An annual visit with an OB/GYN builds a foundation of health and wellness for women and helps battle a wide range of health concerns. These concerns affect all women, so it is important to make regular visits to the gynecologist no matter what your age. Furthermore, issues such as:
- Vaginal irritation
- Any type of pelvic pain
- Abnormal bleeding
should be treated as they occur. Our all-female gynecologists are highly skilled in treating any and all OB/GYN concerns.
WHAT IS A WELL WOMAN EXAM?
A well women exam is a preventive annual gynecological and breast exam. Well women exams are extremely important in preventive care and early detection of diseases.
A well woman exam includes:
- Physical Pelvic Exam
During a pelvic exam the vagina and labia are inspected for lesions and discharges. A speculum is placed in the vagina to evaluate the upper vagina and to perform the HPV test and the PAP smear. Cultures may also be obtained to screen for sexually transmitted diseases depending on age and other circumstances. The uterus and ovaries are also examined.
- Physical Breast Exam
During the Breast Exam, the breasts are inspected for changes in shape, skin texture, nipple discharge, and lumps. Depending upon age, a mammogram and a bone density test may also be ordered.
Our doctors are all-female OB/GYN experts highly skilled in diagnosing and treating any and all OB/GYN conditions.
Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound exams do not use ionizing radiation (as used in x-rays). Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. A pelvic ultrasound provides pictures of the structures and organs in the lower abdomen or pelvis. It can be done from the abdomen (transabdominal) or through the vagina (transvaginal).
Pelvic ultrasounds are most often performed to evaluate the following:
- Fallopian tubes
Pelvic ultrasound exams are also used to locate early pregnancies, diagnose ectopic pregnancies, and monitor the health and development of an embryo or fetus during pregnancy.
Ultrasound examinations can help diagnose symptoms experienced by women such as:
- Pelvic pain
- Abnormal bleeding or other menstrual problems
- Palpable masses such as ovarian cysts and uterine fibroids
- Ovarian or uterine cancers
A transvaginal ultrasound is usually performed to view the endometrium, or the lining of the uterus, its thickness, and the ovaries. Transvaginal ultrasound also affords a good way to evaluate the muscular walls of the uterus, called the myometrium. Sonohysterography allows for a more in-depth investigation of the uterine cavity.
These exams are typically performed to detect:
- Uterine anomalie
- Uterine scar
- Endometrial polyps
- Cancer (especially in patients with abnormal uterine bleeding)
WHAT IS A COLPOSCOPY?
A colposcopy is a procedure that allows a physician to examine a woman’s cervix and vagina using a special microscope called a colposcope. A colposcopy is usually done when a Pap smear result shows abnormal changes in the cells of the cervix. Colposcopy provides more information about the abnormal cells and tissue.
A colposcopy also may be used to further assess other problems, such as:
- Genital warts on the cervix
- Cervicitis (an inflamed cervix)
- Benign (non-cancerous) growths, such as polyps
A colposcopy is a quick procedure and is best done when a woman is not having her menstrual period, giving the health care provider a better view of the cervix. A speculum is used to hold apart the vaginal walls so that the inside of the vagina and the cervix can be seen. The colposcope is placed just outside the opening of the vagina. A mild solution is applied to the cervix and vagina with a cotton swab or cotton ball. This liquid makes abnormal areas on the cervix easier to see. During colposcopy, the health care provider may see abnormal areas. A biopsy of these areas may be done. During a biopsy, a small piece of abnormal tissue is removed from the cervix. Cells also may be taken from the canal of the cervix. This is called endocervical curettage (ECC).
After a colposcopy, the vagina may feel sore for 1 – 2 days. Vaginal bleeding and/or dark discharge may occur. A sanitary pad can be worn to mitigate the flow of discharge.
Activity should be limited at this time. While the cervix heals, nothing should enter the vagina for typically 1 to 2 weeks. Sex, tampons, and douching should be avoided.
Dysplasia or cervical intraepithelial neoplasia (CIN) are terms that describe the actual precancerous changes that occur in the cervix. These changes are due to Human Papillomavirus (HPV) infections. Dysplasia and CIN are graded as mild, moderate, or severe. Mild dysplasia (CIN 1) usually goes away on its own. Moderate (CIN 2) and severe (CIN 3) dysplasia indicate more serious changes.
WHAT IS A CRYOTHERAPY?
Cryotherapy is a technique that freezes and sheds abnormal tissue. It can be used to treat mild to moderate dysplasia. Cryotherapy is an effective method for destroying abnormal cervical tissue; studies show that it can destroy all of the abnormal tissue in 77% to 96% of cases.
During cryotherapy, liquid carbon dioxide (CO2), which is very cold, circulates through a probe placed next to the abnormal tissue. This freezes the tissue for 2 to 3 minutes. It may be allowed to thaw and then be refrozen for another 2 to 3 minutes. Cryotherapy is usually done at the doctor’s office and may cause some discomfort. Most women feel a sensation of cold and a little cramping, and sometimes a sense of warmth spreads to the upper body and face.
After Cryotherapy, a watery vaginal discharge will occur for about 2 to 3 weeks; during this time, tampons, douching, and sexual intercourse should be avoided.
Most women are able to return to their normal activity level the day after the cryotherapy procedure.
WHAT IS A CONE BIOPSY?
A cone biopsy removes a cone-shaped wedge of abnormal tissue that is high in the cervical canal to be examined under a microscope. If the dysplasia is more severe and deeper in the cervical canal, a cone biopsy is recommended. A small amount of normal tissue around the perimeter of the site is also removed so that a margin free of abnormal cells is left in the cervix.
The cone biopsy may remove all of the abnormal tissue. This would mean that no further treatment is needed other than follow-up Pap smears.
The perimeter of the cervical tissue may contain abnormal cells, meaning that abnormal tissue may be left in the cervix. The cone biopsy may be repeated to remove the remaining abnormal cells. If follow-up tests show normal cells, then no further treatment may be needed. If abnormal cells remain, other treatments may be required.
The cone biopsy may show cancer that has grown deep into the cervical tissue (cervical cancer). Further treatment, such as surgery, radiation, or chemotherapy, will be recommended.
A sample of tissue can be removed for a cone biopsy using:
- A surgical knife (scalpel)
- Loop electrosurgical excision procedure (LEEP)
A cone biopsy using LEEP may be done in a doctor’s office with an injected medicine that numbs the cervix (cervical block). Oral pain medicine or pain medicine injected into the muscle (intramuscular, or IM) may be used in addition to the local anesthetic.
After a cone biopsy:
- Some vaginal bleeding is normal for up to 1 week
- Some vaginal spotting or discharge (bloody or dark brown) may occur for about 3 weeks
- Sexual intercourse, tampons, and douching should be avoided for about 3 weeks
- A few women may have serious bleeding that requires further treatment
- Narrowing of the cervix (cervical stenosis) that causes infertility may occur (but is rare)
- Inability of the cervix to remain closed during pregnancy (incompetent cervix) may occur
Women who have had a cone biopsy may have an increased risk of miscarriage or preterm delivery.
After cryotherapy or cone biopsy, it’s very important to have regular follow-up Pap smear. A Pap smear should be repeated every 4 to 6 months or as recommended by a doctor. After several Pap smear results are normal, it will be determined how often future Pap smears should occur.