis (IC)
- People with interstitial cystitis experience significant urgency and frequency of urination. They continuously feel as if they have to urinate and only urinate a small amount at a time. There is usually pain in the lower abdomen or the urethra. Pain is also frequently associated with intercourse. The Urology Wellness Center specializes in alternative treatments for this condition. We have found that the pain may be caused by infection with fastidious organisms (those which do not show up on standard cultures). The pain may also be caused by muscle spasms and trigger points that refer pain to the abdomen and bladder. Allergies, food substances, and the effects of yeast infections can also cause the problems. Our studies show that most of our patients experience a major lessening of pain and pressure, urinary frequency, and depression, and an increase in level of functioning and quality of life. We use bladder training, bowel training, special diet, treatment of trigger points and muscle spasms, biofeedback for pelvic floor muscle rehabilitation, special antibiotics, and treatments for yeast, etc.
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Urinary Urgency and Frequency (Overactive Bladder)
- This condition is similar to Interstitial Cystitis, however, it has not been diagnosed by a physician. It is treated in similar ways. Antibiotics are used for infection and treatment of fastidious organisms. Bladder training, bowel training, special diet, special exercises, medications, and treatment of muscle spasms and trigger points are also major parts of the treatment.
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- This condition is signified by chronic pain in the vulva and vagina. Frequently the patient feels that the area is red and swollen. Sexual intercourse is painful. The patient with vulvodynia may also find that wearing blue jeans, stockings or even underpants causes excessive pain. The Urology Wellness Center has found that vulvodynia patients respond to conservative measures. These include diet, bowel training, medication, specific exercises, and treatment for muscle spasm and trigger points.
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Post - Prostatectomy Urinary Incontinence
- This condition is caused by the damage to nerves and tissue by operations on the prostate, most specifically by removal of the prostate for cancer. Treatment involves rehabilitating the pelvic floor muscle to compensate for damage to the sphincter mechanisms and nerves. Medication, avoidance of bladder irritants, and product support are also utilized.
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- Impotence or sexual dysfunction is the inability to achieve and maintain an erection to the satisfaction of both partners. Impotence has a major effect on the quality of life of many people both male and female. There are many reasons why men suffer from the the effects of impotence. The Urology Wellness Center provides initial evaluation and treatment utilizing patient education, counseling, medications (including Viagra and/or Yohimbine), vacuum erection devices, etc. The Urology Wellness Center does not do injection therapy or surgery.
Do Women Have E.D.?

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Philosophy of Treatment
- The Philosophy of Treatment for Interstitial Cystitis and Vulvodynia is to teach the patient to heal herself or himself with guidance. It includes prescribing medications if necessary, and some treatments such as biofeedback, treatment of trigger points with ice and stretch and massage, but mostly it involves techniques and treatments that the patient does herself/himself, such as diet and fluid management, special exercises, and special treatments. This empowers the patient and allows her/him to have control of the condition. The patients find that this decreases their fear (which is a pain magnifier) and allows them to control relapses without spiraling down into the depths that they had previously reached.
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B.J. Reid Czarapata, CRNP, CUNP
- B.J. is the founder and President of the Urology Wellness Center. She is certified as an Adult Nurse Practitioner and is also certified as a Urology Nurse Practitioner and has been in Urology since 1986. She was part of the Division of Urology at Georgetown University Medical Center in Washington, D.C. prior to starting the Urology Wellness Center in 1992. She has previous experience in geriatrics, women's health, and orthopedics. She is also Past President of the Society of Urologic Nurses and Associates, a member of the Medical Advisory Board of the National Vulvodynia Association, the Nurse Practitioner Associations of Maryland, D.C., and Virginia. She has written many articles for professional journals, and speaks locally, nationally, and internationally.

As of January 1, 2000 the Urology Wellness Center joined with the Fairfax Urology Ltd., in Association with Wm. Lloyd Glover, M.D. a board certified urologist. The association with Dr. Glover has greatly increased the services available to our patients as well as making insurance more available.

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What is a Nurse Practitioner
- A nurse practitioner is a registered nurse with extra medical education. The State of Maryland allows nurse practitioners to: diagnose and treat stable chronic or simple acute diseases, order or perform treatments, order testing, and prescribe medication.

The American Academy of Nurse Practitioners defines a nurse practitioner as:

"a registered nurse (RN) who has advanced education and clinical training in a health care specialty area. Nurse Practitioners work with people of all ages and their families, providing information people need to make informed decisions about their health care and lifestyle choices

Nurse Practitioners practice under the rules and regulations of the Nurse Practice Act of the state in which they work. Most nurse practitioners are also nationally certified in their specialty area. They are recognized as expert health care providers.

Nurse Practitioners may be found in all fifty states. Research studies since 1965 have documented that Nurse Practitioners Provide:

High quality care
Cost-effective care
A unique approach to health care
"Care that results in a high level of patient satisfaction" From "The Nurse Practitioner A Primary Health Care Professional" American Academy of Nurse Practitioners.
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Contact us for information: insurance or billing information, to have a brochure mailed to you, to obtain directions, to schedule appointments, etc.

Patients with urinary incontinence or overactive bladder can be seen by:

B.J. Reid Czarapata, MSN, ANP-BC, CUNP at:
Raman Tuli, M.D., P.C.
10810 Darnestown Rd. Ste. 202
Gaithersburg, MD., 20878
Phone: 301-424-1780

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The Interstitial Cystitis Network
Santa Rosa, CA USA 95409
Phone: (707)538-9442
FAX: (707)538-9444
Serving IC patients and providers in 69 countries.

Agency for Health Care Policy and Research
To receive information on the treatment of urinary incontinence in adults.
Guidelines were published in 1992 and 1996. website:http://www.ahcpr.gov

National Kidney and Urologic Diseases Information Clearinghouse
To receive monographs on assorted urologic conditions. They also have information and pamphlets on urinary incontinence in women. e-mail: nkudic@aerie.com

National Association for Continence (formerly HIP - Help for Incontinent People)
To receive a Resource Guide for products and services for people with incontinence or to receive their Quarterly Newsletter, visit their website www.nafc.org.

The Simon Foundation for Continence
800 23-SIMON (800-237-4666)
For information on urinary continence. Also has programs and videos available for small groups.

Society of Urologic Nurses and Associates (SUNA)(formerly AUAA)
For information on urologic nursing subjects. Continuing education available. Bi-annual conference on continence. For referral to Continence Nurses in your area e-mail: suna@mail.ajj.com

National Vulvodynia Association
For information on Vulvodynia and to receive newsletter. www.nva.org

Interstitial Cystitis Association
To become a member and to receive information on Interstitial Cystitis. http://www.ichelp.com

Interstitial Cystitis Information Center
To receive information on Interstitial Cystitis, particularly alternative therapies. Also available is a packet that includes three articles by B.J. Czarapata, CRNP, CUNP and the diet used by the Urology Wellness Center. There is a small charge for shipping and handling. http:\\www.moonstar.com\~icickay

The Wellness Interactive Network

University of Connecticut Health System/UConn Health Center
The clinical web site for the John Dempsey Hospital in Farmington, CT. They offer current information on disease, wellness, clinical trials and research as well as clinical content on health topics such as Cardiac Care, Orthopaedic Surgery, Urology, Behavioral/Mental Health, Women's Health and more.  http://www.uconnhealth.org.





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