A myomectomy is a surgical procedure to remove fibroids. Depending on the size and placement of the fibroids, the myomectomy can often be accomplished through the vagina with no incision. Minimally-invasive myomectomies can also be performed laparoscopically and robotically, which require small incisions through the abdomen. A laparotomy is a more traditional surgical procedure where an incision is made (usually a “bikini cut”) and the fibroid(s) is/are removed.
A hysterectomy is the removal of the uterus, and is recommended to treat a variety of issues including pelvic pressure, pelvic pain, severe endometriosis, uncontrollable bleeding and fibroids. There are many types of hysterectomies ranging from minimally-invasive to traditional surgical procedures, and your doctor will recommend the best procedure for your situation. A hysterectomy is the removal of the uterus only, although sometimes it is necessary to also remove the ovaries. If you are not in menopause at the time of your hysterectomy, and keep your ovaries which control your hormones, you will not be in menopause after the procedure. You should talk with your doctor about whether or not to have your cervix removed along with the uterus.
Many women suffer from endometriosis, a condition of pelvic pain, often worse during your period. Sometimes medications provide sufficient relief, but laparoscopic surgery remains the best way to diagnose and treat the condition.
An endometrial ablation is 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.
Pelvic Pain Surgery
Pelvic pain can be caused by many conditions. The initial evaluation of the pain often includes an ultrasound, so let us know when you schedule your appointment if you are experiencing pelvic pain so we can plan to do an ultrasound during your visit. Sometimes ovaries have cysts or other growths that can cause pain, and may resolve over time or with birth control pills. When the growths require surgery, we may be able to remove them laparoscopicly or robotically. With either of these minimally-invasive methods, you may be able to return to work as quickly as within a week or two.
If you are having problems with urinary leakage when you cough or sneeze, your bladder might have “fallen”. This commonly happens to women who have had vaginal deliveries, but also can happen to women who have never been pregnant. Your doctor will talk with you about diet and special exercises called Kagels to strengthen the muscles of your pelvic floor. If you need surgery to alleviate the problem, we will advise you on the best “bladder tack” for you.
“Hyster” is from the Greek word for “uterus” and “scope” is from the Greek word “to see”. During this minimally-invasive procedure, your doctor will thread a camera on a long, thin tube through your cervix and into your uterus to determine if there are any growths inside the uterine lining and, if so, to possibly remove them during the hysteroscopy. Afterwards, it is common to have some cramping and possibly some nausea from the anesthesia. You will be given medications and be able to go home later that day.
Laparoscopic surgery is a minimally invasive surgical technique that allows your doctor to see into your pelvis using a thin, lighted tube threaded through a small incision in your abdomen. We use it to find problems such as ovarian cysts, uterine fibroids and other growths. We can also take tissue samples for biopsy using the same tube, or laparoscope. Usually, laparoscopic surgery does not require an overnight stay in the hospital.
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