de Fazio Obstetrics and Gynecology

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• Obstetric Consultation

  Obstetric Consultation An obstetric consultation is an opportunity for a woman to meet with a doctor to discuss the details of her pregnancy. Regular visits with a doctor throughout a pregnancy are recommended, because they allow for professional monitoring of the woman's and baby's health. These consultations also provide time for the woman and doctor to develop a trusting relationship, and discuss any possible health issues affecting her and her baby. The Initial Obstetric Consultation During the initial obstetric consultation, the patient will be able to ask questions about the pregnancy and what it will entail. A physical examination is given, and a thorough review of the patient's medical history is made. Tests performed during the various consultations may include the following: Ultrasound Blood tests Urinalysis Fetal heart tones Blood pressure The patient's weight is recorded at every consultation so that it can be monitored during the pregnancy. Obstetric Consultation Recommendations During the initial obstetric consultation, the doctor and patient usually discuss the various lifestyle changes the patient needs to make, if any, to ensure a healthy pregnancy. In addition to maintaining regularly scheduled healthcare appointments, the following recommendations may be made: Maintain a healthy diet Take prenatal vitamins or supplements Avoid exposure to harmful chemicals Get necessary vaccinations Establish an exercise regimen Manage any preexisting health issues Minimize travel An initial obstetric consultation is usually recommended for an expectant mother approximately 8 weeks after her last menstrual period. Obstetric Care We provide comprehensive obstetrical care from preconception to postpartum. Our experienced doctors provide general obstetric services to guide women through each and every step of their pregnancy, ensuring proper growth and development, as well as a successful delivery. Our facilities are fully equipped with the most advanced technology and equipment to make your pregnancy as simple as possible. During your pregnancy, you will visit your doctor on a regular basis for physical examinations, blood tests and ultrasounds in order to monitor the growth and development of your baby. We will discuss options for the delivery process, and work with you to ensure that labor and delivery is comfortable and stress-free. Postpartum care is also available to help women become acclimated to the new experience of motherhood.

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• Fetal Monitoring

  Fetal monitoring involves checking the heart rate and other vital functions of the baby during labor and delivery. It is a useful tool to ensure that the fetal heart rate falls within the normal range of between 110 and 160 beats per minute. In cases where fetal monitoring shows an abnormal heart rate or rhythm it may indicate a lack of sufficient oxygen to the fetus or another potentially dangerous problem. The Benefits Of Fetal Monitoring And Testing The primary goal of fetal monitoring and testing is to measure the heart rate of the fetus. Detecting and tracing this rate is important during pregnancy, since an abnormal heart rate may be one of the first indications of a problem with the pregnancy. Fetal testing may be recommended by a doctor if the patient is past her due date, at risk for a complicated delivery, or if the baby is not moving as frequently as usual. Fetal testing can make certain signs of fetal distress more clearly evident, such as if the baby is not receiving enough oxygen due to a placental or umbilical cord problem. Methods Of Fetal Monitoring Fetal monitoring is usually performed using the following methods: Fetoscope A fetoscope is a variation on a stethoscope that enables the doctor to hear the heartbeat of the fetus. The doctor moves the fetoscope around the outside of the mother's abdomen to detect and hear the heartbeat of the fetus. Doppler Device A doppler device uses sound waves to monitor the heartbeat of the fetus. A device called a doppler transducer is used on the outside of the abdomen to hear the heartbeat. Electronic Fetal Monitoring There are two types of electronic fetal monitoring; external and internal. The external method uses two belts that are placed around the abdomen of the mother. One of the belts measures the fetal heart rate and the other evaluates the length and timing of contractions. Another option is internal monitoring, which requires passing an electrode through the cervix to affix it to the head of the fetus. Electronic fetal monitoring provides a consistent reading of the fetal heartbeat that will indicate any changes taking place. All forms of fetal monitoring are considered safe to both the mother and baby and are commonly used during labor. Fetal monitoring is an important tool to monitor the condition of the fetus and detect any problems during labor and delivery. Preconception & Bone Health Healthy bones are essential for a long, active lifestyle, and keeping bones healthy is especially essential in early pregnancy. Even before becoming pregnant, women who are trying to conceive should maintain a healthy diet, as well as take vitamins or supplements. They contain valuable nutrients that will not only keep the woman's body strong, but also help strengthen the growing bones of a fetus should conception occur. Preconception measures that optimize bone health have many benefits that will support the changes and growth of the baby, as well as increase the mother's energy levels and help protect her bones from weakening. Calcium & Vitamin D During Preconception Calcium, a rich source of vitamin D, is especially important for bone health before and during pregnancy. During pregnancy, extra calcium is needed by the body for fetal skeletal growth. Calcium and vitamin D may be readily obtained from dietary sources such as milk, cheese, almonds, tofu, orange juice, broccoli and kale. In addition, if a woman is allergic or intolerant to certain food products, calcium and vitamin D can be obtained through a dietary supplement. Maintaining calcium and vitamin D levels may decrease the risk of developing preeclampsia during pregnancy, a condition characterized by high blood pressure and protein in the urine. Gestational diabetes mellitus is also more common in women with lower levels of vitamin D. Folic Acid During Preconception Folic acid, a water-soluble B vitamin that helps increase bone health, is also recommended for women trying to conceive. Folic acid can be obtained by taking prenatal vitamins or eating certain fruits or vegetables such as broccoli. Folic acid is considered one of the best ways to protect the baby from birth defects such as spina bifida, which occurs when the spinal column of the fetus does not close properly.

  Link: Fetal Monitoring

• Obstetric Consultation

  An obstetric consultation is an opportunity for a woman to meet with a doctor to discuss the details of her pregnancy. Regular visits with a doctor throughout a pregnancy are recommended, because they allow for professional monitoring of the woman's and baby's health. These consultations also provide time for the woman and doctor to develop a trusting relationship, and discuss any possible health issues affecting her and her baby. The Initial Obstetric Consultation During the initial obstetric consultation, the patient will be able to ask questions about the pregnancy and what it will entail. A physical examination is given, and a thorough review of the patient's medical history is made. Tests performed during the various consultations may include the following: Ultrasound Blood tests Urinalysis Fetal heart tones Blood pressure The patient's weight is recorded at every consultation so that it can be monitored during the pregnancy. Obstetric Consultation Recommendations During the initial obstetric consultation, the doctor and patient usually discuss the various lifestyle changes the patient needs to make, if any, to ensure a healthy pregnancy. In addition to maintaining regularly scheduled healthcare appointments, the following recommendations may be made: Maintain a healthy diet Take prenatal vitamins or supplements Avoid exposure to harmful chemicals Get necessary vaccinations Establish an exercise regimen Manage any preexisting health issues Minimize travel An initial obstetric consultation is usually recommended for an expectant mother approximately 8 weeks after her last menstrual period. Obstetric Care We provide comprehensive obstetrical care from preconception to postpartum. Our experienced doctors provide general obstetric services to guide women through each and every step of their pregnancy, ensuring proper growth and development, as well as a successful delivery. Our facilities are fully equipped with the most advanced technology and equipment to make your pregnancy as simple as possible. During your pregnancy, you will visit your doctor on a regular basis for physical examinations, blood tests and ultrasounds in order to monitor the growth and development of your baby. We will discuss options for the delivery process, and work with you to ensure that labor and delivery is comfortable and stress-free. Postpartum care is also available to help women become acclimated to the new experience of motherhood.

  Link: Obstetric Consultation

• Preconception & Bone Health

  Healthy bones are essential for a long, active lifestyle, and keeping bones healthy is especially essential in early pregnancy. Even before becoming pregnant, women who are trying to conceive should maintain a healthy diet, as well as take vitamins or supplements. They contain valuable nutrients that will not only keep the woman's body strong, but also help strengthen the growing bones of a fetus should conception occur. Preconception measures that optimize bone health have many benefits that will support the changes and growth of the baby, as well as increase the mother's energy levels and help protect her bones from weakening. Calcium & Vitamin D During Preconception Calcium, a rich source of vitamin D, is especially important for bone health before and during pregnancy. During pregnancy, extra calcium is needed by the body for fetal skeletal growth. Calcium and vitamin D may be readily obtained from dietary sources such as milk, cheese, almonds, tofu, orange juice, broccoli and kale. In addition, if a woman is allergic or intolerant to certain food products, calcium and vitamin D can be obtained through a dietary supplement. Maintaining calcium and vitamin D levels may decrease the risk of developing preeclampsia during pregnancy, a condition characterized by high blood pressure and protein in the urine. Gestational diabetes mellitus is also more common in women with lower levels of vitamin D. Folic Acid During Preconception Folic acid, a water-soluble B vitamin that helps increase bone health, is also recommended for women trying to conceive. Folic acid can be obtained by taking prenatal vitamins or eating certain fruits or vegetables such as broccoli. Folic acid is considered one of the best ways to protect the baby from birth defects such as spina bifida, which occurs when the spinal column of the fetus does not close properly.

  Link: Preconception & Bone Health

• Adolescent Gynecology

  Gynecological exams are valuable to adolescents in many ways. It is important for young women to be assessed early, especially if they are sexually active, and to begin a relationship with a doctor that may guide them through many important milestones in their lives. The adolescent gynecologist provides wellness consultations for adolescents with a goal of establishing a bond of trust and confidence with each patient. Adolescent gynecology is a subspecialty of obstetrics and gynecology, or OB/GYN. Adolescent Gynecological Exam A typical adolescent exam includes a consultation, a full medical assessment and a minimally invasive exam. Annual pelvic exams and pap smears are recommended for all women over the age of 18, but younger patients may receive a modified exam. If the patient is not sexually active, a pelvic exam may not be required. A gynecological exam may be overwhelming for a teenager. The doctor will carefully and thoroughly explain the exam process. Patients will have the opportunity to ask questions and voice concerns about their bodies as they enter adulthood. The doctors are especially sensitive with younger patients and provide special care and confidentiality to these patients. Adolescent Menstrual Development Menstrual development is an important aspect of gynecological care for adolescent girls. This may involve taking a history of the patient's start of menstruation, the duration and frequency of periods or in some cases, the absence of menstruation. Adolescent girls go through puberty and begin menstruation at different times. Some begin menstruation as early as 9 or 10 years old, while others may not have their first periods until their teen years. This may depend on a number of factors, including genetics and ethnicity. Changing hormone levels during puberty can also affect the length and regularity of the menstrual cycle. As a result, it can be a stressful and scary time for the adolescent girl. Adolescent Gynecological Conditions There are several common health conditions that the adolescent gynecologist may assess and treat: Dysmenorrhea Endometriosis Polycystic ovary syndrome In addition, adolescent gynecologist may diagnose and treat sexually transmitted diseases, as well as discuss issues such as contraception, breast care, and safe sexual practices.

  Link: Adolescent Gynecology

• Annual Exam

  Annual pelvic exams and Pap tests are important in monitoring your gynecologic health. During your exam you will be screened for infection, inflammation or other abnormal cells that may indicate disease. Early detection is important in treating any disease and especially important for cervical cancer and other potentially life-threatening diseases. Annual exams are recommended for women who are sexually active or over the age of 18. During the exam, your doctor will examine your breasts and pelvic organs for any abnormalities or changes. A Pap test, which collects tissue from the cervix to be sent to a laboratory for testing, will also be performed. An annual exam is one of the most important steps you can take in preventing disorders of the pelvic organs.

  Link: Annual Exam

• Breast Health

  A woman's breasts may change over time due to different levels of hormones in the body caused by menstruation, pregnancy, breast feeding and menopause. There are a number of benign, or non-cancerous, conditions that may develop within the breasts. Because there are many conditions, benign and malignant, that may be associated with the breast, patients are advised to perform breast self-exams in addition to scheduling routine exams with a physician. Benign Breast Conditions Not all abnormalities that develop within the breast are cancerous. Some common benign breast conditions faced by women include:

  Link: Breast Health

• Cancer Screening & Prevention

  Gynecological cancer includes cancer of the cervix, uterus, ovaries, vagina and breast. While these diseases often cannot be prevented, early detection is essential in receiving successful treatment. Regular screenings are important for patients of any age. While certain people may be at a higher risk than others, undergoing screenings for gynecological cancer helps ensure proper treatment in the event of a diagnosis. Breast Cancer Screening Breast cancer affects a significant number of women each year. It is the second-most-common cancer, and the second-leading cause of cancer deaths among women. Most breast cancers are slow-growing, but there are types that are aggressive, which is why early detection is essential. Breast cancer screenings are the best way to detect breast cancer in its early stages. The most common screenings are mammograms and doctor-performed clinical breast exams. Official recommendations are that, starting at 20 years old, a woman should have a clinical breast exam every three years. At 40 years of age, a woman should have a yearly clinical breast exam. The second recommendation is for a screening mammogram, but there is some dispute about the age at which women should start getting them, and how frequently. A woman should check with her doctor to determine her best course of action. It may also be beneficial for a woman to examine her breasts once a month, usually about a week after her menstrual period. This can help her identify any changes or abnormalities such as a lump, swelling, irritation or pain.

  Link: Cancer Screening & Prevention

• Contraception

  Contraception is any method of birth control used to prevent pregnancy. A woman has many birth control options; which are appropriate depend on her age, overall health and lifestyle. Contraception can be permanent or temporary. Some types of contraception are more effective than others, and it is up to each woman to decide which type is right for her. During a woman's monthly cycle, the ovaries produce an egg that moves through the fallopian tubes into the uterus. When an active sperm reaches and fertilizes the egg, it attaches to the wall of the uterus and begins to develop. There are various methods of contraception that prevent pregnancy, some by changing the process of a woman's cycle, and some by ensuring that the sperm and egg do not meet. Methods Of Contraception There are two basic types of contraception available. Some are available by prescription only, and others can be purchased over the counter, at a pharmacy.

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• HPV Testing & Prevention

  Human Papillomavirus (HPV) Genital human papillomavirus, also known as HPV, is a sexually transmitted viral infection. There are more than 40 different kinds of HPV that can infect the genitalia, mouth and throats of men and women. For some people, the immune system will remove the infection over the course of two years, but, for others, HPV may lead to genital warts or cancers of the cervix, vulva, vagina and anus. More than 20 million people in the United States are infected with HPV, with an estimated six million people becoming infected each year. It is estimated that at least half of all sexually active people will contract HPV at some point in their lives. Causes Of HPV The HPV virus is contracted through the following forms of contact: Vaginal sex Anal sex Oral sex Genital-to-genital contact Childbirth Fortunately, many types of HPV can be successfully treated, while others can be managed to prevent complications such as cervical cancer. Symptoms Of HPV Symptoms of HPV infection vary depending on the type of HPV and the severity of the infection. Many patients do not experience symptoms at all. In some cases, symptoms may include: Genital warts Cervical cancer Cancer of the vulva, vagina, penis or anus Cancer of the back of the throat Diagnosis Of HPV Because many types of HPV do not present any symptoms, regular testing is recommended to screen for cervical cancer and other complications of HPV. There is no standard test to detect HPV viruses. It is important for women to undergo regular Pap tests to detect certain abnormalities that may indicate an HPV infection. If abnormalities are found, a DNA test, which can test for 13 high-risk types of HPV, may be performed. If warts or lesions appear in the genital area, medical attention and testing for HPV. Complications Of HPV Although most cases of HPV will clear up on their own, with no side effects or complications, certain types of HPV can develop into cervical, penile or anal cancer. These diseases are most treatable when detected early, making regular screening important. Treatment Of HPV While there is no cure for HPV, treatment for symptoms such as genital warts, cervical changes and cervical cancer is available. HPV treatment will depend on the diagnosis and the severity of the infection. Genital warts may be treated with: Medications Creams Cryotherapy Electrocautery Laser treatment or surgery to remove the warts Treatment will remove the genital warts but it does not cure the infection. Patients can still transmit the HPV infection to a sexual partner. Other types of lesions may be treated with surgery, laser treatments or cryotherapy to prevent them from developing into cervical cancer. Prevention Of HPV There are currently two vaccines, Gardasil and Cervarix, available to protect against high-risk types of HPV. Gardasil, the first HPV vaccine, targets the types of HPV that cause genital warts. Cervarix helps protect women from cervical cancer. These vaccines are not effective for all types of HPV, so the following recommendations should be followed to reduce the risk of contracting HPV: Abstain from sexual activity Be in a monogamous relationship Use condoms, but note that HPV can infect areas surrounding condom

  Link: HPV Testing & Prevention

• STD Testing & Treatment

  A sexually transmitted disease, or STD, is a disease or infection that is spread from one person to another through sexual contact. Most STDs are caused by bacteria, parasites or viruses, that are transmitted through contact with the genitals, skin, mouth, rectum, or bodily fluids. There are many different types of viruses that are characterized as STDs, some of which include: Genital Herpes Gonorrhea Chlamydia HIV HPV Condyloma Syphilis Hepatitis STDs can cause problems ranging from mild irritation to severe pain. Left untreated, some STDs can cause illness, cancer, infertility or harm to a fetus during pregnancy. Causes Of Sexually Transmitted Diseases STDs are caused by a bacterial or viral infection that is spread through sexual contact. People who may be more at risk for contacting an STD may include those who: Engage in unprotected sex Have multiple sexual partners Are already infected with an STD Abuse drugs or alcohol Share needles for drug use or tattoos Symptoms of Sexually Transmitted Diseases Most sexually transmitted diseases have no symptoms at all, especially in women, so some people may not even know they have been infected with an STD. Other symptoms may vary depending on the specific type of STD and may include: Vaginal or penile discharge Pain during intercourse Painful urination Sores or blisters on the genitals Warts or growths on the genitals Abdominal pain Diagnosis Of Sexually Transmitted Diseases A sexually transmitted disease can be diagnosed by a doctor after a physical examination and review of symptoms. Additional tests may include taking a sample of genital fluids or a culture of swabbed specimens to detect the presence of an STD. Additional tests may include a urinalysis and blood tests. Periodic STD testing is recommended for anyone with multiple sexual partners, even if they are having protected sex. Treatment Of Sexually Transmitted Diseases Treatment for STDS may vary depending on the specific diagnosis. Although many STDs cannot be cured, there is medication available to treat and manage symptoms. Some STDs can be treated with antibiotics to clear the infection or medication to prevent flare-ups of symptoms. The HIV virus is commonly treated with a combination of antiretroviral drugs. In some cases, as with condyloma, genital warts may be removed through surgical methods. Prevention Of Sexually Transmitted Diseases Sexually transmitted diseases may be prevented by avoiding risky sexual behavior. STDs may be avoided by: Abstaining from sexual activity Using condoms for all sexual activity Remaining in a monogamous relationship Not sharing needles There is currently a vaccination available for certain strains of the HPV virus. Two HPV vaccines, Gardasil and Cervarix, are approved by the Food and Drug Administration. Both vaccines are highly effective in preventing persistent infection with HPV types 16 and 18, which cause most cases of condyloma or genital warts. Both vaccines are effective for females between the ages of 9 and 26 and the Gardasil vaccine is effective for males between the ages of 9 and 26. These vaccinations are administered as three separate injections over the course of six months. STDs are serious infections that can cause lifelong or recurring symptoms and side effects. It is important for all patients to practice safe sex and get tested often.

  Link: STD Testing & Treatment

• Menopause Management

  Menopause is the time in a woman's life when her menstrual period has stopped. Menopause is caused by a decrease in the ovaries' production of the hormones estrogen and progesterone, which eventually results in the ovaries' ceasing to produce eggs, and the end of menstruation. A woman has reached menopause when she has not had a menstrual period for at least 12 months. Menopause is a natural process that takes several years. During this time, fertility decreases, and periods often change in duration, frequency, and amount of blood flow. Management of menopause varies depending on the individual. One treatment is hormone-replacement therapy (HRT), in which medication containing estrogen or progesterone is prescribed to replace the hormones that are deficient within the ovaries. These synthetic forms of hormones are delivered through pills, patches or creams. However, there are risks associated with HRT, including heart disease, stroke and breast cancer. Risks may vary depending on a woman's health history and lifestyle. Before deciding if HRT is appropriate, a woman should discuss its risks and benefits with her doctor. Women suffering from depression or mood changes due to menopause may benefit from taking antidepressants or anti-anxiety medications. Low-dose vaginal estrogen, which is available in a pill or cream form, can be prescribed to help reduce dryness within the vagina. Medication is also available to treat the osteoporosis often caused by menopause. Women who maintain a healthy and active lifestyle may experience less discomfort during menopause.

  Link: Menopause Management

• Menstrual Disorders & PMS

  Menstrual disorders can turn your monthly period from a minor inconvenience into a major, debilitating condition. These disorders can cause physical and emotional symptoms and can severely disrupt your daily life for days or weeks at a time. Menstrual cycle disorders can cause symptoms such as: Heaving bleeding Abdominal pain Nausea and vomiting Missed periods Mood swings These symptoms are characteristic of several different menstrual disorders including: Abnormal uterine bleeding Amenorrhea Fibroids Dysmenorrhea PMS PMDD While these disorders are not usually serious, they are often painful. Fortunately, treatment methods are usually successful in relieving these symptoms to make that time of the month less significant. Premenstrual Syndrome (PMS) Premenstrual syndrome (PMS) is a group of symptoms that women commonly experience before their monthly menstrual period, usually going away after the period starts. About 85 percent of women suffer from at least one symptom of PMS during each menstrual cycle, although most cases are fairly mild and may not interfere with a woman's normal activities. Severe cases of PMS may be diagnosed as premenstrual dysphoric disorder (PMDD). The specific cause of PMS is not known, but it is linked to the hormone changes involved in the menstrual cycle, and can also be affected by stress and emotional problems. While symptoms can vary for each woman, some of the common symptoms of PMS include: Breast swelling and tenderness Fatigue Difficulty sleeping Bloating Constipation or diarrhea Joint or muscle pain Acne Appetite changes Anxiety Depression Women who suspect that they have a severe case of PMS and are seeking medical attention for their condition should monitor symptoms and their severity for a few months to help their doctor accurately diagnose the condition. Treatment Of Premenstrual Syndrome (PMS) There are many treatments currently available for PMS, many of which involve simple lifestyle changes. Some of these changes may include calcium supplements, exercising regularly, avoiding salty or sugary foods, managing stress and avoiding smoking. Over-the-count medications such as ibuprofen or aspirin are often effective in relieving the symptoms of PMS as well. Prescription medication may be prescribed for severe cases of PMS.

  Link: Menstrual Disorders & PMS

• Urinary Incontinence

  Urinary incontinence, also known as UI, is a common condition that involves the involuntary loss of urine. Although it is not usually a serious condition, UI can be embarrassing and affect a person's daily life. Urinary incontinence is most common in women, especially during and after pregnancy, but can affect people of all ages. Causes Of Urinary Incontinence Urinary incontinence is often caused by a urinary tract infection or weak muscles in the urinary tract. Some medications may cause weak bladder muscles, therefore causing urinary incontinence. Weak muscles may prevent the closing off of the urethra, and doing certain activities may cause urine to leak. Normal urination involves emptying the bladder when the desire to urinate occurs, at which point the bladder contracts and flows out of the body. Once the bladder is empty, the muscles contract and urination stops. People with UI experience a disruption in this process that causes a loss of bladder control and results in troubling symptoms. Symptoms Of Urinary Incontinence In addition to leaking urine, people with UI may also experience: Strong desire to urinate Pelvic pressure Nocturia, or the need to urinate at night while sleeping Frequent urination Painful urination Bed wetting UI is a common condition with many treatment options that can relieve symptoms and allow patients to perform their regular activities without the embarrassment and worry of urinary leakage. Types Of Urinary Incontinence Urinary incontinence may be classified into three different types based on causes and symptoms. Urge Urge incontinence is the most common type of incontinence. This type of incontinence involves urine leakage that occurs after a sudden urge to urinate, because the muscle wall of the bladder is overactive. Stress Stress incontinence is defined as urine leakage that occurs after an activity places pressure on the bladder. Activities may include coughing, laughing or sneezing. Overflow Overflow incontinence occurs as the result of an inactive bladder muscle that does not completely empty the bladder after urination. This is the least common of the types of incontinence. Diagnosis Of Urinary Incontinence Patients exhibiting the symptoms of UI should see their doctor to determine the cause, type and severity of their condition. Doctors can diagnose urinary incontinence through a series of tests and an evaluation of the patient's medical history. Patients may also be asked to keep a bladder or urination diary to record the frequency and circumstances of their urination troubles. Testing may begin with a pelvic exam to detect any physical abnormalities, and may also include Blood tests, Urinalysis, and/or a Cystogram. A stress test to determine if any urine leaks during physically stressful situations After a diagnosis of UI, the physician may perform further testing to determine the cause of the condition, in order to recommend the most appropriate treatment approach. Treatment Of Urinary Incontinence There are many different treatment options available for urinary incontinence, depending on the severity of the condition. Conservative treatments are often effective, and may include: Bladder training Avoiding alcohol and caffeine Medication to control pelvic muscle spasms Kegel exercises For more severe cases, a medical device such as a urethral insert or pessary may be inserted through the vagina to prevent urine leakage. Surgery may also be recommended to provide support to the bladder neck to relieve symptoms caused by UI. However, there are certain risks associated with surgery, including infection, bladder spasms or recurring incontinence. A doctor will determine which treatment is best for each patient after a thorough evaluation of their condition. Prevention Of Urinary Incontinence Not all cases of urinary incontinence can be prevented, however the following recommendations may help in controlling urinary incontinence in some people: Drinking less fluids Emptying the bladder regularly Avoiding caffeinated beverages Kegel exercises may also be effective at strengthening the muscles of the pelvic floor which can help to prevent incontinence.

  Link: Urinary Incontinence

• Colposcopy

  Colposcopy is a diagnostic procedure used to examine, under magnification, certain areas of the body and determine abnormalities. A vulvar colposcopy typically examines lesions on the vulva and is used to identify cancer or genital human papillomavirus, also called HPV. The procedure is done with a colposcope, a microscope that can help identify malignant lesions on the vulva. It is usually performed as a follow-up to an abnormal pap smear. The exam itself is similar to a pap smear in that a speculum is inserted into the vagina so that the cervix is visible. The colposcope is situated so that the physician may view the area in question with a magnification of 10 to 40 times its normal size. If any abnormal cells are noticed, a biopsy of the tissue may be done. A colposcopy is a safe procedure with few complications. Light bleeding or discharge for up to a week after the procedure is normal.

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• D&C Hysteroscopy

  The dilation and curettage procedure is done to scrape and collect endometrium, which is uterine tissue. Dilation is the widening of the cervix which allows instruments to pass into the uterus, while curettage is the scraping of the uterine walls. This procedure is performed to diagnose uterine cancer or other conditions, remove tissue after a miscarriage, treat heavy bleeding, perform an abortion or investigate infertility. It is performed under general or local anesthesia.

  Link: D&C Hysteroscopy

• Endometrial Ablation

  Endometrial ablation is a surgical procedure used to treat women suffering from excessive or prolonged menstrual bleeding and who have not responded to other treatments such as medication. Endometrial ablation removes or destroys the uterine lining, or endometrium, while leaving the ovaries and uterus intact. The endometrium heals by scarring, which reduces or stops future uterine bleeding. Types Of Endometrial Ablation There are several different methods of endometrial ablation. Most methods are performed under local or general anesthesia and a hysterscopy to examine the uterine area is commonly performed prior to the endometrial ablation procedure. Common methods of endometrial ablation may include:

  Link: Endometrial Ablation

• LEEP Procedure

  Loop electrosurgical excision procedure (LEEP) is used to treat abnormal cells found on the surface of the cervix. During the procedure, the abnormal cells are removed to prevent development of cervical cancer. Wire loops attached to an electrosurgical generator cut away the affected tissue, causing the cells to heat and burst. The tissue removed is sent to a lab for further evaluation, including ensuring that the abnormal area has been fully removed. An assessment as to the cause of the growth of abnormal tissue will also be done. The LEEP procedure takes 20-30 minutes and can be performed in the office. A local anesthetic is administered to minimize pain.

  Link: LEEP Procedure

• Advanced Laparoscopic Surgery

  Advanced laparoscopic surgery is a minimally invasive procedure used to diagnose and treat problems of the genital and pelvic areas. During the procedure, a laparoscope, a thin tube with an attached camera at one end, is inserted through a small incision. This allows the doctor to closely examine the area. Surgical instruments can be inserted through additional incisions to treat any identified problems. Technological advances have brought computers and laparoscopic instruments to the forefront of surgical approaches. This provides patients with a minimally invasive technique that can be used in a wide range of procedures. Reasons For Advanced Laparoscopic Surgery Advanced laparoscopic surgery may be performed for a number of reasons, including to: Examine or remove any growths, such as cysts or fibroids Diagnose or treat conditions including endometriosis, ectopic pregnancy or pelvic inflammatory disease Perform a biopsy Determine the cause of pelvic pain Perform endometrial ablation to treat heavy menstrual periods Remove organs such as the uterus, ovaries or fallopian tubes Determine the cause of infertility The Advanced Laparoscopic Surgery Procedure Advanced laparoscopic surgery is performed under general anesthesia and generally takes 30 to 90 minutes, depending on what is done during the procedure. After making a small incision, the doctor will insert the laparoscope and examine or treat the affected area. Using smaller incisions reduces any discomfort a patient will have after surgery. Risks Of Advanced Laparoscopic Surgery While this procedure is considered safe, the possible risks of advanced laparoscopic surgery include infection, bleeding or allergic reaction to a medication or anesthesia. Recovery From Advanced Laparoscopic Surgery Advanced laparoscopic surgery is less invasive than traditional open surgery and typically results in fewer complications. The surgery is usually performed as an outpatient procedure, and patients are often able to resume their normal activities within a few days.

  Link: Advanced Laparoscopic Surgery