Stokes has provided myself and my family a level of support and attention to detail unmatched in virtually any other service industry. I have one word for Stokes' level of support and service - excellence.”

– Robert, Cherry Hill, NJ

Urology/Urogynecology

Urology is the specialty that focuses on the urinary tracts of males and females and on the reproductive system of males. Urogynecology is a subspecialty within obstetrics and gynecology and focuses on the study and treatment of pelvic floor disorders in women. Here at Stokes we work directly with doctors in both of these areas and have helped to provided quality combinations of medications as well as information that allow prescribers to use alternative methods of treating unique problems.   Please call and speak with our staff here at Stokes so we can assist you in your health needs.

 

Some Types of Therapy for Urologists and Urogynecologists

  • DIAZEPAM SUPPOSITORIES- Can be used in the treatment of high tone pelvic floor dysfunction, a result of spasming of the musculature of the pelvic floor leading to the symptoms of vulvar pain, dyspareunia, overactive bladder, interstitial cystitis, constipation and urinary retention. Diazepam is commonly used in treatment of muscle spasms, in suppository form it may give localized relief with a lower incidence of systemic side effects.
  • ESTRADIOL CREAM- To be used externally around the introitus, prescribed for symptoms of menopause including vaginal dryness and vaginal and vulvar atrophy characterized by thinning mucosa and possible tears in tissue.
  • ATROPINE- A parasympathetic blocking agent affecting blood vessels has been used in treatement of vulvar vestibulities. Topical use can consist of 2% cream used daily at the vaginal introitus or atropine can be combined with estradiol and used topically.
  • CROMOLYN- an antihistamine that blocks release of histamine from mast cells, thus is thought to decrease mast cell degranulation in vulvar tissue. Cromolyn is used topically, applied daily to the introitus, in the treatment of vulvar vestibulitis, interstitial cystitis, vulvar vaginitis.
  • AMITRYPTILINE- Amitriptyline is a tricyclic antidepressant with antinociceptive effects, thought to decrease neuronal hypersensitivity; topical use of 2% cream can be administered to patients with neuropathic pain. Topical use can give localized and effective analgesia while reducing the systemic drug levels.
  • KETAMINE- Ketamine is an antihyperalgesic which inhibits amine uptake and NMDA receptors and is an agonist for mu-opoid receptors. It provides analgesia and used in cases of acute inflammatory pain including vulvadynia where it can be used topically as a 1% cream to the external introitus.
  • AMINOPHYLLINE- A bronchodilator, the topical aminophylline cream can be used to treat women experiencing difficulty reaching orgasm, can be used for relief of vaginal pain, muscle relaxation, and increased blood flow. The cream can be applied externally to the labia and clitoris, intravaginally to the outer 1/3 of the vagina prior to intercourse.
  • BORIC ACID SUPPOSITORIES- Boric acid has antiseptic and antifungal properties associated with it and has been used in the form of boric acid suppositories in the treatment of recurrent candida infections (recurrent yeast infections).
  • CAPSAICIN CREAM- Capsaicin can be used in the treatment of vulvar vestibulitis/ vulvadynia to decrease pain associated with vaginal intercourse by desensitizing the tissue through the degeneration of C fiber afferent neurons and depletion of neuropeptides. 
  • LIDOCAINE GEL- A topical anesthetic, used around the vestibule and introitus to numb the area prior to vaginal intercourse in patients with vulvadynia, interstitial cystitis, high tone pelvic floor dysfunction.
  • TRAUMEEL AND LIDOCAINE CREAM/GEL- Traumeel is a homeopathic combination of 12 different ingredients and is used for its anti-inflammatory and analgesic effects. Traumeel can be mixed with lidocaine in an acid mantle base and used for treatment of vulvar vestibulitis externally to reduce inflammation and pain or can be combined with lidocaine and used in urethral jets for patients suffering from pain associated with interstitial cystitis, additionally, the urethral jets can be used following catheterization to decrease associated pain.
*At Stokes we understand the needs of our patients that is why our compounded creams use bases such as acid mantle, aquaphor or petroleum because they are best tolerated by patients with vulvar pain and they are also used to decrease irritant dermatitis seen with the use of typical base additives.