- Wellness Exam
- Evaluation and Management Visit
- Office Procedures
Annual wellness exams are important to maintaining a happy, healthy lifestyle and preventinginfection, disease or other abnormalities. Since early detection is important in treating nearly every condition, especially diseases like cancer, regular exams and reviews of your medical history can help spot any abnormalities early.
A full physical including a pelvic exam and breast exam is recommended each year for women over the age of 21 or who are sexually active. During the exam your provider can screen you for any sign of breast cancer, cervical cancer, STD’s, infections, diabetes, hypertension, thyroid disease, skin cancer, high cholesterol or other abnormalities. Annual wellness exams are one of the most important steps you can take in preventing disease.
Colposcopy is a diagnostic procedure used to examine, under the vulva, vagina or cervix to determine if there are any abnormalities. Most commonly a colposcopy of the cervix is done as a follow-up to an abnormal papsmear.
The exam itself is similar to a pap smear in that a speculum is inserted into the vagina so that the cervix is visable. The colposcopy is situated so the provider may view the cervix with a 10-40 times magnification. If abnormal tissue is visualized a biopsy may be done. Colposcopy is also used for abnormalities of the vagina and vulva. Some women may experience discomfort when a biopsy is done so we recommend taking 600 mg to 800 mg of Ibuprofen an hour before the procedure.
A colposcopy is a safe procedure with few complications. Light bleeding, mildcramping or discharge for up to a week after the procedure is normal. It is very important to follow your provider’s recommendation for follow up for at least one or two years following this procedure.
Intrauterine devices (IUDs) are a method of birth control that has few side effects. They can provide long-term effective protection against pregnancy. The devices require precision and care to be fully effective and protect against infection. Talk to your provider about the contraception choices available that are best for you.
During proper IUD insertion, the cervix and uterus are measured and the IUD is inserted to the proper depth by a tube. A string is left hanging in the cervical canal for maintenance and removal purposes. IUDs should be inserted by a trained health care professional who will minimize your risk for complications.
Mirena® is a soft, flexible, estrogen-free intrauterine (IUD) that can be effective for up to five years. It is a tiny T-shaped piece of plastic implanted into the uterus to block sperm and make the uterine lining thinner. Mirena is more than 99% effective at preventing pregnancy without the side effects of the Pill. If you want to have children, you can try to become pregnant as soon as the device is removed. Within a year of removal, 80 percent of the women succeed in becoming pregnant.
For those women who have heavy periods, Mirena has been shown to reduce menstrual flow.
Our office also carries Skyla, Paragard and Liletta IUDs.
This procedure is often recommended to assess the lining of the uterus for women who have abnormal bleeding. Abnormal uterine bleeding is frequently caused by a hormonal imbalance. A biopsy is recommended to make sure the bleeding is not related to anything more worrisome including endometrial cancer.
To perform the biopsy, a speculum is inserted into the vagina and a small plastic tube is inserted through the speculum to suction a sample of the lining. The endometrial tissue is then evaluated by a pathologist at an outside lab. This office procedure may briefly cause a little discomfort, so 600 mg to 800 mg of Ibuprofen is recommended one hour before a patient’s appointment.
Loop Electrical Excision Procedure (LEEP)
If a Pap or other tests (colposcopy) reveals abnormal cells in one’s cervix, a LEEP may be recommended to remove the abnormal tissue. A fine wire loop with a special high-frequency current allows our doctor to precisely remove the abnormal tissue. The cervix is numbed with a local anesthetic allowing the doctor to perform this in the office. We recommend taking 60o mg to 800 mg of Ibuprofen an hour before the procedure to minimize potential discomfort. LEEP is usually a successful treatment, but close follow up will need to be maintained for the first two years to be sure the cervix is free of further problems.
For patients that are experiencing urinary or bladder problems, their provider may recommend urodynamic testing to determine the extent of their symptoms. Urodynamic tests measure how well the bladder, urinary tract and sphincter store and release urine. This test will ensure that you have the best treatment for your bladder’s condition.
Urinary incontinence, or loss of bladder control, can affect people of all ages, but women are especially susceptible during and after pregnancy. Incontinence is often caused by a urinary tract infection or weak muscles in the urinary tract. Urodynamics tests are typically performed after an infection is ruled out and may be used to determine the cause of the following urinary symptoms:
- Frequent urination
- Painful urination
- Strong and sudden urge to urinate
- Inability to empty the bladder completely
- Urine leakage
Interstitial Cystitis is a chronic inflammation or irritation of the bladder and the surrounding pelvic area. People who are diagnosed with interstitial cystitis may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Also known as painful bladder syndrome, interstitial cystitis most commonly affects women. This condition is not well understood throughout the medical community, and the symptoms of interstitial cystitis are often similar to other conditions. Therefore, it isn’t uncommon for us to diagnose and successfully treat new patients with this condition who have struggled with this issue for years.
Once a diagnosis of interstitial cystitis has been established, we have excellent tools for providing immediate relief. The patient can receive these treatments in the office and may choose to learn how to self treat themselves at home. In the long run a prescription medication can significantly help restore the lining of the bladder and eliminate the need for further treatments.
- Oral medication
- Medication instilled directly into the bladder
- Diet modification – Avoiding food that may make symptoms worse
- Bladder training
There is no cure for interstitial cystitis, but after treatment many patients report that their symptoms are greatly reduced. Symptoms can recur, so it is important to be in contact with a doctor if diagnosed with this condition.