Why Choose the GYN Surgical Institute for your Uterine Procedures?
We dedicate an entire team to assist you throughout the process of your uterine procedure. Women who are suffering from painful fibroids or polyps can find relief of their symptoms at the GYN Surgical Institute that offers multiple procedures for treatment, including hysteroscopies and myomectomies.
REMOVING FIBROIDS WHILE PRESERVING THE UTERUS
A myomectomy is an operation to remove fibroids while preserving the uterus. These common noncancerous growths appear in the uterus, usually during childbearing years, but they can occur at any age. For women who have fibroid symptoms and want to have children in the future, myomectomy is the best treatment option. A myomectomy can be performed several different ways. Depending on the size, number and location of your fibroids, you may be eligible for an abdominal myomectomy, a laparoscopic myomectomy, or a hysteroscopic myomectomy. The surgeon’s goal during myomectomy is to take out symptom-causing fibroids and reconstruct the uterus.
During this operation, an incision is made on the lower abdomen (a “bikini cut”). The fibroids are removed from the wall of the uterus, and the uterine muscle is sewn back together using several layers of stitches
In a laparoscopic myomectomy, four one-centimeter incisions are made in the lower abdomen: one at the belly button, one below the bikini line near the pubic hair, and one near each hip. The abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the doctors can see the ovaries, fallopian tubes and uterus. Long instruments, inserted through the other incisions, are used to remove the fibroids. The uterine muscle is then sewn back together, the gas is released and the skin incisions are closed. Athe GYN Surgical Institute we offer the 3D laparoscopic technology which allows us to perform the procedure with one incision in the belly button.
Only women with submucosal fibroids — fibroids that expand from the uterine wall into the uterine cavity — are eligible for this type of myomectomy. During the procedure, the woman, most likely under anesthesia, is on her back with feet in gynecology stirrups. A speculum is placed in the vagina and a long, slender telescope is placed through the cervix into the uterine cavity. The uterine cavity is filled with fluid to lift apart the walls of the uterus. Instruments passed through the hysteroscope are used to shave off the submucosal fibroids.
Removal of Uterine / Endometrial Polyps
REMOVAL OF POLYP WITHOUT DISTURBING THE REST OF THE ENDOMETRIUM
The best way to remove endometrial polyps is to to perform a hysteroscopy. An anesthetic is used to eliminate discomfort. During the procedure a small scope is inserted into the intrauterine cavity which allows the doctor to see the inside of the uterus. With direct visualization, the polyp can be removed without damaging the rest of the endometrium.
WHAT ARE UTERINE POLYPS?
Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign).
SYMPTOMS OF UTERINE POLYPS
Polyps often have no symptoms. When symptoms do occur, they include irregular or excessive menstrual bleeding, bleeding between menstrual periods, or bleeding after menopause.
DIAGNOSIS OF UTERINE POLYPS
Uterine polyps can be diagnosed with the help of:
- Transvaginal Ultrasound – A slender, wand-like device placed in your vagina emits sound waves and creates an image of your uterus, including its interior. Your doctor may see a polyp that’s clearly present or may identify a uterine polyp as an area of thickened endometrial tissue.
- Hysterosonography – Involves having salt water (saline) injected into your uterus through a small tube threaded through your vagina and cervix. The saline expands your uterine cavity, which gives the doctor a clearer view of the inside of your uterus during the ultrasound.
- Hysteroscopy – The doctor inserts a thin, flexible, lighted telescope (hysteroscope) through your vagina and cervix into your uterus. A hysteroscopy allows the doctor to examine the inside of your uterus.
- Endometrial biopsy – The doctor might use a suction catheter inside the uterus to collect a specimen for lab testing. Uterine polyps may be confirmed by an endometrial biopsy, but the biopsy could also miss the polyp.
LAPAROSCOPIC UTERINE NERVE ABLATION
Laparoscopic Uterine Nerve Ablation, or LUNA, involves the destruction of the uterine nerve fibers that exit the uterus through the uterosacral ligament (this ligament connects the uterus to the large bone at the base of the spine). During this procedure, the abdomen cavity is inflated with carbon dioxide gas and small incisions are made in the abdomen to provide access for the laparoscope and surgical instruments. The uterus is anteverted (inclined forward toward the front of the abdomen) with a uterine manipulator and the uterosacral ligaments are identified and transected close to their attachment to the cervix. One or both of the ligaments may be transected. LUNA is often carried out during the course of other surgical treatment for endometriosis and to treat chronic pelvic pain.
REMOVAL OF THE UTERUS
Hysterectomy is a major surgical procedure in which the uterus is removed. Many women choose hysterectomy to definitively resolve their fibroid symptoms. After hysterectomy, menstrual bleeding stops, pelvic pressure is relieved, frequent urination improves and new fibroids cannot grow. Hysterectomies at the GYN Surgical Institute are performed laparoscopically either by using the common laparoscopic approach with 4 incisions or by using our one incision 3D technology. During the procedure the abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the surgeon can see the ovaries, fallopian tubes and uterus. Long instruments, inserted through the incision/incisions are used to remove the uterus. A special instrument is used to cut the uterus into smaller segments for removal through the small incisions. At the end of the procedure, the gas is released and the skin incision/incisions are closed.
Dilation and Curettage
REMOVING UTERINE CONTENTS
A dilation and curettage procedure, also called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the uterine lining (endometrium) can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues. A suction D&C uses suction to remove uterine contents. A sample of uterine tissue is also taken and viewed under a microscope to check for abnormal cells. The procedure can be either operative or diagnostic.
WHY IS IT DONE?
D&C is usually done to remove tissue in the uterus during or after a miscarriage or abortion or to remove small pieces of placenta after childbirth (This helps prevent infection or heavy bleeding) and also to diagnose or treat abnormal uterine bleeding. D&C can be treatment for fibroids, polyps, Endometriosis, Hormonal imbalances and uterine cancer.
THE LOOK INSIDE THE UTERUS
A hysteroscopy is a procedure that allows your provider to look inside the uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopies are done using a hysteroscope – a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.
This procedure used to diagnose problems of the uterus. A diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG). An HSG test uses an X-ray dye to check the uterus and Fallopian tubes. Often, diagnostic tests can be done in an office setting without need for full sedation.
The operative procedure is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.
Our surgeons may perform hysteroscopies to treat polyps and fibroids, adhesions, septums and abnormal bleeding.
More About the Uterus
What Is The Uterus?
The uterus is the medical term for the womb and it is also the Latin word for womb. A typical uterus is about the size and shape of an inverted pear. The uterus sits quite low in the abdomen and is held in position by muscles, ligaments and fibrous tissues. The uterus is joined to the vagina by the cervix, commonly referred to as the neck of the uterus. It is connected at the other end to the Fallopian tubes. It is within the uterus that the fetus develops during gestation.
FUNCTIONS OF THE UTERUS
Common functions of the uterus include nurturing fertilized ovum that develop into the fetus and holding it until the baby is mature enough for birth. The fertilized ovum is implanted into the endometrium to derive nourishment from blood vessels, which develop exclusively for this purpose. The fertilized ovum becomes an embryo, develops into a fetus, and continues developing until childbirth.
Additionally, the uterus provides structural integrity and support to the bladder, bowel, pelvic bones and organs. Commonly, pregnant women will comment that their kicking baby will press on her bladder causing a sudden need to urinate, this is due in part because the womb expands over the bladder. The networks of blood vessels and nerves of the uterus directs blood flow to the pelvis and to the external genitalia, including the ovaries, vagina, labia, and clitoris for sexual response.
Most Common Uterine Disorders
Certain conditions, abnormalities, or defects in your uterus can cause problems, chronic pain, and challenges before/during pregnancy.
- Uterine fibroids
Fibroids are benign (non-cancerous) growths made of muscle tissue in the uterus and are an acquired uterine condition. You not born with fibroids; instead, they develop later in life. Treatments include prescription management and surgery, a myomectomy.
Uterine polyps are growths attached to the inner wall of the uterus. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps.They are more common in women of menopause age, although younger women can get polyps.
- Chronic pelvic pain
Chronic pelvic pain is a complex condition which may have multiple causes. Sometimes, a single disorder may be identified as the cause. In other cases, however, pain may be the result of multiple medical conditions. If you have sharp pelvic pain, we do recommend coming to see one our women’s health specialists as soon as possible.
A miscarriage is the loss of a fetus before the 20th week of pregnancy.
Symptoms you should not ignore
- Heavy menstrual bleeding
- Periods that last longer than 7 days
- Bleeding between menstrual periods
- Bleeding at the beginning of a pregnancy
- Vaginal bleeding after menopause
- Fertility problems
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying the bladder
- Backache or leg pain
Please call our office and book an appointment with one of our specialist who can assist you.