In-Office Procedures
"Essure" Tubal Ligation
"Her Option" Endometrial Ablation
Leep Procedure
Colposcopy
Endometrial Biopsy
Instead of being performed in the hospital or a surgery center, the Esssure procedure can easily be done in the comfort of the office. It is a permanent birth control that is performed without any incisions.
The procedure is performed using a mild sedative and a local anesthetic block on your cervix. After the block has “set up”, a small instrument called a hysteroscope is inserted through your cervix into the inside cavity of the uterus. The hysteroscope, which is much like a telescope, allows the inside cavity of the uterus to be seen and the small openings where the fallopian tubes come into the uterus are found. A small flexible device called a micro-insert is placed into each tubal opening. These inserts are permanent. Over a three month period, body tissue grows into the micro-inserts, blocking the fallopian tubes. Blocking the tubes prevents sperm from reaching and fertilizing the egg, giving you permanent sterilization.
In order to make sure that the tubes are blocked, 3 months after the procedure, a special X-Ray called a hysterosalpingogram will be performed. This X-Ray is performed in the radiology department of the hospital. A small amount of dye is inserted through your cervix into your uterus. Under X-Ray view the dye can be seen in your uterus. If it does not go into the fallopian tubes, we know the tubes are blocked.
“HER OPTION” ENDOMETRIAL ABLATION
The Her Option procedure provides relief to women suffering from excessive bleeding during their period and who have no intention of becoming pregnant in the future. It is performed in the comfort and privacy of the Clinic, so there is no need to go to the hospital. This procedure is a form of endometrial ablation called cryoablation, which means that it uses subzero temperatures to remove the lining of the uterus (the endometrium). A thin probe is inserted through the vagina into the uterus under ultrasound guidance. The probes are then hooked up to a machine that cools them to subzero temperatures, which freezes the lining of the uterus to permanently remove it. The procedure typically takes 20 – 30 minutes. There is generally minimal discomfort associated with this procedure, mostly menstrual like cramps, and all that is necessary is some mild pain medication, such as Ibuprofen, given prior to the procedure. After the procedure you will experience a watery discharge that will last for 1 – 3 weeks, however, most women return to normal activities the day after the procedure.
The general success rate for this procedure in treating abnormal bleeding is approximately 90% with 20-30% of women experiencing total resolution of their periods. You many not appreciate the full effect of the procedure until you have had 3 – 4 menstrual cycles after the ablation. Being that the uterus itself is not removed, the production of your natural hormones will continue.
Cryoablation is not a form of birth control and pregnancy is still possible after the procedure. Effective birth control continues to be important after this procedure. Should pregnancy occur, there is a higher than normal chance of ectopic (tubal) pregnancy, miscarriage, premature delivery or birth defects that can be dangerous for both mother and baby
This is a procedure that is occasionally advised for women with an abnormal pap smear. The LEEP procedure removes the abnormal cells from the cervix with the hopes that when the cervix heals, it will heal with normal cells.
The usual course is that you have a colposcopy (see below) and biopsies of your cervix that show a high grade pre-cancer lesion on your cervix. Once this is known, a LEEP is usually advised. The procedure is performed in the office using local anesthesia (numbing medication) on your cervix.
A wire loop is hooked up to a machine that sends an electrical current through the loop. Once the loop touches the cervix, it cuts into it and removes the portion of the cervix containing the abnormal cells. This is much like taking a divet out of the ground when you are golfing. The portion of the cervix that is removed is sent to the pathologist for analysis. The most important part of that analysis is whether or not the edges, or margins, of the biopsy are clear of any abnormal cells. If it is clear, you would then have a 90% chance that the pre-cancer cells will not return. The healing time is about a month from the procedure. You will experience some bleeding initially, some cramping for a day or two and, a light discharge that will last for a couple of weeks.
This procedure is performed on your cervix when you have an abnormal pap smear. It is looking at the cervix more carefully with a microscope. Some special stains are used on the cervix so that the abnormal cells can be easily seen with the microscope. If abnormal cells are seen, a biopsy is performed. This is a small bite taken from your cervix in the area of the abnormal cells. The biopsy is sent to the pathologists for analysis.
You may experience some slight cramping, like menstrual cramps, when a biopsy is performed, otherwise the procedure feels like doing a pap smear. Once the results from the pathologist are known, recommendations for follow-up will be made.
If you are experiencing abnormal bleeding, an endometrial biopsy may be recommended. This is a biopsy of the lining cells of uterus. It tells your physician many things including how your hormones are working and whether or not you have an abnormality within your uterus such as hyperplasia (an overactive, thickened lining) or uterine cancer.
A small straw is inserted through your cervix into the inside cavity of the uterus. On the other end of that straw there is a plunger that when pulled back sucks up a sample of the lining into the straw. There is minimal discomfort with the procedure, mostly mild menstrual like cramps, that goes away quickly after the procedure is finished.
The tissue that is removed from the uterus is then sent to the pathologist for analysis. Once the results are known, your physician will discuss the results with you and make a plan for treating your abnormal bleeding.
For more information on any of the procedures done in our Clinic, please call 218-722-5629 to schedule an appointment.