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Profession: Obstetrics and Gynecology
Clinic: Jay R. Trabin, MD, FACOG
Address: 560 Village Boulevard
City: West Palm Beach, FL
ZIP: 33409
Country: USA
Telephone: (561) 687-5000
Fax: (561) 687-7666
Email: turbo911doc@aol.com
Website:
Phrase: This is a private, solo gynecology office offering personalized care with no-rushed visits.
Submit: Submit
Date: 24 Mar 2009
Virtually all conditions causing vulvar irritation, pain, disfigurement, or sexual difficulties. These include a wide range of infections including bacterial, yeast, herpetic, and HPV; specific vulvar pathologies such as vestibulitis, erosive lichen planus, lichen sclerosis, and atrophy; manifestations of systemic disease including psoriasis, Behçet’s and Crohn’s Disease, allergies; congenital anomalies, stenosis, or scarring; sexual trauma, pelvic floor muscle dysfunction, neuropathies, and vaginismus.
Treatment is customized to each individual. In general, with some exceptions, we prefer to start with treatments having the fewest side effects, lowest cost, and least risk. (assuming they have not been tried previously) These may include single or mixed preparations of tacrolimus, corticosteroids, sex steroids, crotamiton, antihistamines, emollients, and a wide variety of specially blended compounded topicals. We may raise the level of treatment to include intralesional steroids and anesthetics if they are appropriate. Additional management may include systemic medications such as gabapentin, pregalbin, tricyclic compounds, hydroxyzine, SSRIs, etc. and continue if effective. The more aggressive therapies including surgery (partial vestibulectomy, perineoplasty, local resections) are usually held until other reasonable treatment has failed. If pelvic floor dysfunction is a factor, local experts in physical therapy are available. Counseling for sexual trauma or dysfunction is readily available. The patient should keep in mind that therapies previously tried and failed elsewhere will affect our management plan, as will specific diagnoses that warrant specific therapy. (i.e. nerve blockades may be employed if needed.) We emphasize that combinations of therapies and other modalities are used to optimize treatment for the individual patient.
Dr. Trabin has an average of over 75 hours of postdoctoral education per year, much of which encompasses vulvovaginal disorders. He has accumulated three decades of personal experience in treating vulvar disorders, and interacts regularly with other experts from around the country. Just one recent example of postgraduate training is a course entitled Clinical Approach to Vulvovaginal Disease. Perhaps the best testimony to our success in this field is patient satisfaction and the comments of referring physicians (both available upon request)!
Jay R. Trabin, MD is a graduate of Thomas Jefferson College of Medicine in Philadelphia, and a board certified gynecologist. He is currently the Chair of the Florida Section of the American College of Obstetricians and Gynecologists, and he serves on the national ACOG Committee for Gynecologic Practice and the Committee on Voluntary Review of Quality of Care. He has also been President of the Florida Obstetrics and Gynecologic Society. Recently he has been invited to join the voluntary teaching staff at the University of Miami. Dr. Trabin has been practicing obgyn continuously for over 32 years in West Palm Beach in a comfortable private office, with admitting and surgical privileges at two excellent hospitals. He has been treating vulvar disorders for almost as long a period of time. Because he is in solo practice and allows plenty of time for every patient, women never feel rushed. Vulvodynia evaluation and treatment requires time and patience! He has been a consultant for the National Vulvodynia Association and interacts regularly with experts from around the country. He cares for patients with vulvar disorders from throughout Florida and the nearby Caribbean. Our office recognizes the complex interaction between the very real physical findings of vulvar pain syndromes and the equally important associated emotional effects. We also understand that many patients have been unsuccessfully treated elsewhere with resultant frustration. The whole patient is thus evaluated thoroughly - including the possible effect that vulvar pain and dyspareunia have on sexuality, self image, and relationships. A skilled counselor is available on site to assist with these issues if needed. We obtain a thorough history including detailed symptom review, previous therapies, provocative or palliative factors, history of sexual abuse or vulvar trauma, etc.; we perform a careful physical examination including vulvoscopic or magnification views, neurologic evaluation; cultures and DNA testing are done to rule out common or esoteric infections; and a biopsy may be performed when indicated. Because we also practice primary care and gynecology, we may be able to address associated problems such as hormonal imbalance and medical illnesses which may impact vulvar disorders. Our staff is sensitive to the patient's issues and we pride ourselves on a very personal approach to care.