Gynecology ♦ Obstetrics ♦ Gynecological Surgery ♦ Center for Pelvic Medicine
At Women’s Health we offer minimally invasive in-office procedures. To learn more about each of these, simply click on the name.
Endometrial Biopsy
An endometrial biopsy is a procedure used to evaluate the lining of the uterus. During the biopsy small tissue samples are taken from the uterine lining. The tissue samples are used to evaluate certain medical problems such as heavy or irregular periods or bleeding after menopause. The procedure takes only a few minutes to perform.
Preparing for the procedure- For 24 hours prior to your procedure avoid using vaginal medications and douching. You may wish to take Ibuprofen 600mg 30-45 minutes prior to your appointment to help minimize discomfort during your procedure.
After the procedure- You may experience mild cramping and light bleeding or spotting. Call the office if you have a fever >101° F, foul smelling or unusual discharge, severe abdominal pain, heavy vaginal bleeding (more than one pad per hour for 2 hours), or any other questions or concerns.
Colposcopy
A colposcopy is a procedure done to evaluate the cervix after an abnormal pap smear. During the procedure, a speculum is inserted into the vagina and a vinegar solution will be applied to your cervix so the abnormal cells can be seen by your doctor. If abnormal cells are seen, a biopsy (tissue sample) may be taken so the cells can be further examined under the microscope to see if further treatment is needed.
Preparing for the procedure- The procedure is best performed when you are not having your period. For 24 hours prior to the test it is best to avoid sex, douching, using tampons, and using vaginal medications.
After the procedure- You may have some mild spotting for several days. If you have a biopsy, you may have a dark discharge for several days and mild cramping. For the week following your biopsy, do not put anything in the vagina (for example: tampons, intercourse). Call the office if you have a fever >101° F, foul smelling or unusual discharge, severe abdominal pain, heavy vaginal bleeding (more than one pad per hour for 2 hours), or any other questions.
LEEP (Loop Electrocautery Excisional Procedure)
A LEEP is a procedure used to treat abnormal cells that if left untreated may progress to cervical cancer. A thin wire loop is used to remove the surface cells of the cervix. During the procedure a speculum will be placed and your cervix will be numbed with local anesthetic. You may experience a dull ache or cramping during the process. The entire procedure usually takes less than 10 minutes.
Preparing for the procedure- The procedure is best performed when you are not having your period. For 24 hours prior to the test it is best to avoid intercourse, douching, using tampons, and using vaginal medications.
What to expect after the procedure- Make sure to rest the day of your LEEP. You may return to work or school the day after the procedure. You may have a watery, clear, brown, or bloody discharge. It may have a mild odor. This is normal. Bleeding or spotting 7-10 days after the LEEP can occur and it may be similar to a menstrual period. This is normal.
- Do not put anything in your vagina or rectum (for example: tampons, douching or intercourse) for 4 weeks after treatment
- Avoid swimming or heavy exercise for 2 weeks after your LEEP
You may experience some lower abdominal discomfort or cramps for 1-2 days after the procedure. You may take Tylenol or Ibuprofen (as long as you have not been advised to avoid either) if needed. You may find a heating pad helpful. Call the office if you have a fever >101° F, foul smelling or unusual discharge, severe abdominal pain, heavy vaginal bleeding (more than one pad per hour for 2 hours), or any other questions or concerns.
Click here for ACOG LEEP FAQs.
Hysterosalpingogram (HSG)
A HSG is a procedure used to evaluate for blockages in the tubes or to detect abnormalities in the uterine cavity. It is a test routinely used during the evaluation of infertility or recurrent miscarriages. It is performed in the radiology department and takes less than 10 minutes. A speculum will be placed and a catheter will be inserted inside the uterus. Dye will be slowly injected while the radiologist takes films. You may feel some cramping and or pressure during the procedure. You will receive preliminary results at the time of your procedure.
To schedule your HSG please the office at 508-755-4861 on the first day of your menstrual cycle. We will then schedule the procedure between cycle days 7-12. Forty-five minutes prior to your appointment, we advise you take 600mg of Ibuprofen (unless you have been advised against taking NSAID’s such as Motrin – in which case you make take the recommended dosage of Extra Strength Tylenol).
After the procedure, you may experience cramping, mild nausea, and slight vaginal bleeding. Call the office if you have a fever >101° F, foul smelling or unusual discharge, severe abdominal pain, heavy vaginal bleeding (more than one pad per hour for 2 hours), or any other questions or concerns.
Click here for ACOG hysterosalpingogram FAQs.
Sonohysterogram
A sonohysterogram is a specialized ultrasound performed in the office to examine the inside of the uterine cavity. It is used to evaluate abnormal bleeding, infertility, and recurrent miscarriages. When you come to your appointment a standard vaginal ultrasound will be performed first. Then your doctor will come into the ultrasound suite to complete the exam. A speculum will be placed and a small catheter inserted into the uterus. A saline solution will then be injected into the uterus allowing your doctor to assess the inner lining of your uterus. The whole procedure takes less than 10 minutes. You may experience some cramping during the procedure. To help minimize discomfort during the exam, you may take 600mg of Ibuprofen 45 minutes prior to your appointment time.
After the procedure, you may have some mild cramping. Call the office if you have a fever >101° F, foul smelling or unusual discharge, severe abdominal pain, heavy vaginal bleeding (more than one pad per hour for 2 hours), or any other questions or concerns.
Click here to access ACOG Sonohysterogram FAQs.
Intrauterine Device (IUD) insertion
WHCMA offers two types of IUDs, Paraguard: a copper IUD which is effective forup to ten (10) years and the Mirena which contains hormones and is effective for five (5) years.
Click here for ACOG’s IUD FAQs.
An IUD is an intrauterine device used most commonly for contraception, but it may also be used in patients to control abnormal, heavy vaginal bleeding. It is placed in the office and takes only a few minutes to insert. Sometimes it is placed using ultrasound guidance, this decision will be made by your doctor at the time of insertion. During the procedure, you may experience some menstrual type cramping. In order to decrease your discomfort, forty-five minutes prior to your appointment, we advise you to take 600mg of Ibuprofen (If allergic to NSAID’s such as Motrin, you make take the recommended dosage of Extra Strength Tylenol).
After the procedure, you may have some mild to moderate cramping for 1-2 days after the procedure. Use Ibuprofen as needed. You may also experience irregular vaginal bleeding, this is normal. Call the office if you have a fever >101° F, foul smelling or unusual discharge, severe abdominal pain, heavy vaginal bleeding (more than one pad per hour for 2 hours), or any other questions or concerns.
Endometrial Ablation
Women’s Health offers two types of ablations, Novasure and ThermaChoice balloon ablation, both of which can be performed in the office for women suffering from excessive menstrual bleeding. This procedure is only recommended for women who have completed childbearing. Discuss your options with your health care provider.
Click here for ACOG’s endometrial ablation FAQs.
An endometrial ablation is used to treat heavy vaginal bleeding with no underlying cause. It is a short procedure that destroys the inner lining of the uterus. There are now two types of ablative procedures that can be performed in the office. We currently offer Novasure Ablation and Thermachoice III.
Ablations are minimally invasive, require no incisions, and can be done in the office under local anesthesia. 90 percent of patients are satisfied with their bleeding after the procedure. After the procedure, it is normal to experience menstrual like cramping and watery discharge which can last from 24 hours up to two weeks. You should be able to return to work within 24-48 hours after the procedure.
Permanent Contraception
Using the Essure coil system, it is now possible to undergo a permanent contraception in the office and avoid the operating room and general anesthesia. Essure uses flexible coil inserts to block the fallopian tubes. The coils are placed under direct visualization using a device called a hysteroscope (a small camera to look inside of the uterus). Once the coils are placed, the tubes adhere to the coils creating a barrier to prevent pregnancy. After approximately 3 months, a special x-ray test (HSG) is used to ensure blockage of the fallopian tubes.
Women’s Health offers two types of permanent contraception performed in-office: Adiana and Essure. These procedures require no incisions, no general anesthesia and no hormones. They are permanent methods of birth control and only recommended for women who have completed childbearing. Most patients report minimal discomfort and are usually able to return to normal activities within 24 hours.
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