Services & Procedures

Hysterectomy
Hysterectomy is removal of the uterus. There are many reasons one may need to have a hysterectomy. The type of hysterectomy chosen depends on the reason for the surgery. It also depends on the findings of a pelvic exam. Your doctor may suggest abdominal, vaginal, laparoscopically assisted vaginal, or laparoscopic supracervical hysterectomy. You may or may not have your ovaries and tubes removed at the time of your hysterectomy. That is something you should discuss with your doctor.

Abdominal Hysterectomy
In abdominal hysterectomy, the doctor makes an incision (cut) through the skin and tissue in the lower abdomen to reach the uterus. The incision may be vertical (up and down) or horizontal(side to side). Abdominal hysterectomy requires a longer healing time than vaginal or laparoscopic surgery. The doctor may suggest this procedure if you have fibroids (large tumors) or if cancer may be present.

Vaginal Hysterectomy
In vaginal hysterectomy, the surgery is done through the vagina. With this type of surgery, you will not have any scarring on your abdomen. Because the incision is inside the vagina, the healing time may be shorter than with abdominal surgery.

Laparoscopically Assisted Vaginal Hysterectomy
With laparoscopically assisted vaginal hysterectomy (LAVH), the doctor removes the uterus through the vagina. Your doctor may suggest LAVH if standard vaginal surgery cannot be done. LAVH involves the use of a small light-transmitting device called a laparoscope. The device is put into the abdomen through a small incision. It lets the doctor see the pelvic organs on a screen while doing the surgery. Additional small cuts are made in the abdomen to assist the surgery. The uterus is removed through the vagina. Recovery from LAVH is similar to vaginal hysterectomy. However, the time it takes to perform an LAVH can be longer time than a standard vaginal hysterectomy.

Laparoscopic Supracervical Hysterectomy
If faced with having a hysterectomy, a LSH (Laparoscopic Supracervical Hysterectomy) is worth considering. This is a minimally invasive procedure that may reduce pain and minimize scarring. Your surgeon uses a thin, lighted, telescope-like instrument called a laparoscope, which is inserted through tiny incisions into the abdomen. The uterus is removed in small pieces through these incisions. The cervix is left with this procedure, so you must have a history of normal pap smears. As this type of surgery does not require a large incision, you can expect less scarring and a reduced recovery time. In some cases, the procedure can be done as an outpatient, with most cases it is an overnight hospital stay. For more information about the procedure, click here> http://www.lshinfo.com

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Treatment for Excessive Menstrual Bleeding
If you suffer from heavy menstrual bleeding, also known as menorrhagia, an endometrial ablation may me the solution. We perform the *Gynecare Thermachoice Endometrial Ablation, which is minimally invasive and highly effective. It is performed as an outpatient alternative to a hysterectomy.

• The *GYNECARE THERMACHOICE Uterine Balloon Therapy System is a one-day treatment option designed to end heavy menstrual flows by removing the lining of the uterus.

This medical device resolves heavy menstrual periods (clinically known as menorrhagia) due to benign causes in premenopausal women who have completed childbearing. Unlike hysterectomy, which takes out the entire uterus, the device only treats the lining of the uterus with heat through a process called endometrial ablation.

*GYNECARE THERMACHOICE has been used by physicians for 8 years and has been used in more than half a million women worldwide. It is now being used during a minimally invasive 8-minute treatment that can be performed with a local anesthetic in the convenience of a gynecologist's office, eliminating the need to go to the hospital and making it easier to schedule it into your busy life. Recovery is fast and most women can return to their normal activities by the next day. To learn more about the procedure, click here> http://www.endheavyperiods.com

Laparoscopy
A laparoscope is a small telescope that is inserted into the abdomen (belly button) through a small incision (cut). It brings light into the abdomen so the doctor can see inside. Laparoscopy is usually done on an outpatient basis, meaning you don't have to stay in the hospital overnight. Laparoscopy is often used to diagnose causes of abdominal pain. If the doctor finds that he or she can treat the condition during the procedure, diagnostic laparoscopy can turn into operative laparoscopy. This procedure is used to treat many health problems. Laparoscopes can be used to aid in the diagnosis and treatment of endometriosis, fibroids, adhesions, ovarian cysts, and infertility. Before undergoing laparoscopy, you and your doctor will discuss the procedure and any other treatment.

Dilation and Curettage (D&C)
This surgical procedure is used to remove the lining (endometrium) and contents of the uterus. The D & C is most often used to diagnose and treat abnormal uterine bleeding. It is also sometimes used to treat miscarriage. We normally perform this procedure in a hospital or outpatient surgery setting.

Diagnostic Hysteroscopy
A hysteroscope is a camera that is used to look inside the uterus. This procedure can be used to help remove polyps, uterine lining, and fibroids. In most cases this is done with a dilation and curettage(D&C).

Versapoint Resection for Uterine Fibroids
GYNECARE VERSAPOINT* is a minimally invasive technique that is used to remove uterine fibroids or polyps. The surgery is done using a camera(hysterscope) that has a special instrument that helps vaporize the fibroid or polyp. With this procedure there is no cutting of the skin or sutures, therefore recovery is quick. It is an outpatient procedure. For more Information about the procedure , click here> http://www.gynecare.com/bgdisplay.jhtml?itemname=versapoint_about

Anterior, Posterior, & Complete Prolift for Pelvic Organ Prolapse
There are a number of different types of prolapse that can occur in a woman's pelvic area and these are divided into three categories according to the part of the vagina they affect: front wall, back wall or top of the vagina. It is not uncommon to have more than one type of prolapse. Pelvic reconstructive surgery can be performed through the vagina or abdominally. The Gynecare Prolift* is a minimally invasive technique that is performed through very small incisions in the vagina. The system employs a mesh that is specially designed to restore pelvic support. There are three different systems available: The anterior is used to correct a cystocele, a posterior to correct a rectocele, and complete is used for complete uterine/vaginal prolapse. The surgery takes 1 to 2 hours and can be performed under spinal or general anesthesia. Most people require an overnight stay and recover pretty quickly. The biggest restrictions following this procedure are; no lifting greater than 8 pounds and nothing in the vagina. To learn more about Pelvic Organ Prolapse and the prolift procedures, click here> http://www.gynecare.com

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Permanent Birth Control
Is your family complete or are you unhappy with your current birth control? Sterilization is an elective procedure. This means that it is your choice whether or not to have it done. We offer two methods of permanent birth control.

The traditional sterilization method is Laparoscopic Bilateral Tubal Ligation. For laparoscopy, the doctor uses a device like a small telescope called a laparoscope to look at the pelvic organs and identify the fallopian tubes so they can be blocked or cut. This prevents pregnancy. This is done as an outpatient under general anesthesia. The recovery is pretty quick. This method is effective with fewer than 1 per 100 (more than 99% effective) women becoming pregnant after this procedure. For more info, click here> http://www.acog.org/publications/patient_education/bp035.cfm

We also offer a minimally invasive and effective method of permanent birth control known as Essure. Unlike other methods of permanent birth control, this non-invasive method does not require cutting or general anesthesia-and typically can be completed within 30 minutes. Generally you can return to work within 24 to 48 hours of your procedure. This method is 99.8% effective. If you would like to learn more, click here> http://www.essure.com

Intrauterine Devices
The intrauterine device (IUD) is a type of birth control. It is a small, plastic device that is inserted and left inside the uterus to prevent pregnancy. Although there have been several types of IUDs, currently only two are available in the United States: the hormonal IUD and the copper IUD. The hormonal IUD (*Mirena) must be replaced every 5 years. The copper IUD (*Paragard) can remain in your body for as long as 10 years. As soon as the IUD is removed, it no longer protects against pregnancy. We use both, the *Mirena and *Paragard IUDs. IUDs can be inserted in the office, during your menses or right after your menses. If you are interested in an IUD you should discuss this with your medical provider.

To learn more about the *Paragard IUD, click here> http://www.paragard.com/

To learn more about the *Mirena IUD, click here> http://www.mirena-us.com/index.jsp

Implanon
*Implanon is an implantable birth control option that prevents pregnancy for 3 years. It is more than 99% effective. It prevents pregnancy by stopping release of the egg and it thickens the cervical mucus preventing fertilization. It is placed in the office by a trained medical provider. If you would like to learn more, click here> http://www.implanon-usa.com

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Put an End to Urinary Leakage
Many women are affected by urinary incontinence. If you leak urine when you cough, sneeze, or run; you likely suffer from this embarrassing condition. There are three types of urinary incontinence: Stress, Urge, and Mixed. Urodynamics testing is performed to better evaluate the bladder and the urethral function. This test helps to determine which type of incontinence you experience. If you truly have stress incontinence it can be repaired with a minimally invasive outpatient procedure known as the Tension Free Transvaginal Taping (TVT). The procedure is performed by placing a ribbon-like mesh under the urethra. This prevents urine leakage by helping support the urethra to it normal position. The procedure takes about 30 minutes to do and the recovery following the procedure is quick. Following the procedure, the main restrictions are no lifting greater than 8 pounds and nothing in the vagina for 6 weeks. There are three types of TVT procedures: Retropubic, Secur, and Obturator. To learn more about Urinary Incontinence and the TVT, click here> http://www.gynecare.com

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Infertility
Infertility is defined as the inability to get pregnant after one year of unprotected intercourse. Couples aged 35 and older are encouraged to seek help for infertility after 6 months of trying. Infertility occurs in about 10 percent of the population. There are many causes for infertility in women and men. Some causes include: Polycystic Ovarian Syndrome(PCOS), blocked fallopian tubes from previous surgery or infection, lack of ovulation, and low sperm count or motility. In some couples there is not cause for infertility. Your physician will do an in-depth history and physical evaluation, and discuss the diagnostic and treatment options. The following tests may need to be done: Laboratory Tests, Ultrasound Exams, Semen Analysis, Hysterosalpingogram(HSG), Injections, Intrauterine Insemination(IUI).

Intrauterine Insemination(IUI)
We offer intrauterine insemination (IUI) in our office. With this particular procedure you are on oral or injectable medications that stimulates the ovaries to produce eggs or follicles. An IUI is performed by inserting a very thin catheter through the cervix, and injecting the sperm directly into the uterus. The discomfort associated with the procedure is similar to a pap smear. The sperm sample that is used for an IUI is collected through ejaculation into a sterile collection cup. We ask that couples avoid intercourse for 72 hours before the procedure. The sample must be collected in the office, we ask that it is collected by masturbation without lubrication. If lubrication is needed we have a special sperm-safe lubrication called Pre-Seed*. Following the IUI, you are placed in a tilted position for 20 minutes and then given and injection of HCG to help release the egg or follicles.

For more information about infertility costs, click here.

Saliva Testing
Saliva testing is a convenient, inexpensive, and above all, accurate means of testing steroid hormones. Scientific studies have shown a strong correlation between steroid hormone levels in saliva and the amount of hormone in the blood that is active or "bioavailable." It is this fraction of total hormone that is free to enter the target tissues in the brain, uterus, skin, and breasts. We use *ZRT laboratory to do our saliva testing. Kit are issued to patients in the office and it is up to the patient to collect the sample and return it to the lab. Your provider will let you know what hormones should be tested and what profile should be performed by the lab.

Hormones we test in saliva include:

• Estradiol (E2)
• Estrone
• Estriol
• Progesterone (Pg)
• Testosterone (T)
• DHEA-S (Ds)
• Cortisol (C)

Profiles we offer in saliva include:

• Saliva Profile I
  (E2, Pg, T, DS, & C)
• Saliva Profile II
  (E2, Pg, T, DS, & C x 2)
• Saliva Profile III
  (E2, Pg, T, DS, & C x 4)

To learn more about *ZRT Lab, click here> http://www.salivatest.com/

In office testing:

• Lab Facility in office
• Non Stress Test
• Ultrasound
• Mammography

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