OBGYN Office Procedures

Bone Mineral Density (BMD) Test

The bone mineral densitometry screening test is a painless, non-invasive way to measure your bone density and screen for osteopenia and osteoporosis. Osteoporosis is a loss of bone mass that causes bones to become weak and brittle and puts you at increased risk for fractures. Osteopenia is a reduction in bone mass that is less severe than osteoporosis.

Colposcopy

Your physician may perform a colposcopy if your Pap test results show abnormalities that may lead to a more serious condition. A colposcopy provides additional information about abnormal changes in the cervix, and can be used to assess problems such as abnormal bleeding, cervical polyps, or cervicitis.

Your physician will apply a mild solution to your cervix that allows easier visualization of the abnormal area(s). Then, she will use a magnifying device called a colposcope to look at your cervix more closely. A biopsy of any abnormal area(s) found on the cervix may be taken during the exam. This involves taking a small tissue sample and sending it to the lab for analysis. Your physician may also take a sample of the cells from the canal of the cervix. This is called an ECC (endocervical curettage). We will develop your plan of care once we receive your lab results.

During the exam, you will lie on your back on a table while a moveable x-ray arm passes over your hip and spine. You will not feel any discomfort during the procedure and it will

take about 30 minutes to complete. A computer will compare your results to others whose age, sex, and racial background are similar to yours. Your doctor will interpret the results and make the appropriate recommendation.

Cryotherapy

Your physician may perform an office procedure called cryotherapy if your pap or colposcopy results show abnormal cells. During cryotherapy, the abnormal tissue is frozen. You will experience vaginal discharge as your body heals in the weeks following your procedure. The tissue that grows back is most often normal. We will see you back in the office for a follow-up visit to make sure your cervix is healing well.

Endometrial Ablation

Some women experience unusually heavy or long-lasting menstrual periods, also referred to as menorrhagia. A heavy period may be caused by conditions such as fibroids, polyps, or hormonal changes. Endometrial ablation is a minimally-invasive procedure for pre-menopausal or peri-menopausal women who are done with childbearing. This procedure can be an alternative to a hysterectomy for the management of menorrhagia. Our office performs endometrial ablations with the NovaSure® ablation system one to two days per month for patients who are candidates.

A slender wand is inserted into the uterus, and a mesh device expands to fit the uterine cavity. Electrical energy is used to remove the endometrial lining. Most women experience little or no pain after the procedure, and can return to work and regular activities in one to two days.

Endometrial Biopsy

An endometrial biopsy is a diagnostic procedure that involves the removal of a small amount of tissue from the endometrium (inner lining of the uterus). This test may be used to rule out endometrial cancer or hyperplasia in a woman who has abnormal bleeding. This test may also be used as part of an infertility exam to rule out problems with the development of the endometrium.

To obtain the sample, an instrument is inserted through the cervix into the uterus and a small amount of tissue is removed and sent to the laboratory for analysis. There is some mild cramping or discomfort with the procedure but recovery time is minimal.

LEEP

Loop Electrosurgical Excision Procedure (LEEP) is a safe method to remove abnormal tissue from the cervix called dysplasia, which might otherwise progress to cancer.

A colposcope allows the physician to see a magnified view of the dysplasia on the cervix. A local anesthetic is used to numb the cervix and the abnormal portion of the cervix is removed with a thin wire loop carrying a small electrical current. The tissue that is removed is sent to the lab for analysis. You may feel some cramping during the procedure, but the procedure takes only a few minutes. You will have some vaginal discharge and light bleeding after the procedure. This is normal. Usually, the cervix will heal completely in about one month.

Mammography

Mammography is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast and is used as a diagnostic and screening tool. The goal of mammography is the early detection of breast cancer typically through detection of characteristic masses and/or microcalcifications. We now offer screening mammograms, recommendations by the FDA are that all women age 40 and older should have a screening mammogram every 1-2 years. Diagnostic mammograms will be performed at our Central Texas Women’s Imaging Center.

Our mammography unit is a Full Field Digital Hologic Selenia, which is specifically designed to give the best picture with the lowest possible dose of radiation and least discomfort to the patient. This state-of-the-art imaging machine along with CAD (Computer Aided Diagnosis) is the most powerful tool in the detection of breast cancer. It allows for better visibility of the breast especially near the skin line, the chest wall and in women with varying density of breast tissue. We are accredited by the American College of Radiology (ACR); the Federal Drug Administration’s Mammography Quality Standards Act for Mammography Services (MQSA); and the Texas Department of State Health Services.

Pelvic Floor Physical Therapy

Pelvic floor therapy is focused on the evaluation and rehabilitation of the muscles of the pelvic floor as indicated. This type of therapy treats conditions such as stress uterine incontinence, urge incontinence, generalized pelvic floor laxity, and pelvic floor weakness. In addition, conditions such as pelvic pain, pain with intercourse, and post-partum recovery benefit from pelvic floor therapy. Neuromuscular stimulation is used during this process to help identify, strengthen, and normalize pelvic tone. A regimen of pelvic floor rehabilitation has been proven effective in decreasing symptoms without invasive measures. Over a number of weeks, an exercise regimen is personalized to the patients’ individual needs.

Potassium Sensitivity Test

A Potassium Sensitivity Test, or PST, can be a useful tool in diagnosing Painful Bladder Syndrome or Interstitial Cystitis. Your physician may recommend this procedure if you have experienced chronic pelvic pain or persistent, painful urinary symptoms.

During this procedure, a small catheter is inserted into the bladder. Distilled water is pushed through the catheter into the bladder and your level of discomfort is recorded. The bladder is drained and then filled with a potassium solution. If you experience a difference in sensation, you may require additional testing. You will have a follow-up appointment with your physician to discuss further treatment options.

Sonohysterograms

A sonohysterogram is a transvaginal ultrasound that is performed to diagnose possible causes for abnormal bleeding, infertility, or other conditions. This exam is usually performed at a specific point in a woman’s cycle. You will receive specific information and instructions prior to your scheduled appointment.

Using a speculum, a thin, flexible plastic catheter will be inserted through the vagina and cervix into the lower part of the uterine cavity. The speculum is then carefully removed, and a vaginal ultrasound probe is placed into the vagina. Through the catheter, a small amount of saline (sterile salt water) is injected into the uterine cavity to separate the walls. The saline solution allows better visualization of the uterine walls and possible irregularities such as polyps or fibroids. Your physician will discuss any abnormal findings with you, and develop an appropriate plan of care.

Ultrasounds

Ultrasounds, also called sonograms, are exams that use sound waves to create images of internal organs. Ultrasounds are done to assess possible gynecological medical conditions, such as pelvic/abdominal masses, fibroids, and to determine possible causes for pelvic pain and/or abnormal bleeding. During pregnancy, ultrasounds are used to assess the well-being of the fetus. Typical obstetric ultrasounds can show the placement of the fetus and the placenta, the number of fetuses, the heart rate, growth, breathing, and movement of the fetus, and the estimated gestational age of the fetus.

At Women Partners In Health, we perform both transabdominal and transvaginal ultrasounds. A transabdominal ultrasound is performed by rolling a device called a transducer back and forth across the abdomen. A transvaginal ultrasound is performed by inserting a wand-shaped transducer into the vagina. We have two (2) ultrasound technicians in our office for your convenience. If your physician recommends an ultrasound, we will give you specific information and instructions prior to your appointment.

Urodynamics

Urodynamic testing is used to diagnose different types of urinary incontinence. The test is designed to assess the overall function and health of the bladder. The process of urination begins as the bladder pushes the urine out and down a tube called the urethra. The urethra opens to the outside of the body. Urination takes place only when the muscles and the nerves are working correctly. Nerves carry messages from the brain to the bladder and sphincter muscles. The urodynamics test helps to determine how well these nerves and muscles are working together, and can help determine which type of treatment is best for you.

You are asked to arrive at our office with a full bladder. The urodynamics test will take about one hour. This time is spent asking questions that you may have and setting up the procedure. Small catheters are inserted into your bladder to measure the amount of urine and the flow rate (how fast the urine comes out). Every effort will be made to make you as comfortable as possible during the procedure. You may have mild discomfort for a few hours after these tests. A warm tub bath will help to ease discomfort. Drink about 8 to 10 glasses of water a day. You will schedule a follow-up appointment to discuss the results of the test with your doctor.


Is My ObGyn Surgeon a Robot?

Some of the most leading edge surgical techniques, such as the da Vinci Surgical Method, utilize robotic wristed instruments to perform precise, highly technical procedures through very small incisions. We can assure you that your ObGyn surgeon controls every move, and has greatly enhanced visualization and dexterity through the entire procedure while in the room with you.

Surgery at WPIH


In Office Procedures

  • Diagnostic hysteroscopy
  • Permanent birth control
  • Endometrial ablation
  • Novasure

Minimally Invasive & Robotic Surgery

  • Myomectomy for fibroids
  • Treatment for endometriosis
  • Treatment for pelvic pain
  • Uterine polyps
  • Ovarian cysts
  • Heavy or abnormal menstrual bleeding
  • da Vinci Hysterectomy
  • Vaginal Hysterectomy