Endometrial Ablation an effective minimally invasive treatment for heavy menstrual cycles due to benign disease. It treats heavy bleeding by reducing most if not all of the endometrial lining of the uterus. Endometrial ablation is an outpatient treatment using heat is applied to the endometrium. This procedure requires no incisions and is hormone free, avoids excess cost and allows for a quick recovery.
Before the procedure you may be given medications to help thin the lining of the uterus, as well as treat pain and help you relax. After the procedure for 24-48 hours you may continue with cramping. In addition, you may have a pinkish to red watery vaginal discharge.
With this type of procedure you should have a permanent form of sterilization and abstain from sexual activity for 14 days post procedure.
Essure tubal occlusion is a permanent birth control method that works with your body to prevent pregnancy. This procedure is incision-free. The devices that are placed to occlude the tube are hormone free and are made from the same material that is used in cardiac stents. The procedure is greater than 99% effective. The procedure does cause mild cramping and this will last for 24 hours at the most. This procedure is not immediately effective and another form of birth control must be used for 12 weeks until the tubes are confirmed to be completely blocked with a confirmation test, which is performed in radiology. This procedure can be performed in office or in the operating room depending on patient preference.
For many years routine Ob and Gyn ultrasounds have been performed in our office. We are now happy to offer 3D and 4D ultrasounds. Like regular ultrasounds, 3D and 4D ultrasounds use sound waves to create an image of your baby in your womb. What's different is that 3D ultrasounds create a three-dimensional image of your baby, while 4D ultrasounds create a live video effect, like a movie -- you can watch your baby smile or yawn.
My Baby's Heart Beat Bears:
There is nothing more precious to an expectant mother than the sound of her baby's heartbeat. My Baby's Heartbeat Bear provides everything you need to capture the sound of your baby's heartbeat and create a keepsake that will be cherished forever. The kit includes an adorable stuffed animal, and a 20-second red heart recorder that will easily preserve the sound of your baby's heartbeat. My Baby's Heartbeat Bear Kits also make fantastic baby shower gifts! Remember there is nothing more special to the expectant parents than their baby's heart beat.
Total Laparoscopic Hysterectomy:
Often definitive therapy for gynecological complaints is necessary and we are proud to offer minimally invasive surgery. With advanced laparoscopic skills, gynecological surgeons are able to perform TLH. The surgery is completed utilizing only three to four tiny abdominal incisions less than one-quarter to one-half an inch in length. Even a large uterus can be removed laparoscopically using this technique. A traditional open hysterectomy requires an abdominal incision of four to eight inches.
Post surgically, patients have a much quicker recovery, usually going home the same day or stay one overnight in the hospital. Often, patients are able to return to their normal routine in one to two weeks. Patients report less pain, minimal post-surgical narcotic pain medication use, and a faster recovery time than women undergoing abdominal hysterectomies who usually require a three to four-day hospitalization and lengthy recovery time of usually six to eight weeks.
Long Acting Reversible Contraception (LARC):
- Nexplanon is a LARC which is placed under the skin of the inner upper arm for birth control. It contains progesterone and is effective for 3 years. With this type of LARC you will get irregular bleeding for some time and most commonly menstrual cycles will stop. It can be removed at any point after placement if pregnancy is desired. This type of birth control is 99% effective.
- Mirena is a LARC which is a device that is placed in the uterus for birth control. It contains progesterone and is effective for 5 years. With this type of LARC, it is very common to have irregular bleeding for up to 8 months and them most often menstrual cycles will stop. Because of the cessation of menses with this LARC it is also used for the treatment of heavy menstrual cycles. It can be removed ant any point after placement if pregnancy is desired. This type of birth control is greater than 99% effective.
- Kyleena is a LARC which is a device that is placed in the uterus for birth control. It contains progesterone and is effective for 5 years. With this type of LARC you will get a short light cycle monthly. It can be removed at any point after placement if pregnancy is desired. This type of birth control is greater than 99% effective.
- Paraguard is a LARC that is a device that is placed in the uterus for birth control. This type of LARC contains no hormones. It is highly effective at greater than 99% and lasts for 10 years. It may be removed at any time after placement if pregnancy is desired.
Prior to placement, a pregnancy test must be done this can be done as a blood draw or a urine test. LARCs are placed ideally during a menstrual cycle, as they are easier to insert. Also, it is preferred to place them under ultrasound guidance so that proper placement is conformed and potential complications are avoided. A common side effect of LARC placement is cramping with menses this will most likely diminish over time.
Endometrial Biopsy/Endometrial Sampling/Pipelle:
WHAT IS IT? An endometrial sampling is considered to be an in-office procedure whereby a sample of the lining of the uterus is obtained. The sample is then sent to the Lab to be examined by a pathologist for any abnormality. The presence or absence of any abnormality will assist your doctor in determining if it is necessary for you to have any additional treatment.
HOW IS IT DONE? A vaginal speculum is inserted (usual for any pelvic exam) into the vagina and a cotton swab is then used to cleanse off the cervix. An instrument (tenaculum) may be attached to the cervix to hold the cervix steady; this may cause a pinching sensation. A disposable instrument, called a Pipelle, is then inserted into the cervical canal. This instrument is much like a small straw and through negative pressure, a sample of the lining of the uterus is obtained. This specimen will be sent to the Lab. Results usually take about 5-7 days and we will notify you of the results after your doctor views the results of the report.
WILL THERE BE AFTER EFFECTS? Because this procedure may be scheduled close to the end of your cycle, you may experience some spotting which may or may not last until the onset of your next period. Minimal cramping may be relieved by the use of Motrin or Tylenol. For the next 3 days, please refrain from having intercourse or the use of tampons.
INSURANCE INFORMATION: Since Endometrial sampling is done in the office and eliminates the need for an expensive hospital stay, this procedure will probably be covered by your insurance company. If you have any questions, please follow up with your insurance company to obtain any benefit information. PLEASE HAVE YOUR INSURANCE INFORMATION READY AT THE TIME OF YOUR APPOINTMENT.
Evaluation of an Abnormal Pap Smear with Colposcopy:
WHAT IS A COLPOSCOPY? Colposcopy is a procedure used in conjunction with the Pap test (cancer detection) to diagnose abnormalities of the female reproductive organs, primarily the cervix and the vagina. It is used most frequently if the Pap smear results suggest that further evaluation is indicated.
HOW IS IT DONE? Colposcopy is conducted with an instrument called a colposcope. This is a low powered microscope that does NOT touch or enter the body. This is a "looking" procedure that allows the doctor to see the cervix and walls of the vagina in much greater detail than would be possible with the naked eye. There is no pain A speculum (the shoehorn type instrument used for most pelvic examinations) is inserted into the vagina. A pap smear may be taken and the cervix is cleansed with a vinegar solution. The colposcope is then used to visualize the cervix and/or the walls of the vaginal. If abnormal areas are seen, biopsies (sample of tissues) are taken for laboratory study. The use of the colposcope in no way affects a women or her childbearing capabilities. It takes approximately ten minutes to complete the examination.
After the examination, the doctor will discuss his findings with you. Laboratory results will be available in about 7 days. You will be contacted by phone for a follow-up office visit to discuss those findings or for corrective treatment.
REASONS FOR COLPOSCOPY: DYSPLASIA – A reversible precancerous condition involving the presence of abnormal cells on the uterine cervix. Over a period of time (months-years) dysplasia can stay the same, disappear on its own or progress to cancer. Since we can not predict its trend, we feel obligated to evaluate and treat all cervical dysplasias.
DES EXPOSURE: Between 1940 and 1971 DES (diethylstilbestrol) and other synthetic estrogen's were given to pregnant women who had problems such as frequent miscarriages, diabetes and other complications of pregnancy. In 1971, studies showed an association, although very small, between intrauterine exposure to DES and the development of vaginal and cervical cancer. However, noncancerous changes appear in the vagina and on the cervix of the majority of those exposed.
The American Cancer Society and The American College of OB/GYN suggested that women who were not in the HIGH RISK group being pap smear screening at the age of 21 or within 3 years of first sexual activity and have a pap smear every 3 years, We strongly recommend that a YEARLY pap smear be taken starting around age 18 or upon sexual activity. This will help to stamp out cancer or at least diagnose it in its earliest stages when it is easiest to treat and when the cure rate is the highest.
IMPORTANCE OF PAP SMEARS: Every year thousands of new cases of cervical cancer are diagnosed in the United States and the pap smear is our #1 diagnostic tool. If this cancer is found early enough it can be cured by simple methods and since screening has begun the number of cervical cancer cases in the United States have declined.
There are certain HIGH RISK FACTORS that studies have shown may increase a woman's chances of developing cervical cancer.
- Women who have intercourse before the age of 20.
- Women whose mothers took DES while pregnant with them.
- Women who have acquired viral bacterial infections through intercourse.
- Intercourse with many sexual partners.
Cervical Dysplasia is a pre cancerous condition to cervical cancer. It is not cervical cancer. Often times no treatment is required, however, sometimes treatment is necessary.
Cryosurgery: Cryosurgery involves applying liquid nitrogen or carbon dioxide to the cervix. This causes the cervical tissue to freeze, which destroys the abnormal cells. Cryosurgery can be done in the office, similar to a pelvic examination, without any anesthesia. It may cause mild cramping or discomfort.
Most women have watery vaginal discharge for one week to 10 days after cryosurgery. Care after cryosurgery is described below. If the watery discharge begins to have an odor contact your provider.
Loop Electrical Excision Procedure: Loop Electrical Excision Procedure is an in-office procedure used to treat cervical dysplasia. Under local anesthesia, a small portion of the cervix is removed using a hot wire loop. The procedure takes 15 minutes to complete.
Laser ablation: Laser ablation uses high-intensity energy from a light beam to destroy abnormal areas of the cervix. The laser is directed to the abnormal area of the cervix through the vagina. This is usually performed in an operating room after the woman has received anesthesia.
Like cryosurgery, laser ablation destroys the abnormal tissue, which means that the tissue cannot be examined under a microscope and analyzed. As a result, laser ablation is not recommended in certain situations, such as when the extent and type of cervical abnormality are not clear based upon colposcopy and/or biopsy.
Most women have vaginal discharge for one to two weeks after laser treatment.
Saline Instillation Sonogram:
This examination is done in the office to allow visualization of the endometrial cavity. It is indicated sometimes in infertility, heavy menses, endometrial polyps and fibroids.
Ultrasound is performed after your doctor has inserted a small tube or catheter into through the cervical opening into the uterine cavity. Saline solution is injected through the catheter under direct ultrasound guidance. The saline solution fills the uterus and acts as a contrast material so that abnormalities can be seen.
You may experience abdominal cramping during the procedure. We recommend that you take 800 mg. of an Ibuprofen product one hour prior to the procedure. If you are allergic to Ibuprofen you may take two Extra Strength Tylenol. Please do not take any of these medications on an empty stomach. It is not necessary for you to be fasting for a Saline Instillation Sonogram however, we ask that you refrain from intercourse for at least 24 hours prior to this procedure.
This examination is performed in the Department of Radiology at the St. Luke's Campus. The procedure is done for two reasons, the first being to check tubal patency in the event of infertility or trouble conceiving pregnancy. The second being as a confirmation test to assure, after Essure tubal occlusion that the fallopian tubes are no longer patent. It is recommended that you take 800 mg. of an Ibuprofen product one hour prior to the procedure. If you are allergic to Ibuprofen you may take two Extra Strength Tylenol or call the office for other orders. Please do not take any of these medications on an empty stomach. It is not necessary for you to be fasting for a Hysterosalpingogram. We also ask that you refrain from intercourse for at least 24 hours prior to this procedure.
If you have any questions, please feel free to contact the office.
Monday – Friday 9am – 4:30pm