Welcome to the practice of James S. Dunn, Jr., M.D.
Here you will find a courteous staff and dedicated health care professionals providing the highest level of care for women with gynecologic and urogynecologic problems. Please note that our practice only treats female patients. This website is designed to acquaint you with the office and our medical practice: our services, policies and procedures. The more you know about the practice, the better we can be of service to you. Our goal is to provide the highest quality medical and surgical care to our patients.
We will strive to bring you the best health care services. One convenient way to do that is by offering you, our patient, this Web site to get to know us better and access health services and information 24 hours a day, 7 days a week. Please take the time to browse this site. If you have questions or require clarification please do not hesitate to ask any of our staff.
Frequent Questions
What Is Urinary Incontinence?Urinary incontinence is an embarrassing condition that most women do not discuss, even with close friends or a physician. While studies show that 25-40 percent of all women may suffer from some degree of incontinence, only one in ten will seek help for the problem. Instead, some women rely on absorbent pads. Others begin to go to the bathroom more frequently or avoid social and work situations which seem to aggravate the problem.
Myths regarding incontinence abound. Many patients and physicians mistakenly believe that incontinence is a normal part of childbirth, menopause, and aging. Others think that there is no effective treatment for incontinence. Fortunately, with proper diagnosis and treatment, urinary incontinence can be treated successfully in the vast majority of cases.
Urinary incontinence is a complex problem and may have many causes. Also, many women may leak urine for more than one reason. With a careful medical history, physical examination, and appropriate testing, an accurate diagnosis of all factors contributing to the leakage can be made, and individual treatment plans can be constructed.
Pelvic support problems (prolapse, when the pelvic organs begin to sag out of place) can also cause significant dysfunction and disruption in a woman's life. These support problems commonly are found with incontinence. Even in situations where a woman with prolapse has no urinary problems, treatment of the prolapse can often cause incontinence.
Incontinence, prolapse, and other pelvic problems are very common. In most cases, they can be successfully treated. Auburn Urogynecology provides an integrated diagnostic and therapeutic approach for the patient who is experiencing loss of continence (urinary or fecal), pelvic support, or other bladder or pelvic dysfunction. Our approach not only results in the most satisfactory care rendered but is more convenient for the patient and cost-effective as well. If you are bothered by these types of problems, or if they affect your daily living and enjoyment of life, please explore the website further and contact us immediately to schedule an appointment.
What Kind of Training Does a Urogynecologist Have?
Fellowship-trained urogynecologists have completed medical school, a four-year residency in Obstetrics and Gynecology, and a formal two- or three-year fellowship in Urogynecology and Reconstructive Pelvic Surgery. During the fellowship, these physicians undergo rigorous additional training and experience in the evaluation and treatment of conditions that affect the female pelvic organs, and the muscles and connective tissue that support the organs. The fellowship training focuses on the diagnosis and treatment of urinary and fecal incontinence, urinary and pelvic dysfunction, and pelvic support disorders.
What does "Fellowship-Trained" Mean?
There is currently no "board-certification" in urogynecology, so finding a fellowship-trained urogynecologist gives you the best chance of getting the best treatment for your lower urogynecologic problems. A fellowship-trained subspecialist has spent two or three years of additional training after residency to acquire the skills and sophistication to treat incontinence, prolapse, and pelvic dysfunction. Most fellowship programs were two years in length until the late 1990s, when most programs transitioned to three-year programs. Sometimes, general gynecologists and urologists attend weekend courses or go watch specialists do surgery, but this type of learning does not equal the training of a fellowship-trained urogynecologist.
When Should I See a Urogynecologist?
It is not a normal part of a woman's aging process to develop uncomfortable, troublesome symptoms of incontinence, prolapse, or pelvic pain. Women need not "learn to live with it." Effective help is usually available through the services of a urogynecologist. Although your primary care physician or gynecologist may have knowledge about these problems, a urogynecologist can offer additional, more sophisticated expertise. You should see a urogynecologist when you have problems of prolapse, incontinence, urinary or pelvic dysfunction, or when your primary doctor recommends consultation. Other problems for which you or your doctor might think about consulting a urogynecologist include: problems with emptying the bladder or rectum, pelvic pain, and the need for special expertise in vaginal surgery.
What Treatment Options are Available from a Urogynecologist?
A urogynecologist can recommend a variety of therapies to cure or relieve symptoms of prolapse, urinary or fecal incontinence, or other pelvic floor dysfunction symptoms. He or she should discuss both nonsurgical or surgical therapy although you will ultimately make decisions based on a number of factors including the severity of your condition and your general health. Nonsurgical options include medications, pelvic exercises (Kegels), behavioral and/or dietary modifications, and devices (e.g., vaginal weights, pessaries, urethral plugs). Biofeedback and electric Stimulation are treatments that are most effective when performed as part of a comprehensive pelvic floor program. Safe and effective surgical procedures are also utilized by the urogynecologist to treat incontinence and prolapse. He or she should discuss all of the options that are available to treat your specific problem(s) before you make treatment decisions.
How Do I Find a Urogynecologist?
If you believe that a urogynecologist is the right specialist for you, ask your primary care provider for a referral or contact your hospital's referral service for recommendations of urogynecologists in your local area. The availability of a fellowship-trained urogynecologist may be limited (for example, Northeast Urogynecology has the only fellowship-trained urogynecologists within a 75-mile radius of Albany), but usually the extra expertise is well worth the trip. Various web sites provide information to women about urinary incontinence and pelvic prolapse problems.
What is the difference between a urologist and a urogynecologist?
Answer: That is a very good question, and I get asked that frequently. The truth is that the basic fields are quite different, but as the fields get more specialized, the two fields become more similar and have a great deal of overlap. A urogynecologist is an OB/Gyn by training who has gone on to more training after residency. Usually this doctor has completed a four-year OB/Gyn residency followed by two or three more years of training, called a fellowship, devoted only to reconstruction of the pelvic floor and other disorders including incontinence of the bladder. A urologist has gone through five or six years of residency with the focus on the genitourinary system--kidneys, ureters, bladder, prostate, and urethra. A urologist can then go on to a fellowship in many different fields including “female” urology and urethral reconstruction. It is those fields that have a lot of overlap with the urogynecologist.