Category: News

 Office Procedures for COVID-19

NOTE: As we are experiencing high volume, please use our patient portal for any appointment changes or cancelations, as well as TeleVisit requests. You can visit our page with instructions by clicking here. 

Due to the COVID-19 pandemic, we are taking the following precautions to protect our patients and staff:  Effective May 11th, 2020 Potomac Urology Center will be seeing both urgent and a limited number of routine patient visits while maintaining social distancing principles to ensure safety of both staff and patients during the COVID crisis.

If you are or anyone in your home is experiencing signs or symptoms of a respiratory illness, or is running a fever, we ask that you reschedule your appointment, as we will not be able to see you in the office. Please note, if you are unable to be seen in the office, we will be able to offer a televisit instead.

  1. We are requesting that patients attend their appointments alone.  Due to social distancing recommendations, and limited space in the office, additional visitors with the patient will be allowed only in extenuating circumstances. Family members or other visitors can be looped in via teleconference or conference call during the appointment as necessary.
  2. To limit patients in the waiting room and maintain social distancing, you may be asked to wait in your car after check-in, and receive a call or a text to return to the office when a patient room is available.
  3. Mask wearing/nose and mouth covering is required while in the office, to protect yourself and others.
  4. All patients and visitors will be subject to screening upon arrival and will be asked to reschedule if you are exhibiting respiratory symptoms or a fever upon arrival.  Please feel free to reschedule any non-urgent appointment, or convert to a televisit.

Please feel free to contact our office using the following options:

  1. Log-in to Patient Portal (PLEASE CLICK HERE FOR INSTRUCTIONS ON USING THE PORTAL)
  2. By Phone: 703-680-2111

If you have an upcoming surgery, please stay in close contact with our surgery schedulers. Based on guidance by governor Northam, area hospitals are reopening for elective surgeries, with special procedures in place to maintain safety. A COVID test may be necessary prior to surgery, and the schedulers will be able to help you get this testing completed 72 hours prior to surgery. A surgery scheduler will guide you to make a new plan if your surgery is cancelled for any reason.

In order to assist our community with the burden to all healthcare facilities during this time, we ask that you contact our office FIRST for any URGENT urologic conditions prior to going to an Emergency Room or urgent care facilities. We may be able to offer an alternative to an acute care facility visit.

Our team at Potomac Urology Center appreciates the trust you place in us to care for your urologic needs.  During this unprecedented time, we appreciate your patience and understanding as we navigate through the coming weeks.  We can assure you that we will do our best to continue to deliver the best care possible for all our patients. We encourage you to stay informed, practice social distancing, and assist our communities in getting through this time as safely as possible.

Female Sexual Dysfunction FAQ

Why don’t I feel like having sex anymore?

You may have the most common type of female sexual dysfunction which is Hypoactive Sexual Desire Disorder (HSDD)

  1. What is it? It is an ongoing decrease or lack of spontaneous sexual desire and/or loss of desire to initiate sex that a woman may find frustrating. There is an imbalance of chemical messenger activity in the brain that results in low sexual desire
  2. Symptoms can include? Having a negative body image, find that you are avoiding intimacy, and having low self -esteem
  3. Who does it affect? Any woman
  4. How can we help you with this? Medications, treat low testosterone if appropriate

Why do I have pain with sex?

You may have Female Genital Arousal Disorder (FGAD)

  1. What is it? Trouble with being able to have an adequate genital response for sex
  2. Symptoms can include? Physical vaginal concerns or pain, Vaginal dryness and lack of lubrication for sex, find yourself avoiding intimacy, and having low self-esteem
  3. Who does it affect? Any woman
  4. How can we help you with this? Medications, Lubrication, increase blood flow with devices, treat low testosterone if appropriate

Why can’t I have an orgasm?

You may have Female Cognitive Arousal Disorder (FCAD)

  1. What is it? Trouble with being able to feel mental excitement about sex
  2. Symptoms can include? Cannot feel aroused mentally, negative body image, find you are avoiding intimacy, and having low self-esteem
  3. Who does it affect? Any woman
  4. How can we help you with this? Medications, lubrication, treat low testosterone if appropriate

Potomac Urology is one of the only practices in Northern Virginia with providers who have clinical interest and specialized training in helping women with sexual dysfunction. Katie Cage, NP is a Board Certified Family Nurse Practitioner who is also one of the few Certified Urology Nurse Practitioners in Northern Virginia, and she can help you with any of these concerns. Katie has over 10 years of experience in female urology and she works closely with our Urogynecologist, Dr. Alok Desai.

If you feel any of these describes how you are feeling, then please take this questionnaire below. Please click on the “make appointment” tab and make an appointment with Katie Cage, NP so that she can work with you to develop a personalized plan to help address your sexual issues. Potomac Urology is excited to be able to offer this type of care to members of our community.


The Decreased Sexual Desire Screener (DSDS) is a simple, validated diagnostic tool to help you identify and discuss HSDD

Please choose YES or NO

  1. In the past, was your level of sexual desire or interest good and satisfying to you? YES NO
  2. Has there been a decrease in thy or level of sexual desire or interest? YES NO
  3. Are you bothered by the decreased level of sexual desire or interest? YES NO
  4. Would you like your level of sexual desire or interest to increase? YES NO

CHOOSE ANY OF THE FOLLOWING FACTORS THAT MAY APPLY:

5. What factors do you feel may be contributing to your current decrease in sexual desire or interest?

  1. an operation, depression, injuries, or other medical conditions
  2. medications, drugs, or alcohol you are currently taking
  3. pregnancy, recent childbirth, menopausal symptoms
  4. other sexual issues you may be having (pain, decreased arousal or orgasm)
  5. your partner’s sexual problems
  6. dissatisfaction with your relationship or partner
  7. stress or fatigue

What should I do about vaginal dryness?

Vaginal dryness after menopause is rarely addressed, and is the leading cause for decline in sexual function and pleasure, recurrent urinary tract infections, and vaginal pain disorders.

Here at Potomac urology, we strive to address all areas of a woman’s health, particularly the areas that are under treated elsewhere.

Our providers are specially trained in evaluating underlying causes of vaginal symptoms in order to present patients with a full spectrum of treatment options. Evaluation typically includes a complete medical history,a simple pelvic exam with assessment of vaginal skin health and proper pH.

In brief, options can include vaginal estrogen-based creams and tablets, and treatments that did not involve estrogen such as moisturizers, lubricants, and minimally invasive office based vaginal laser procedures.

Dr. Alok Desai is the only physician in Northern Virginia double board certified in both urology and urogynecology, and is dedicated his career to help in women with their pelvic health issues. His specialty involves treating women sexual health, incontinence and urinary issues, as well as pelvic organ prolapse.

Nurse practitioner Katie Cage has more than 10 years of experience in treating women with pelvic health issues. She has specialized training and interest in treating women’s sexual health disorders.

Why should I treat my vaginal dryness?

  • Vaginal dryness can occur in both premenopausal in postmenopausal women
  • In premenopausal women, it can be secondary to oral contraceptive use as well as vaginal and vulvar skin conditions such as lichen sclerosus
    • These conditions can result in precancerous changes as well as painful intercourse, and loss of pleasure with intercourse
  • In postmenopausal women, this is most commonly due to atrophic changes of the vaginal skin.
  • In postmenopausal women, there are 3 changes that occur in the vaginal and vulvar lining:
    • The vaginal lining becomes thinner with less folds, resulting in loss of elasticity or the ability of the vaginal skin to stretch
    • There is a decrease in the proportion of the cells that produce vaginal fluid resulting in less fluid production
    • There is a change in consistency of the vaginal fluid, mainly associated with the loss of glycogen which is food for healthy bacteria(lactobacillus) that maintains proper vaginal acid base balance(pH). The normal acidity of the vagina is a barrier against colonization by bacteria that commonly cause urinary tract infections. When this acidity is lost, infections become more common

Why do I keep getting urinary tract infections (UTI’s)?

What is a urinary tract infection (UTI)?

A urinary tract infection refers to a condition where there is overgrowth of bacteria in the urinary system. This is a general term that can include any portion of the urinary system including the kidneys, the ureters, the bladder, and the urethra.

What is the difference between a bladder infection and a kidney infection?

A bladder infection is the most common type of urinary tract infection, and is also known as bacterial cystitis. Symptoms of a bladder infection are typically irritative and localized. Symptoms can include painful urination, pain in the lower abdomen or lower back, urgency and frequency of urination. We note that your body is able to eliminate some bladder infections on its own without antibiotic use.

A kidney infection is also known as pyelonephritis. Symptoms of a kidney infection tend to be systemic. These can include fevers, chills, back pain in addition to the symptoms of a bladder infection such as painful urination urgency and frequency. Kidney infections are more serious than a bladder infection and require prompt treatment with antibiotic therapy to prevent progression to a more serious infection known as urosepsis.

Where do the bacteria that cause urinary tract infections come from?

The majority of bacteria that cause urinary tract infections come from the bowel system. The distance between the vagina and anus is quite close in women and colonization of the opening of the vagina occurs quite easily. This has nothing to do with hygiene, the majority of our patients who have recurrent urinary tract infections do practice good hygiene. Since it is impossible to sterilize the skin, even with hygienic behaviors, colonization of the opening of the vagina can occur. The distance between the urethra and the opening of the vagina is quite short, and it is quite easy for bacteria to be pushed from the vaginal opening into the urethra either with intercourse or with daily activities.

Less commonly, bacterial infections can be related to concurrent conditions such as very large kidney stones, abnormal connections between the bowel and the bladder, abnormalities of the anatomy of the urinary tract, or incomplete bladder emptying.

How do antibiotics treatment urinary tract infections?

Antibiotics typically are processed either through the liver or the kidneys, excreted into the blood which then achieves therapeutic levels in the urine. There are numerous antibiotics, and each has a different mechanism of action that results in either stopping growth of bacteria or destroying the bacteria.

When we obtain urine tests for infection, we commonly will obtain a test called a urine culture, which shows us which bacteriuria is causing the infection and also gives us a list of antibiotics that the bacteria is sensitive to.

What are the risks of using antibiotics too frequently?

There are many healthy bacteria that exist in every organ system in our body. Antibiotics act fairly indiscriminately, and result in destruction of both healthy and unhealthy or pathogenic bacterial colonies. As a result of this, antibiotic use can result in disruption of bowel function, overgrowth of yeast, and overgrowth of bacteria on the skin. The worst complication can be overgrowth of a bacteria in the gut known as C. Dificile. This bacteria results in severe inflammation of the lining of the intestine, loss of the intestines ability to absorb fluid and nutrients, severe diarrhea and can be life-threatening.

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