In Office Procedures
A colposcopy is done when we need to further evaluate an abnormal pap smear. Your doctor places a speculum into the vagina and uses a large cotton swab to apply vinegar to your cervix. As we look through a specially-designed microscope equipped with a green light, the vinegar will cause abnormal areas on the cervix to “light up”. We then usually take a few biopsy specimens which can feel like a menstrual cramp. A liquid iron solution is placed over the biopsy area to stop the bleeding, and it will cause a discharge that looks like coffee grounds for up to several days. You should not use tampons or have intercourse for at least one week after your procedure.
You may need a LEEP procedure if you have abnormal or precancerous cells on your cervix (dysplasia). For moderate or severe dysplasia, we will remove the cells using a thin, electric wire loop at the end of a wand. After inserting a speculum into your vagina, your doctor will clean and numb your cervix. Then, the wire loop will be inserted through your vagina to remove the area where the abnormal cells are growing. Your doctor will use a liquid iron solution to stop the bleeding, so you will have a brown discharge that looks like coffee grounds for up to two weeks. After the LEEP, you should not use tampons or have intercourse for two weeks.
An endometrial biopsy is done to obtain tissue from inside the uterus to determine the cause for irregular bleeding, which is sometimes only due to changes in hormones. It only takes a few minutes, and the procedure can also let us know if you have a polyp (extra tissue growth) or even cancer. Your doctor will glide in a speculum and may numb your uterus. A long, thin suction device will then be threaded through your cervix and into your uterus. You may experience a feeling like strong menstrual cramps, which usually resolve within a few minutes. You may resume normal activities after an endometrial biopsy.
A fibroid is an overgrowth of uterine muscle and can be found inside the uterine lining, in the muscle of the uterus or just under the surface. They can range in size from very tiny to larger than a basketball and can cause problems including heavy bleeding, pelvic pressure, constipation, bloating and pain. Most are benign, but very rarely they can be malignant. Treatments can range from pain management to surgical removal of just the fibroids or the entire uterus.
An endometrial ablation is an in-office procedure done to stop excessive uterine bleeding in women who no longer wish to become pregnant. If you still want to have children, this procedure is not for you. If you are experiencing irregular bleeding or excessive periods, the first thing your doctor will do is evaluate the cause by reviewing your medical history and conducting an endometrial biopsy. After examining the results, we may do a special ultrasound called a sonohysterogram to check for polyps of fibroids in the uterine lining. At that point, we will advise if you are a candidate for an endometrial ablation. If so, we will give you pain medication and injections to numb your uterus. Your doctor will examine your uterus with a camera inserted through your vagina and then cauterize or heat the uterine lining. This ablates, or vaporizes, the cells that make you bleed. The procedure does not affect your ovaries, so it will not put you into menopause.
A sonohysterogram is a vaginal ultrasound done while fluid is injected into the uterus. The fluid separates the walls of the uterus so your doctor can see any growths which might otherwise be hidden from view.
Femvue is performed as part of an infertility evaluation; Femvue evaluates the fallopian tubes to make sure they are open. Fluid is injected into the uterus under ultrasound guidance.