Excessive Menstrual Bleeding
Women who experience excessive menstrual bleeding may have tried a variety of treatments without success. They may not be appropriate candidates for hysterectomy or may not wish to undergo that procedure. These patients may consider Endometrial Ablation, an outpatient procedure in which the uterine lining is removed using freezing, electricity, microwave, or heat ablation techniques. The endometrium is removed, leaving the ovaries intact. As the endometrium heals, scar tissue forms and prevents future bleeding. Recovery time is a few days to a few weeks. This procedure is not for women who wish to become pregnant or have a history of cancer or pre-cancer of the uterus.
Patients with Fibroid Tumors, Endometriosis Genital Prolapse or excessive bleeding may need to have a Hysterectomy, which involves removal of the uterus and sometimes the ovaries and fallopian tubes. A less-extreme procedure called Laparoscopic Supracervical Hysterectomy (LSH) involves removal of the uterus through a small abdominal incision using a laparoscope to allow the surgeon to view the internal area. Traditional abdominal surgery may be avoided altogether with a Laparoscopic-Assisted Vaginal Hysterectomy (LAVH). In this procedure, a small incision in the navel allows the insertion of a laparoscopic device to enable the surgeon to view the internal organs. Surgical access through the vagina allows the surgeon to make the incision needed to remove the uterus. Post-operative recovery is much shorter than that required by traditional abdominal surgery.
If during a routine gynecological exam abnormal cells are found on the surface of the cervix, the doctor will perform a Colposcopy and if the report confirms an abnormality shemay recommend a Loop Electrosurgical Excision Procedure (LEEP). This outpatient procedure may be performed in the doctor's office with local anesthetic in approximately half an hour. Abnormal tissue is excised to prevent the development of cancer of the cervix. Samples are tested to determine possible causes of abnormality. The patient may experience mild discomfort but same-day recovery is typical, and side effects are rare.
If the patient is found to have non-cancerous tumors of the uterus, she may choose to have a hysterectomy if she no longer has a desire to bear children. For women who plan to have children or who wish to keep their uterus, the physician may recommend a Myomectomy to surgically remove fibroid tumors and repair the uterus. Depending on the type and size of the fibroids, the physician may recommend one of the following procedures.
- Abdominal myomectomy, involving an incision to remove the problem tissue, brief hospitalization, and recovery in 4 to 6 weeks.
- Hysteroscopic myomectomy, in which a small device called a resectoscope enters through the vagina to remove the fibroid tissue.
- Laparoscopic myomectomy, where a small incision allows the surgeon to view the pelvic region with tiny camera and excise the fibroid tissue. Following this hospital procedure, the patient is usually released the same day, and there is a brief recovery period of a few days.
Pelvic Organ Prolapse
When abdominal muscles are weakened after childbirth or surgery, an organ may drop from its normal location. The patient feels pressure in the area of the vagina and may experience incontinence. The condition is often painful, but is not considered a serious health problem and may correct itself over time. If symptoms do not go away, the physician may recommend a Pelvic Prolapse Repair Surgery on the affected organs. Proper treatment can prevent future recurrence.
Women who wish to end the possibility of pregnancy may choose to become sterilized using an Essure Tubal Ligation. This procedure may be performed in the doctor's office and involves inserting small flexible micro-inserts™ into the fallopian tubes, reached through the vagina, cervix, and uterus. Most patients can return to work and normal activities the same day or following day. Birth control methods must continue and may be stopped following an examination and verification test three months after the procedure is performed. Women still have the option of having a more invasive laparoscopic procedure to perform a tubal sterilization but they need to be informed of a less invasive procedure that does not rquire incisions or general anesthesia.