We also offer complete gynecologic care for all ages. Whether your needs are for a yearly exam, hormone management, or complex surgeries for pelvic disorders we are here for you. We are trained in the latest techniques of in office procedures including endometrial ablation and tubal ligation. More complex surgeries are performed using minimally invasive techniques using the da Vinci robot to minimize your discomfort and recovery. Vaginal reconstruction and bladder suspension are performed using the latest techniques and meshes for vaginal prolapse. These techniques have greatly improved the treatment of pelvic prolapse and urinary incontinence for the long term success. Your comfort and health are our top priority, and our doctors work hard to give specialized care to each individual.
Services
General Gynecology
- Well visit
- Birth control
- Menopause and hormone dysfunction
- Bio-Identical hormones
- Hormone and saliva testing
- Sexual dysfunction
- Weight loss
- Abnormal pap smear
- Bleeding problems
- Pelvic pain
- Infertility evaluation
- Sexually transmitted disease testing
- In office ultrasound
- Osteoporosis assessment utilizing the latest DEXA equipment
In office procedures
- Endometrial ablation (to decrease bleeding)
- Tubal ligation
- Treatment of urinary incontinence
- Hysteroscopy
- Evaluation and treatment of abnormal pap smears
- Bladder testing for leaking and interstitial cystitis
Surgical Services
- Hysterectomy
- Vaginal
- Laparoscopic
- Da Vinci robot
- Abdominal
- Supracervical (preserving the cervix)
- Myomectomy (removal of fibroids using the da Vinci robot)
- Pelvic reconstruction for pelvic prolapse and urinary incontinence using the modern meshes and slings
- Advanced laparoscopy for treatment of pelvic pain, endometriosis, and removal of ovarian cysts
- Tubal ligation
- Hysteroscopy, D&C, endometrial ablation
- Surgery using the da Vinci robot
Abnormal Bleeding | Uterine Fibroids | Abnormal Pap Smears | Birth Control | Pelvic Prolapse | Urinary Incontinence | Pelvic Pain | Menopause and Hormone Problems | Surgery using the da Vinci robot
Abnormal Bleeding
A change in a women’s bleeding pattern is described as abnormal bleeding. Bleeding can become lighter, heavier, shorter, longer, absent or more frequent. Common reasons for concern include:
- Absence of cycles
- Bleeding between periods
- Bleeding after intercourse
- Spotting
- Change in your normal flow
- Bleeding after menopause
Common Causes
- Hormone problems
- Pregnancy
- Problems with birth control
- Infection of the uterus or cervix
- Problems with the cervix
- Uterine polyps or fibroids
- Problems with blood clotting
Diagnosis and Testing
- Medical history and exam
- Blood tests
- Pelvic ultrasound
- Endometrial biopsy
- Hysteroscopy
- D&C
- Laparoscopy
Treatment Options
- Hormone therapy
- Antibiotics
- In office treatments
- Surgery
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Uterine Fibroids
Uterine fibroids are mostly non cancerous growths that occur on or in the uterus. As they grow, they can cause heavy irregular bleeding, pain and infertility. Approximately 25-50% of women get fibroids as they age. Fibroids are more common in the darker races.
Common Causes
There are no known causes of uterine fibroids
Diagnosis and Testing
- Exam
- Pelvic ultrasound
- CT scan
- Blood test for anemia
- Endometrial biopsy
Treatment Options
- No treatment is acceptable if patient is not having any problems
- Birth control pills or progesterone to control bleeding
- Myomectomy is the surgical removal of the fibroids without removing the uterus.
- Depending on the size and location of the fibroids, this may be an option.
- Fibroids are removed thru an incision, laparoscopy, using the Da Vinci robot, or thru the cervix via hysteroscopy.
- Hysterectomy is the removal of the uterus and the fibroids. This can usually be done using the less invasive types of surgery.
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Abnormal Pap Smears
The purpose of having a pap smear is to find abnormalities on the cervix that may over time turn into cervical cancer. Fortunately, cervical cancer in this country is relatively uncommon. There are only about 13,000 new cases per year and most are treated successfully if detected early.
Common Causes
- Vaginal infection
- Cervicitis
- Douching
- Recent sexual activity
- Multiple partners
- HPV infection
Diagnosis and Testing
- Liquid based pap smear with HPV testing has a better rate of detection
- Repeat pap testing if indicated
- Colposcopy with possible biopsy
Treatment Options
- Cervical LEEP conization
- Surgical conization
- Cryo conization (rarely used today)
- Hysterectomy
- Close follow up
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Birth Control
Many forms of birth control are available today. To choose a method you must decide permanent or non permanent, hormone vs. no hormone, and convenience of use. Listed below are the various options available.
Non-permanent Options
Permanent Options
Additional Links
- American College of Obstetrics and Gynecology
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Pelvic Prolapse
Pelvic prolapse is the weakening or stretching of the pelvic support tissues. This causes the pelvic and internal organs to push into the vagina. This pressure can result in back pain, feeling of vaginal pressure, painful intercourse, constipation, or loss of bladder control.
Common Causes
- Pregnancy and child birth
- Heavy lifting
- Chronic coughing
- Weak tissue
- Lack of hormones
- Smoking
- Weight gain
Diagnosis and Testing
- Pelvic exam
- Pelvic ultrasound
- Urodynamics (bladder testing)
Treatment Options
- Keegle exercises to strengthen the muscles of the pelvis
- Pessary: (a plastic device placed in the vagina for support)
- Surgery: Various types of operations are done to support the vagina and and fix the prolapse. Most procedures are completed thru the vagina. With the use of modern mesh support systems the long term success is excellent with minimal recovery time. Removal of the uterus is not required.
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Urinary Incontinence
Urinary incontinence is the uncontrolled leakage of urine from the bladder. There are three types of incontinence:
- Stress incontinence is the uncontrolled leaking of urine when coughing, lifting, sneezing, or any other type of straining.
- Urge incontinence is due to a bladder that is overactive and causes frequent need to urinate and loss of urine due to a sudden urge to urinate.
- Mixed incontinence is a combination of the other two.
Common Causes
- Vaginal child birth
- Previous gynecologic surgery especially hysterectomy
- Heavy lifting or straining
- Smoking
- Obesity
- Chronic coughing
- Constipation
Diagnosis and Testing
- Examination
- Urine culture and analysis
- Voiding diary
- Urodynamics testing (bladder pressure studies)
- Pelvic ultrasound
Treatment Options
- Lifestyle changes and diet changes can help decrease number of accidents
- Keegle exercises
- Medications are used mainly for the treatment of urge incontinence
- Surgical treatments are used to correct stress incontinence
- Renessa Procedure. A new in office treatment for urinary incontinence
Our office can provide a complete evaluation of problems with incontinence and offer the full range of medical and surgical treatments. Treatments are always tailored to wishes and needs of the patient.
Additional Links
- American College of Obstetrics and Gynecology
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Pelvic Pain
Pelvic pain is a general description of discomfort in the lower abdominal and female organs. There are many possible causes of pelvic pain depending on the patient’s age, menstrual status, prior surgeries, and other underlying conditions. Different causes of pain result in different symptoms. Diagnosis can only be made by examination and testing. Our office provides the complete range of services and testing needed to evaluate and treat pelvic pain.
Common Causes
- Menstrual problems
- Pelvic infection
- Uterine fibroids
- Pelvic prolapse
- Ovarian cyst
- Endometriosis
- Interstitial cystitis
- Chronic constipation
- Dyspareunia (painful sex)
- Adenomyosis
- Scar tissue
- Vulvodynia (painful vagina)
Diagnosis and Testing
- History and exam
- Pelvic ultrasound
- Bladder testing for interstitial cystitis
Treatment Options
- Treatments can vary from simple antibiotics to complex surgical options. Our office provides the full range of treatments that may be needed.
Additional Links
- American College of Obstetrics and Gynecology
- Interstitial cystitis
- Other
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Menopause and Hormone Problems
A woman’s hormones are constantly changing. Long before she reaches menopause, she can experience hormone dysfunction causing a multitude of symptoms. Symptoms range from lack of energy, weight gain, low sex drive, and emotional problems. We offer testing and treatment as needed using saliva testing, compounded hormones and traditional hormones.
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Surgery using the da Vinci robot
One of the most innovative tools for surgery has been the development of the da Vinci robot. The use of this tool has greatly improved the surgeon’s visibility and ability to manipulate the tissue during complex operations. Operations in the past that required large incisions and long hospital and recovery times can now be done with several small incisions, minimal hospital stay and shorter recovery time with less pain. In gynecology the da Vinci robot is used for conditions requiring hysterectomy, myomectomy (removal of uterine fibroids) and pelvic prolapse. If you need surgery, I would encourage you to become educated on the benefits of robotic surgery.
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