Patient Care

Gynecological Care

Detecting medical problems early and receiving treatment are essential for maintaining your overall health. We encourage our patients to have yearly exams for proper screening and evaluation.

Routine Pap Smears

A Pap smear is a test performed to detect abnormal cell changes in the cervix (the lower end of your uterus). Your doctor will take samples of cells from several areas of the cervix for examination. These cells will be smeared on a slide plate and sent to a lab, where they will be studied under a microscope. Your Pap smear results indicate any changes in cell shape or color. If your Pap test results are negative, all the cells viewed in the sample were normal. A positive result means some of the cells were abnormal. An abnormal Pap result may be due to inflammation caused by an infection or a more serious condition, such as cervical cancer. Your doctor will perform additional tests in order to diagnose and treat the specific problem.

Abnormal Vaginal Bleeding

Many women may experience bleeding or spotting between periods. Vaginal bleeding is considered abnormal if it occurs when you are not expecting your menstrual period or when your menstrual flow is lighter or heavier than what is normal for you. Bleeding is also considered abnormal if it occurs at a time in your life when it is not expected, such as during pregnancy or after menopause. Abnormal vaginal bleeding can have many possible causes and does not necessarily indicate a serious condition. However, if you experience abnormal vaginal bleeding, contact your doctor immediately so he or she can perform a pelvic exam and/or other tests to determine the cause.

Pelvic Pain

Pelvic pain can be a source of frustration for many women because it is a symptom of several different conditions, which can sometimes make it difficult to determine the cause. The pain may be intermittent or recurrent, or it may be constant and severe. Some of the most common sources of pelvic pain include the following conditions:

Endometriosis

Endometriosis is a disease in which cells that look and act like the cells lining the uterus (endometrial cells) are found in other areas in your body, usually in your pelvis. These cells can attach to your ovaries, fallopian tubes, the outer surface of your uterus, your bowels or other abdominal organs. Endometriosis can cause pelvic pain, painful periods and pain during intercourse and may also affect your fertility.

Pelvic Adhesions

A pelvic adhesion is scar tissue that forms between two structures or organs not normally connected to each other. This tissue may attach to nearby surfaces because of inflammation, gynecological conditions (such as endometriosis) or previous surgeries. Adhesions can cause pain, blockage or other problems. Surgery may be needed to remove the scar tissue and to separate the structures or organs – although the adhesions may recur after surgery.

Uterine Fibroids

Uterine fibroids are non-cancerous growths that develop in the uterus. They can grow on the inside of your uterus, within the uterine muscle wall or on the outer surface of your uterus. Fibroids can alter the shape of the uterus as they grow, and the size, shape, location and symptoms of fibroids may change over time.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that form in your ovary. They are the most common ovarian growths in women of childbearing age, 20 to 35 years old. If you experience pelvic pain, see your doctor so he or she can perform a pelvic exam to help determine the cause of your pain. Your doctor may also need to order additional tests after your pelvic exam.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when one or more of the organs inside the pelvis falls from its normal position. The condition may cause a feeling of fullness or pressure in your lower abdomen, problems passing urine or having a bowel movement, urine leakage, pain or pressure in your lower back or problems having intercourse. Pelvic organ prolapse may be caused by one or more of the following factors: vaginal childbirth, hormonal changes occurring with menopause, constant coughing (due to bronchitis or smoking), heavy lifting, chronic straining (due to constipation) or being overweight. The prolapse may be mild, moderate or severe, and you may have more than one type of prolapse.

If you think you may have pelvic organ prolapse, see your doctor. He or she will review your medical history and symptoms and then perform a pelvic exam. Additional tests may also be necessary to confirm the diagnosis. The goal of treatment – whether surgical or non-surgical – is to relive your symptoms. Your doctor can help you choose the treatment that is best for you and your lifestyle.

Urinary Incontinence

Southern OB-GYN is delighted to announce the addition of its bladder health program. Our practice offers a holistic, multifaceted approach to the comprehensive management of bladder problems.

The program will focus on conservative strategies in the evaluation and management of bladder conditions such as overactive bladder and urinary leakage. As you know, the problem of urinary incontinence and overactive bladder is widespread. Critical demographic trends are changing the nature of the country. The fastest growing segment of the population is the middle-aged population, the “aging baby-boomers”. As the number of elderly people rises so will their need for services, particularly around the issues of bladder problems and pelvic floor dysfunction. The National Kidney and Urologic Diseases Advisory Board estimates that bladder problems have grown to a staggering 17 million people, most of them older women. Most researchers agree that the condition is greatly underreported due to the private nature of the condition and the unwillingness of women to broach the subject with their health care provider.

Left untreated, incontinence can lead to feelings of embarrassment and shame, depression, decreased sexual activity, and social isolation. It is a socially, emotionally and physically devastating problem. Women must be made aware that help is available. Research documents that there are non-surgical treatment approaches that can dramatically cure or decrease incontinence and overactive bladder in 85% of women treated! Research also suggests that many women are never asked about a bladder problem by their health care providers, mainly because there were no resources available for help.

Successful participation in the program will help restore dignity to and improve a woman's quality of life. Conservative approaches work best in motivated and properly screened women. Pelvic floor rehabilitation using biofeedback, use of medication (particularly when combined with behavior modification) and pelvic floor support devices (pessaries) will be the mainstay of treatment at our center. Dietary implications including avoidance of bladder irritants are discussed in depth with modifications reviewed. Vaginal estrogen status is assessed and treated as needed. Other behavior modifications are reinforced. Women will attend 4-6 sessions over a series of weeks to months.

Don't let your bladder control your life. Let us help you take back control.

Breast Health

The key to breast health is recognizing changes in the way your breasts look and feel. Performing a breast self-examination (BSE) every month will help you detect any changes, such as a lump, dimpling of the breast or nipple discharge. (If you are unsure how to perform a BSE, make sure you ask your doctor.) You should perform a BSE at the same time each month (after your period, or if menopausal, the first day of the month). Contact your doctor immediately if you notice any changes in your breasts.

Professional breast exams should be performed by your doctor at least every one to three years if you are between the ages of 20 and 40, and then annually after age 40. In addition, you should have your first screening mammogram by age 40. From age 40 to 49, you should have a mammogram every one or two years (or as directed by your doctor), and then annually after age 50. If you are over 40 or have a family history of breast cancer, you may be at a greater risk of developing the disease. Although breast cancer cannot be prevented, early detection is the best means possible of ensuring prompt, successful treatment and, in many cases, a cure. Knowing your risk factors will help you and your doctor develop a breast health program suited to your individual needs.

Osteoporosis Screening

Osteoporosis is a progressive disease that causes your bones to become thin and porous, significantly increasing your risk for fractures. The disease occurs mostly in post-menopausal women when estrogen levels decline. (Estrogen helps women maintain bone strength.) If your doctor feels you are at risk for osteoporosis, you may need a dual-energy X-ray absorptiometry (DEXA) test. The DEXA bone density test measures bone thickness and can help predict your risk of breaking a bone due to osteoporosis. The outcome of the DEXA test can help your doctor develop an osteoporosis treatment plan suited to your individual needs, based on your lifestyle and risk factors.

Menopause

Menopause is a natural stage in every woman's life when her ovaries cease functioning and her menstrual periods stop, marking the end of her childbearing years. While the average age of menopause is around 50, every woman's body has its own unique timeline. Many of the changes you experience during menopause occur because of the decrease in the production of the sex hormones estrogen and progesterone. You may experience unpleasant symptoms, including hot flashes, night sweats, vaginal dryness and sleep disturbances.

Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) is a way of replenishing some of the female hormones (estrogen and progesterone) your body no longer makes – or makes less of – during menopause. Many women decide to take HRT because it can relieve some of the uncomfortable symptoms of menopause. However, every woman's body is different, and you may not be a good candidate for HRT. Your doctor will evaluate your medical history and discuss the risks and benefits with you to determine if HRT is the right choice for you.

Surgical Therapy: Gynecological Procedures

Diagnostic Laparoscopy

A diagnostic laparoscopy is a surgical procedure in which a thin, lighted tube (called a laparoscope) is inserted through an incision in the abdominal wall to examine the pelvic organs. To diagnose certain conditions, your doctor needs to look directly into your abdomen at your reproductive organs. Diagnostic laparoscopy is often used to diagnose causes of abdominal pain, including ectopic pregnancy, endometriosis, cysts, adhesions, fibroids and infection, as well as causes of infertility.

Laser Laparoscopy

In addition to using a laparoscope to look into the abdomen to diagnose a problem (diagnostic laparoscopy), your doctor can also use the procedure for treatment. Laser laparoscopy is a common surgical procedure used to treat a variety of conditions causing pelvic pain; a medical laser is attached to the laparoscope to assist with surgical treatments.

Hysteroscopy

A hysteroscopy is a procedure that allows your physician to look inside your uterus to help diagnose or treat a uterine problem. A thin, telescope-like instrument (called a hysteroscope) is inserted into the uterus through the vagina and cervix. A hysteroscopy is usually performed just after menstruation to obtain the clearest view of the uterine cavity.

Dilation and Curettage

Dilation and curettage (D&C) is a surgical procedure used to locate and treat abnormal bleeding. A D&C is performed by passing a small instrument (called a curette) through the vagina into the uterus and scraping the lining of the uterus (endometrium).

Myomectomy

Myomectomy is the surgical removal of fibroids from the uterus. The procedure allows your uterus to be left in place, preserving your fertility.

Microwave Endometrial Ablation

Microwave endometrial ablation is a procedure developed by Microsulis – a health care company committed to the healing of acute and chronic medical conditions through the delivery of therapeutic microwave thermal energy – to alleviate the symptoms associated with excessive menstrual bleeding. During the three-and-a-half-minute, minimally invasive procedure, the lining of the endometrium is ablated (removed), leaving the uterus intact. To learn more about microwave endometrial ablation or Microsulis, click here www.microsulis.us.

Hysterectomy: Vaginal and Abdominal

A hysterectomy is the surgical removal of the uterus and is performed to treat certain gynecological conditions, including childbirth complications, cancer, fibroids, endometriosis or uterine bleeding that has not responded to other treatments. Several different hysterectomy procedures are currently in use, including removal of the uterus through an incision in the vagina (vaginal hysterectomy) or through a large incision in the lower abdomen (abdominal hysterectomy).

Tubal Ligation

A tubal ligation, or female sterilization, is a surgical procedure that involves tying, cutting or blocking the fallopian tubes so eggs cannot travel down the tubes to be fertilized or to implant in the uterus.

Surgical Therapy: Urinary Incontinence Procedures

Burch Procedure

The Burch procedure is used to treat urinary stress incontinence (the escape of small amounts of urine during activities, such as laughing, coughing or playing sports). During the Burch procedure, the lower bladder is supported by suturing the vagina to the pelvic ligaments. This corrects the weakness so the bladder does not move down and allow urine to escape.

Tension-Free Vaginal Tape Procedure

Urinary stress incontinence can cause the involuntary release of urine during activities that put pressure on your bladder, such as coughing or laughing. The tension-free vaginal tape (TVT) procedure provides support for a sagging urethra so when you cough or move vigorously, the urethra can remain closed – eliminating the accidental release of urine. During TVT surgery, a mesh-like tape is placed under your urethra to return it to its normal position. The tape is inserted through incisions in your abdomen and vaginal wall, and no sutures are required to hold the tape in place.

Surgical Therapy: Pelvic Organ Prolapse Procedures

Paravaginal Cystourethropexy

Paravaginal Cystourethropexy (PVCUP) can be used to treat a condition called a cystocele – a type of pelvic organ prolapse in which the bladder sags into the vagina – as well as urinary incontinence. This type of pelvic organ prolapse surgery can be performed through the abdomen or the vagina (or both). During the procedure, sutures are used to attach the vagina to strong tissue in the pelvis. Or, in some cases, a “sling” of tissue is wrapped under the bladder and urethra, and the ends of the “sling” are sewn to strong tissue in the abdomen.

Sacral Colpopexy

A sacral colpopexy may be used to correct vaginal vault prolapse, a type of pelvic organ prolapse that occurs when the uterus has been removed and the walls of the vagina fall in on themselves. This type of surgery can be performed through the vagina or the abdomen. During the procedure, the vagina is attached to strong tissue in the pelvis or to the sacrum (a bone at the base of the spine that forms the back of the pelvis).

Anterior Repair

An anterior repair can be used to treat a cystocele. (Please see description above under Paravaginal Cystourethropexy.) This type of surgery is performed through the vagina. During the procedure, the prolapsed bladder is moved back into its normal position. Sutures are placed in tissue between the bladder and the vagina. In some cases, another type of surgery is performed to correct weakness in the front wall of the vagina. During this procedure, the vagina is attached to strong tissue in the side wall of the pelvis.

Posterior Repair

A posterior repair can be performed to correct a rectocele, a type of pelvic organ prolapse in which the rectum bulges into the vagina. During the procedure, which is done through the vagina, the rectum is restored to its normal position. Sutures are placed between the vagina and the rectum. An enterocele, a type of pelvic organ prolapse in which the small intestine bulges into the vagina, can also be corrected during a posterior repair. During this procedure, the small intestine is moved away from the vagina. Sutures are then used to tie off the excess tissue that had bulged into the vagina.

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