Guzman Nancy

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Phone: (212) 969-9540

Address: 330 W 58th St Ste 401, New York, NY 10019

Guzman Nancy

General Practitioners

Fibromyalgia
A lot of our patients with IC also have chronic fatigue. There's about a 15 percent overlap between IC and chronic fatigue and fibromyalgia and scleroderma and other collagen vascular type diseases, which are immune system disorders. The link with these conditions is not understood.
Cryotherapy
There are many treatments for prostate cancer. Traditional treatments include hormone therapy, cryotherapy, radiation therapy and prostate removal. While the appropriate procedure for your given situation is best determined by your doctor, each treatment has their own advantages and disadvantages.
Primary Care
We are going to talk about the painful bladder. IC is the official term for it. I would like to dispel some myths that too many people have. I am sorry to admit that many of my colleagues in urology still believe some of these myths. It is your job as educated consumers to teach your urologists that there are new things happening with IC. It is not a rare disease, it is not necessarily difficult to diagnose if we understand this disease, and it certainly is not difficult to treat, and that is even more true these days. I don't want to belabor you with statistics, but suffice it to say that the harder we look for patients with this disease, the more we find. It is estimated now that there are probably close to 1,000,000 people whom we have already diagnosed with IC. This is just the tip of the iceberg. The more we spread the word and the more we educate our primary care doctors and gynecologists, the more patients we will be able to find and, most importantly, the more patients we will be able to help.
Male Infertility
, including male infertility and chronic pelvic pain syndromes in men and women. He has received praise from colleagues for developing many new treatments that are effective alternatives to surgery, and he lectures about this across the nation. Learn More
Constipation
Erectile Dysfunction
Urinary Incontinence
Urinary incontinence is a widespread health problem, affecting more than 13 million women in the U.S., which is not widely discussed. It is most common in women, especially mothers and older women. Dr. Kaufman has nonsurgical treatments to uncover the source of your problem.

Gynecologists

Gynecology
A lot of female patients are misdiagnosed as having endometriosis because of their pelvic pain. But many patients have both IC and endometriosis. There have recently been some published studies that have found that the overlap between endometriosis and interstitial cystitis is really nothing short of astounding. About 70 percent of patients presenting to gynecology clinic with pelvic pain are found to not only have endometriosis but to have evidence of interstitial cystitis as well.
Female Infertility
Endometriosis
While this chronic pain disorder is still under-diagnosed, the National Institutes of Health estimates that about 700,000 Americans have IC. Many of these cases aren't being picked up because people assume the symptoms are due to other conditions such as endometriosis, or that the symptoms are psychosomatic. Below, Dr. David Kaufman, a urologist in private practice at Central Park Urology in New York City, talks about why people with IC symptoms should seek help for this uncomfortable condition.
Pelvic Pain
To summarize, some of the conditions we see associated with PFD are: IC, vulvodynia and vulvar vestibulitis and chronic pelvic pain syndrome, which is a new catchword for IC in men.
Pregnancy

Internists

Urology
Central Park Urology offers compassionate and expert service in state-of-the art facilities in New York City. Informational videos are available for education on your particular urological concern. Dr. David Kaufman provides patient information in this section on the following topics...
Kidney Stones
Kidney stones are serious and require immediate attention. If detected early, they can be treated easily, without surgery. Dr. Kaufman can also treat stones with a routine, minimal procedure. With regular checkups, you may be able to prevent subsequent stones and/or lessen their severity.
Testicular Cancer
Colon Cancer
Dr. Kaufman: I don't know the answer to that. It makes sense. My personal belief is that I think a vast majority of patients, if not all, have an epithelial defect as the primary etiology. I don't know why Elmiron doesn't work in all of those patients. It could be that we are using too low a dosage. This is under investigation right now and perhaps we are not treating it for long enough. As in many other disease states, there are cofactors involved. In cancers we know you need to have a number of things happening. In colon cancer you need to have biochemical things in the gut and you also need to have a poor diet. I think in IC there are probably cofactors that we do not understand yet. You have a defective lining, but there is something else we have not identified. Why don't all patients who have recurrent UTIs get IC? There is obviously something that happens to IC patients that does not happen to others.
Interstitial Cystitis
In April 2002, he was featured on ABCnews.com about his experience with successfully treating IC. For his latest lecture on interstitial cystitis, visit the Interstitial Cystitis Network.
Urinary Tract Infection
This is my favorite slide of the whole talk. This is a new concept to many urologists. It is hypothetical but I think it makes sense to so many of us. The gist of this slide is that we believe that it is those young women who start off in their late teens or early twenties with recurrent urinary tract infections (UTI) which don't get adequately addressed. They don't get rid of the infection. It is MY idea that over time, not all of these patients, but a percentage of these patients, will evolve down this unfortunate roadway to IC. This is moderate, or classic, IC. The NIH has very strict criteria for IC, which require more in the way of symptoms. The advanced case of IC (what I call mature IC) is a combination of IC and pelvic floor dysfunction. This is an important part of that disease. Urologists used to perform cystectomies (removal of the bladder) in severely affected patients with IC, and a sizable percentage still had bladder pain following their surgery. I think the reason is that, in addition to their IC, they also had pelvic floor dysfunction (PFD), a terrible spasm of the pelvic floor muscles. We call this pelvic pain and the patient interprets it as bladder pain. Colorectal surgeons have been dealing with this entity for years. They call it something different, levator ani syndrome. It is basically the same pathology. It is a neuropathic change that occurs to the nerve endings that go to the bladder, bounce back to the spinal cord, and come right back down to the muscles surrounding the bladder and cause those muscles to go into spasm. In patients with mature IC, you can do anything to the bladder They can have a great response to medications, but if you don't address the PFD, they will still have pain with intercourse and pelvic pain. If some of you are involved in therapy for the bladder with IC and you are still having symptoms, ask your doctor about PFD. We will talk about treatment for this later.
Prostate Cancer
The Sonablate HIFU medical device is developed by Focus Surgery, inc. to treat prostate cancer and benign prostate hyperplasia (BPH).

Neurologists

Epilepsy
There is a new class of medications, called neuroleptics. This includes NeurontinÆ. Neurontin, as well as DilantinÆ and TegretolÆ were developed for the treatment of epilepsy. The anesthesiologists who treat chronic pain discovered that they work well in the treatment of neuropathic pain, which is what IC patients have. We start with 300 mg three times a day of Neurontin, and go up to 900 mg three times a day, and sometimes higher. I was at an IC support group a few years ago and a patient said that Neurontin was the only drug that had made a difference in his life.

Psychiatrists

Depression

Endocrinologist

Diabetes Care

Radiologist

Ultrasound
High Intensity Focused Ultrasound is a new and innovative way to treat prostate cancer that is minimally invasive and highly precise. High Intensity Focused Ultrasound or HIFU works by destroying cancerous tissue with highly focused sound waves. These ultrasound waves
Radiation Therapy
It is not only your bladder that behaves this way. There are other conditions in the bladder that are also KCl (potassium) positive. There is a condition similar to IC in people who have had too much radiation therapy to their bladder which also shows a positive response to the KCl test. In men with prostate enlargement, who suffer no pain or urgency related to bladder disease, the KCl test is negative.

Surgeons

General Surgery
Dr. Kaufman earned his medical degree from the State University of New York at Stony Brook School of Medicine. He performed his General Surgery internship at The Mount Sinai Hospital and his Urology Residency Training at Columbia Presbyterian Medical Center in New York City. He currently serves as Assistant Professor of Clinical Urology at the Weill Cornell Medical School and is an Attending Urologist at St. Luke’s-Roosevelt Hospital Center and New York Presbyterian Hospital, Cornell campus.
Vasectomy
NFL free agent cornerback Antonio Cromartie just welcomed his 14th child, despite having a vasectomy years ago. Cromartie’s wife, Terricka, gave birth to a baby girl named Jhett Paxton—a little over a year after the couple swore they were done having kids after they had twins in 2016. Now, the couple says they really, really mean it.

Dermatologists

Skin Cancer
Next to skin cancer, Prostate cancer is the most prevailant form of cancer in men and the third leading cause of male cancer related mortality. Generally, prostate cancer is slow growing. However, there are cases where the diease can grow and spread rapidly. Even with the latest research, it can be difficult to distinguish between a fast growing cancer requiring immediate care and a slower one.
Ulcer
Right now I fully believe that to make a diagnosis of IC you have to go back to the standard diagnostic test, the cystoscopy with hydrodistention under anesthesia. As you all know, branding a patient with those scarlet letters of IC is not to be taken lightly. Before I do that, I like to make sure these patients have IC. In my book, the only way to do that is by doing it by the book. There is a silver lining to this procedure; about 40-50% of patients actually improve afterwards. However, for the most part, it is done for diagnostic purposes. When a hydrodistention is done, typically you can see glomerulations and petechial hemorrhages. A normal bladder clearly does not look this way. I believe there is only one disease that causes a picture like this and that is interstitial cystitis. Some of you will read about a diagnosis of a Hunner's ulcer. In the early 1900s, Dr. Hunner was one of the first doctors to describe IC. He described an ulcer, which I have never seen. What I have seen is just a big erythematous patch. I think to explain what Dr. Hunner was seeing you must go back to 1908, to the very early cystoscopes, which were probably using "candle power" to look inside the bladder. I don't think he achieved the same quality of optics we get today. We take biopsies of the bladder and ask for a mast cell count. We have already spoken about mast cells, which contain histamine. This is something we see in higher percentages in many patients with IC.

Physical Therapists

Physical Therapy
Uses "hands-on" and "internal" physical therapy to relax pelvic muscle trigger points, release abnormal myofascial attachments and provide deep tissue massage of these muscle groups in spasm. Biofeedback and electrical stimulation is often used as part of the "hands-on" technique to facilitate recovery. Neuromuscular reeducation is critical for the return of normal functional activities of daily living, relief of pelvic pain, and return of normal urinary and bowel function. This physical therapy is performed only by specially trained Physical Therapists and usually requires visits to the Physical Therapy office one or two times a week for at least two months. The following physical therapy groups specialize in Pelvic Floor Rehab in New York City and are highly recommended...
Back Pain

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