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Bladder Instillations
Bladder instillations are used to place numbing medications into the bladder for temporary pain relief due to interstitial cystitis. This procedure may also be performed to test for bladder mucosal sensitivity. First the urethra is cleaned with betadine soap. A small catheter is placed in the bladder. Through this catheter a mixture of anesthetic medications is placed. The entire procedure is done in the office setting.
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Abdominal Myomectomy
The size and location of the incision will depend on the size and number of fibroids you have. The abdominal approach is usually reserved for patients with a large number of fibroids, or very large fibroids. The advantages of the Abdominal myomectomy in this setting is that it allows the surgeon the ability to actually feel the uterus and allows the surgeon to find fibroids deep inside the uterus that may not be visible just by looking. The disadvantages are a longer hospital stay, longer recovery period,greater risk of blood loss, and pain. Patents typically require a 48 to 72 hour hospital stay.
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Colposcopy
A colposcopy is indicated in the setting of an abnormal pap smear. If your pap smear showedatypical cells of undetermined significance(ASCUS) with the presence of human papilloma virus, low grade squamous intraepithelial neoplasia (LSIL), or high grade squamous intraepithelial neoplasia you will be scheduled for a colposcopic examination. A colposcope is used to enlarge the cervix, and vaginal skin and labia if needed, so that your provider can better visualize potentially abnormal areas. A special solution called acetic acid is applied to the cervix which assists in visualizing areas of concern. If an area is identified, a biopsy will be taken to send to a pathologist for more accurate diagnosis. The goal of the procedure is to obtain a tissue sample if abnormal areas are identified because the tissue will aid the pathologist to make a more accurate diagnosis of the type of abnormal cells that exist than a pap smear alone.
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Labial Reduction
Labial hypertrophy is a condition that results in labia majora or labia minora that are enlarged. The size of both labia may be reduced to relieve discomfort with walking, sport activity, sitting or intercourse. The procedure is performed in the operating room under anesthesia. Post-operative care and vaginal hygiene is key to prevent infection. The biggest risk to the procedure is suture (stitches) breakdown, infection, and scarring.
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Laparoscopic Excision of Endometriosis
Endometriosis is a condition that describes the growth of glandular tissue that usually is found within the uterus, located outside the uterus and within the abdomen such as on the fallopian tubes, ovaries, intestines, bladder, or on the lining of the abdominal wall. Endometriosis can only be diagnosed with laparoscopic surgery and biopsies. This condition can cause infertility, pelvic pain, severe pain with periods, pain with intercourse, and in extreme cases bladder pain or intestinal pain. In rare instances patients might also present with bleeding from other organ sites during their menstrual cycle. More commonly endometriosis is found on the fallopian tubes, ovaries, and on lining of the abdominal cavity. Excison (removal) of the lesions has been found to decrease pain at 6-12 month intervals. However, even after surgery medical management is essential for suppressing endometriosis and controlling pain.
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Intra Uterine Device Placement
An intrauterine device(IUD) is a T-Shaped contraceptive device placed inside the uterus. The procedure is performed in the office. There are two types of IUD’s the paragard IUD (Copper, hormone free) and the Mirena IUD (releases progesterone to the uterine lining daily). The paragard last for 10 years and the Mirena for five years. Both can be removed prior and are a long-term form of reversible contraception. Not all patient’s are optimal candidates for IUD placement, this will be determined at your visit.
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Excision or Marsipulization of Bartholins Gland Cysts
Bartholin’s Glands are located just inside the vagina at the 5 and 7 o’ clock positions. These glands may become blocked resulting in
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Laparoscopic Excision of Adhesions
If you have history of chronic abdominal orpelvic pain and history of prior surgery, endometriosis, pelvic inflammatory disease (PID) or inflammatory bowel disease (Crohn’s, Ulcerative Colitis, Diverticulitis) you may have scarring (adhesions) inside your abdomen. After reviewing your medical history and performing an exam you may be advised to have a Laparoscopic Excision of Adhesions.
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Hysteroscopic Myomectomy
If the fibroid/fibroids are small and located mostly within the uterine cavity, the procedure may be performed with a hysteroscope. This scope is place through the cervix and into the uterus and allows the surgeon to directly visualize the inside of the uterus. If a fibroid is present, a small loop is used to cut the fibroid away from the uterine wall. No incisions are necessary on your abdomen or on your pelvic organs or vagina. You may experience some light vaginal bleeding or spotting after this procedure. This procedure does not require an overnight stay in the hospital.
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Hysterectomy
Hysterectomy is the term used to describe a gynecologic surgical procedure which is performed to remove the uterus for various reasons such as, but not limited to, dysfunctional bleeding, fibroids, and chronic pelvic pain. There are two types of hysterectomy: A Total hysterectomy and a Supracervical (Sub-total) Hysterectomy.
