New Treatments In Gyneclogy

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Advances in Gynecology

Often when we think of technological advances in medicine we think of improved survival or better results. However, in addition it has meant less pain, cost, and faster recovery. Many problems, which in the past required surgery in the hospital, can now be treated in the office or an outpatient surgery center. These often involve minimal anesthesia and, since they are not performed in a hospital, the patient often is only charged their office co-pay. Three common gynecological conditions have seen significant advances in treatment in the past few years:

Heavy Periods

The most common problem women discuss with their gynecologist is heavy periods. Until recently, the two most common treatments involved were birth control pills, which can reduce blood loss, or hysterectomy (removing the uterus). However, if the women could not or desired not to take hormones many women were left with the only other major option, which was hysterectomy. If heavy periods are keeping you from enjoying your life to the fullest then you should learn about endometrial ablation. About one in five women experience unusually heavy menstrual bleeding (menorrhagia). These women can experience fatigue, anemia, embarrassing accidents and restricted activities. If you are familiar with these effects, you know that menorrhagia can disrupt your life.

Endometrial ablation is a quick, simple procedure that requires no incisions or hospital stay, and involves no hormones. It is intended to reduce or eliminate future menstrual bleeding by permanently removing the lining of the uterus (endometrium)by either the brief application of electrical energy or placing heated salt water into the uterine cavity. This procedure takes only a few minutes to perform. It can be performed with minimal anesthesia and can be performed in the doctor’s office or surgery center if the patient prefers. Women typically return home 45 minutes after the procedure. You may experience some cramping, which should go away by bedtime. Most women should be able to return to normal activities the next day. The procedure is intended to destroy all or most of the tissue that is responsible for menstrual bleeding (endometrium). After the procedure, you may never bleed again, or if you do, your bleeding should be greatly reduced. Many women may also experience the added benefits of a significant reduction in painful menstruation (dysmenorrhea). As a result, 95% of patients would recommend this procedure to other women.

Permanent Birth Control

Many women who have completed their childbearing do not wish to continue to take a birth control pill daily or use any of the other forms of reversible contraception. Up until recently, the only available options have included a surgery called tubal ligation (tube tying), or a vasectomy for the man. Permanent birth control (sterilization) is meant to prevent pregnancy for the rest of your life. There is a new procedure called Essure. The Essure procedure involves placing a soft, flexible coil through the body’s natural pathway (cervix) into each fallopian tube. This blocks the tubes so that the sperm cannot reach the egg. This does not involve any hormones. Unlike vasectomy for men or laparoscopic sterilization (tube tying) for women this procedure does not require cutting or puncturing the body and requires no stitches and therefore does not cause scars. It involves minimal cramping afterward and can be performed in the office if desired. Three months after the procedure a special type of x-ray (HSG) is performed to ensure that the tubes are completely blocked. This procedure is 99.8% effective and covered by most insurance plans.

Urinary Incontinence

Urinary incontinence is the unintentional release of urine. Even if you are not familiar with the term, you may be all too familiar with the embarrassment and inconvenience it may cause. You may even restrict or avoid physical activity, travel, or social engagements because of your condition. However, it is important to know that you don’t have to live with it. You should also know that you’re not alone. More than 11 million women in the US experience urinary incontinence. The majority have what is known as stress urinary incontinence (SUI), a treatable condition that affects women of all ages. Stress urinary incontinence is the unintentional release of urine during normal everyday activities — laughing, sneezing, coughing, walking, exercising and getting up from a seated position. You may also go to the bathroom frequently throughout the day in order to avoid accidents.

There are two basic causes for SUI. Most commonly, a weakening or damage in the muscle of the pelvic floor causes SUI. These muscles support the urethra (the tube from the bladder through which urine exits the body). Weakened pelvic floor muscles cannot hold the urethra in the correct position. Therefore, activities that put pressure on the bladder (such as a sneeze) may cause the urethra to loose its seal and allow urine to escape. Another cause of SUI is intrinsic sphincter deficiency. The sphincter muscle holds the urethra closed until it’s time to urinate. In women with ISD, the sphincter muscles don’t function as they should and can cause urine to leak during movements. Stress urinary incontinence is not necessarily a natural part of the aging process. The following can contribute to SUI: childbirth, pelvic surgery, chronic constipation, chronic cough, or weak tissue.

If other therapeutic approaches fail,surgery may be required to treat the underlying cause of incontinence. Surgical treatment may deliver the most reliable, permanent results. Today’s procedures are simpler, faster, do not require hospitalization, and cause minimal discomfort afterward. The procedure involves placing a “sling” of mesh tape through the vagina to support the urethra during sudden movements, such as a cough or sneeze. This allows the urethra to remain closed and prevents the involuntary loss of urine. The procedure involves three small incisions and takes about 30 minutes. Most women can return to most normal activities with in a few days.




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