Caring for women
for over 25 years
701 University Blvd. East
Suite 502
Tuscaloosa, AL 35401
Telephone: (205) 349-4131
Fax: (205) 759-2569
Email: info@phpobgyn.com

medical terms

Abnormal pap smears http://www.acog.org/publications/patient_education/bp161.cfm

Birth control:  http://www.webmd.com/sex/birth_control/default.htm

Colposcopy http://www.acog.org/publications/patient_education/bp135.cfm

Cystocele:  Cystocele means bladder appearing like a balloon prolapsing (dropping) into and sometimes out of the vagina.  This problem can cause abdominal pain, leakage of urine or pressure sensations.  To correct this problem we can use behavioral therapy, pessary or surgery.

Dilation and Curettage (D&C):  Dilation and curettage is a surgical procedure that allows a physician to remove contents of the uterine cavity for evaluation.  It is performed through the vagina.  The cervix is dilated gently with instruments specifically made for this purpose.  Once the cervix is dilated, an instrument is passed into the uterine cavity and a sample of the tissue is removed and sent to pathology for evaluation.  Many patients with abnormal uterine bleeding or post menopausal bleeding are evaluated with this procedure.  A suction D&C is used to treat patients who have had a miscarriage.

Endometrial ablation http://www.acog.org/publications/patient_education/bp134.cfm

Endometriosis:  Endometriosis is a medical condition where tissue that normally lines the uterine cavity (endometrium) is outside of the uterus in other parts of the body.  This growth (implant) is usually in the pelvis-on the ovaries, fallopian tubes, bowel, rectum, bladder or the lining tissue of the pelvis.  Rarely the implants can occur in other parts of the body-i.e. lungs, brain, previous incisions and scars. There are several theories on the course of endometriosis but it remains unknown.

The implants respond to monthly hormonal stimulation just like the lining tissue of the uterus.  This process may lead to scarring and adhesions (internal organs sticking to surrounding organs and tissue).This can lead to pain, irregular bleeding and infertility.

Endometriosis occurs in approximately 10% of ladies.  This may be as high as 35% in infertility patients.  A family history of endometriosis in a patient's mother or sister increases her risk six times over the general population.

Symptoms include: increasing painful periods, increasing pelvic pain; especially before and with your period, pain with or after intercourse, pain with bowel movements, irregular bleeding, cyclical bleeding from a previous incisional scar or episiotomy site or no symptoms at all.  Some women with severe endometriosis can have no symptoms at all, while other ladies have severe pain and symptoms with minimal implants. A pelvic exam and ultrasound can be helpful for evaluation but a diagnostic Laparoscopy is necessary for a definitive diagnosis.

Treatments depend on the severity of symptoms, if the patient wants children and her age.

Pain medications, birth control pills, taken cyclically or continuous, or other hormonal treatments, including progesterone (pills or shots) can be used as treatment options.  Other medications include Depo-Leuprolide which prevents the ovary from releasing estrogen, creating a menopausal state.  This can be used up to 6-12 months.  Side effects can occur with all medical treatment options.  Surgery usually involves Laparoscopy (uses a scope and instruments passed through small incisions on your abdomen) or Laparotomy (operating through a single incision on your abdomen).  Some patients with severe symptoms and not desiring future pregnancies may ultimately require Hysterectomy with removal of uterus, fallopian tubes, ovaries, implants and scar tissue.

Link:  http://www.acog.org/publications/patient_education/bp013.cfm

Essure:  http://essure.com

Fibroids:  Fibroids, or leiomyomata, are tumors (growths) in the uterus.  They are non-cancerous and non-pre-cancerous.  They are the most common pelvic tumor occurring in up to 40% of all women over the age of 30.  Fibroids occur 2-3 times more frequently in African-American women.  With menopause, they usually stop growing and may regress some in size.  Their size can range from tiny seeds to filling the entire abdominal cavity, weighing several pounds.  Often patients have no symptoms at all.  Others may notice pressure or fullness, clothing fits differently, urinary frequency, increased cramps, heavier periods with clots, increased gas or constipation.

The physical exam by your doctor often reveals an enlarged or irregular shaped mass in the pelvis.  Often a pelvis or transvaginal ultrasound is done to confirm the physical exam.  Sometimes a biopsy of the endometrium (lining tissue of the uterus) is done in the office or as a Hysteroscopy-D&C in the operating room.  This procedure uses a scope and light system to look inside the uterus and a scraping biopsy instrument to biopsy.

Treatment is determined by the patient's degree of symptoms, her age, whether she is pregnant or desires future childbearing, if the fibroids are rapidly enlarging and her overall health. 

Treatments include: 

  • Following conservatively with pelvic exams and/or ultrasounds.
  • Non-steroidal anti-inflammatory drugs (NSAID's-ibuprofen or naprosyn).
  • Birth control pills, Depo-Provera shots or Mirena Intrauterine Device (IUD) may help control the heavy periods.
  • Depo-Leuprolide shots can be used short term to help shrink the fibroids and decrease the blood supply to them; but they will begin to grow after the therapy is stopped.
  • Hysteroscopy can be used to resect fibroids inside the uterine cavity.
  • Myomectomy is a procedure to surgically remove fibroids and preserve the uterus for possible future childbearing.
  • Uterine Artery Embolization places a catheter in the blood vessels supplying the fibroids and puts material in them to block blood flow to the fibroids.  This treatment is for women who are planning no future pregnancies.
  • Endometrial Ablation uses electricity or heat to destroy the endometrium (lining tissue of the uterus).  This reduces or stops menstrual bleeding.  Again, this is for women not planning on future pregnancies.
  • Hysterectomy is the removal of the uterus through an abdominal incision (Abdominal Hysterectomy), through the vagina (Vaginal Hysterectomy) or with instruments placed through several small abdominal incisions (Laparoscopic Hysterectomy).  Your doctor would determine the best route for each individual case.

Link:  http://www.acog.org/publications/patient_education/bp074.cfm

HPV http://www.acog.org/publications/patient_education/bp073.cfm

HTA http://www.bostonscientific.com/procedure/procedurelanding.bsci/,,/navRelId/1000.1002/method/procedure/id/10000871/attributetypeId/2/serve.seo

Hysteroscopy:  Hysteroscopy is a procedure performed through the vagina and cervix where the physician looks into the uterus for evaluation of the uterine cavity.  Patients who have abnormal uterine bleeding, infertility or abnormalities of the uterine cavity may benefit from this procedure.  It is performed in an outpatient basis with the patient being able to go home that same day.  This procedure may be diagnostic, where the physician simply evaluates the uterus by observation.  An operative hysteroscopy may also be performed.  This allows the physician to evaluate the uterine cavity and also to remove any abnormalities such as scar tissue, polyps or uterine fibroids.  It is common for a hysteroscopy to be performed simultaneously with a D&C (dilation and curettage) 

Implanon:  http://www.implanon-usa.com

 

Infertility:  http://www.webmd.com/infertility-and-reproduction/default.htm

                    http://www.acog.org/publications/patient_education/bp137.cfm

Laparoscopic assisted vaginal hysterectomy (LAVH):  Laparoscopic assisted vaginal hysterectomy is a common way to perform a minimally invasive hysterectomy.  Patients generally only have three very small incisions (1/2") and the remainder of the procedure is performed vaginally.  The physician visualizes the abdominal and pelvic organs through the laparoscope and is able to evaluate for pelvic pain or scar tissue.  Patients generally only stay one night in the hospital and have less pain and bleeding than a traditional hysterectomy through a large incision.  While robotic surgery is gaining popularity in gynecologic surgery, LAVH requires less operative time, fewer incisions and the same recovery time for the patient.

Laparoscopy (LSC):  Laparoscopy is a surgical technique that uses small incisions in the abdominal wall to explore the pelvis and abdomen.  The abdomen is inflated with CO2 gas and a camera and surgical instruments are passed through the small incisions.  This type of surgery is often performed as an outpatient procedure.  Patients have less pain and a faster recovery time since a large abdominal incision is not needed.  In gynecology laparoscopic surgery serves many purposes.  A diagnostic laparoscopy is often performed for evaluation of pelvic pain to look for endometriosis, scar tissue or other sources of pain.  The pelvic organ, including the uterus, fallopian tubes and ovaries, as well as abdominal organs, such as the appendix, colon, small bowel and gallbladder can be evaluated with laparoscopy.  Other procedures performed laparoscopically include tubal ligation procedures, removal of ovarian cysts or the ovaries, removal of ectopic pregnancies and laparoscopic assisted vaginal hysterectomies.

LEEP http://www.acog.org/publications/patient_education/bp110.cfm

Mirena:  http://www.mirena-us.com

Novasure http://www.novasure.com

Overactive Bladder:  Often called urge incontinence, is the urge to urinate but not being able to get to the bathroom in time.  It can be caused by bladder muscle spasms, infection or a mass of the bladder.

Paragard:  http://www.paragard.com/

Pelvic Pain:  Pelvic pain is common in many women.  It can be very debilitating and chronic.  The diagnosis is often challenging because it may involve overlapping causes, not specifically in one's specialty, including gynecologic, gastrointestinal, urologic and neuro-musculoskeletal.  It is important to have a physician who takes a careful history and listens to the patient.  Laboratories and diagnostic tests are carried out.  Diagnosis and management may require multiple disciplines and a multi-focal approach to management and treatment

Link:  http://www.acog.org/publications/patient_education/bp099.cfm

Pelvic Prolapse, Pelvic Relaxation and Vaginal Prolapse:  "40% of women over the age of 50 will experience pelvic organ prolapse."  It can occur at any age.  Many factors can lead to the weakness or defect of the fascia (connective tissue of the body) which holds organs in place.  These can be from genetic inheritance or from our own environmental factors, number 1 being pregnancy or childbirth.  Others include obesity, age, menopause, hormonal status, smoking (chronic cough), heavy lifting and "high impact activity."

Most ladies may notice a bulging or mass at the opening of the vagina, pelvic pressure or heaviness ("I feel like something is falling out.").  Many notice leakage of urine, urgency, frequency of urination, constipation or "vaginal splinting" (placing a finger in the vagina or leaning forward to help pass a bowel movement).  Some may notice trouble keeping a tampon in place.  Others have problems with discomfort with intercourse.

The most important part of the workup is the physical exam by your physician.  Often Cystometrics (bladder testing) is ordered by your physician to help further assess the problem. 

Treatments may include non-surgical options; observation, placement of pessaries (a device worn in the vagina to support the uterus, vagina, bladder or bowel in place) or pelvic floor exercises.

Surgical treatment options include: Anterior and/or Posterior repair (tacking up the bladder or rectum); Enterocele repair (tacking up small bowel pushing down the top of the vagina); Mesh sling repair (using mesh to support the urethra); Sacralcolpopexy or Sacrospinous fixation (tacking the vagina to the sacrospinous ligament).  Some procedures may now use mesh (synthetic material for added support).

Link:  http://www.acog.org/publications/patient_education/bp012.cfm

Rectocele:  Rectocele means rectum appearing like a balloon prolapsing (dropping) into and sometimes out of the vagina.  This problem may cause back pain, pressure or difficulty evacuating bowel movements from the rectum.  Symptoms may be improved by behavioral therapy, pessary or surgery.

Sling Procedure for Stress Urinary Incontinence (SUI):  Stress urinary incontinence is a very common problem for women in their reproductive years and beyond.  While correction for this problem previously required major surgery, a minor surgical procedure is now available and has great success rates.  Placement of a mesh sling can now be accomplished through a small vaginal incision.  This sling essentially acts as a hammock and supports the bladder neck during times of increased abdominal pressure such as coughing, sneezing or lifting.  Patients generally stay one night in the hospital.  Most patients see a decrease in episodes of incontinence immediately and long term data is excellent.

Sterilization:  http://www.webmd.com/sex/birth_control/birth-control-sterilization

http://www.acog.org/publications/patient_education/bp011.cfm

ThermaChoice http://www.pelvichealthsolutions.com/thermachoice

Urinary Incontinence:  Urinary incontinence is described as the leaking of urine involuntarily.  It is a very common problem especially among women and occurring in half of women.  Several different problems may cause urinary incontinence including anatomical defects, bladder muscle spasms, neurologic defects or infection. It is important to determine the type of incontinence in order to find the most appropriate treatment.

Urodynamic Study:  Urodynamic study is often used to evaluate a patient who has a problem with leaking urine or voiding urine.  It is a series of tests designed to understand every detail of your bladder problem.

Urogynecologist:  A physician who specializes in women's health specifically related to the diagnoses and management of structural and functional changes of the pelvic floor in women, including urinary incontinence and prolapse (dropping) of the pelvic organs.