| • Annual Physical Exams
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Visiting your gynecologist each year for an annual examination is an extremely important part of maintaining your health. As a critical part in the early detection of many life-threatening diseases, annual gynecologic exams provide peace of mind for you and those who care about you. DMC gynecologists can provide the following as part of an annual exam:
• Routine measurements: weight, blood pressure, pulse
• Internal check-up
• Breast examination
• Pap smear
• Human papillomavirus (HPV) screening
• Family health history
• A conversation to answer questions and identify any concerns
• Contraceptive advice and management
• Complex Contraception Clinic
• Colposcopy
• Bone & spine assessment
• Adhesions
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These abnormal bands of scar tissue can form in the pelvic region after gynecologic surgery and cause post-operative pelvis pain, infertility, and small bowel obstruction. DMC gynecology specialists are experts at preventing pelvic adhesions as well as treating them with the latest techniques.
• Alternatives to Hysterectom
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Physicians at the DMC are pioneering minimally invasive alternative to traditional hysterectomy. Often, the nationally recognized experts at Hutzel can eliminate excessive menstrual bleeding by removing the endometrial lining of the uterus without surgery. Benefits include les pain and fast recovery.
• Contraception Advice and Management
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If you are between the reproductive ages of 15 to 45 you are at a time in your life where you may be seeking a way to avoid unintended pregnancy or planning to start a family. These life decisions can be made more difficult if you have a complex or chronic medical condition. Our gynecologists provide access to the highest quality of care for women with conditions that complicate contraception and preconception care. This unique program, is staffed by physicians and family planning and contraception fellows, offers consultative services addressing contraception and preconception counseling for patients with complex or chronic medical conditions.
Our gynecologists provide access to the highest quality of care for women with conditions that complicate contraception and preconception care. This unique program, is staffed by physicians and family planning and contraception fellows, offers consultative services addressing contraception and preconception counseling for patients with complex or chronic medical conditions.
• Cancer
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At the DMC our patients have access to state-of-the art treatments for breast, ovarian, cervical and colon cancer.
• Cervical Lesions
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DMC gynecologists specialize in the Loop Electrosurgical Exision Procedure (LEEP) to remove cervical lesions.
• Chronic Pelvic Pain
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The pain can be unbearable, many times worse than a urinary tract infection. As if that weren’t bad enough, women often visit eight or nine doctors before it’s accurately diagnosed. The condition is Interstitial Cystitis (IC) and about 1 million Americans — most of them women — suffer from it. But there is hope. Doctors at the DMC are skilled in diagnosing and treating the condition. With support of the National Institutes of Health (NIH), researchers are now exploring the causes of IC and new treatments. What is Interstitial Cystitis? Interstitial Cystitis is a chronic, inflammatory condition of the bladder wall. For some reason, the protective layer of the bladder is not present in women with IC. Without this protective layer, the chemical content of urine is very irritating to the bladder and the muscles and nerves that surround the bladder. Symptoms include severe pain and urinary frequency. Women with IC may feel the need to urinate up to 20 times a day. IC is often misdiagnosed as endometriosis, urinary tract infection or irritable bowel syndrome. In some cases, IC is closely associated with these other conditions. Gynecologists at the DMC use the latest techniques to treat Interstitial Cystitis. The primary treatments are dietary modification and a solution of medications instilled directly into the bladder. These medications can help to replace the protective layer of mucus that is missing in women with IC. Other treatment options include: Oral medications Stress reduction techniques Bladder hydrodistention (slowly stretching the bladder with fluid)
• Endometriosis
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Endometriosis is a condition where endometrium (the lining of the uterus) is found in locations outside the uterus. DMC gynecologists are experts in the surgical and non-surgical treatment of endometriosis.
• Excessive Menstrual Bleeding
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Minimally invasive alternatives to hysterectomy such as HydroThermAblation™ (HTA) are used to treat abnormal menstrual bleeding.
• Fibroids
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DMC gynecologists offer advance surgical and non-surgical treatment of uterine fibroids
• Incontinence
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Urinary and Fecal – Using the latest techniques and procedures which include urodynamic testing, cystocopy, tension-free vaginal tape and anal manometry, Hutzel urogynecologists diagnose and treat urinary and facal incontinence and pelvic floor disorders.
• Mammography
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Time for the Most Advanced Diagnostic Care DMC features the latest breast diagnostic services and bone density testing. Digital Mammography DMC now features the latest digital mammography technology. Every mammography machine is equiped with the Fuji Computed Radiography for Mammography (Fuji CR Mammography or FCRm). Stereotactic Breast Biopsy This minimally invasive alternative to surgical biopsy is available if your physician recommends it.
• Menopause
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Menopause isn’t a disease, it’s a normal, healthy part of life. Not long ago, many women looked at menopause as the beginning of the end — the start of old age. But today, women often live half their adult lives after menopause. Physicians at the DMC are nationally recognized authorities on menopause — working with women to minimize menopause symptoms while conducting groundbreaking research.
• Pelvic Floor Disorders
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DMC treats pelvic floor disorders and urinary/fecal incontinence, vaginal pain and the abdominal discomfort they can cause – using the latest techniques and procedures including urodynamic testing, cytoscopy, tension-free vaginal tape, anal manometry and advanced reconstructive pelvic surgery. Read more.
• Ovarian Cysts
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DMC offers the most advanced, minimally invasive laparoscopic and microlaparoscopic procedures to remove ovarian cysts and diagnose pelvic pain
• Sexually Transmitted Diseases
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Women turn to the experts at the DMC for advanced screening and treatment of sexually transmitted diseases
• Vulvar Disorders
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The DMC offers services to women with problems of the outer genital area (vulva) and vagina including itching, irritation and pain, abnormal discharge and pain with intercourse.
• Varicose Veins
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Varicose veins are most often swollen, gnarled veins that most frequently occur in the legs, ankles and feet. They are produced by a condition known as venous insufficiency or venous reflux, in which blood circulating through the lower limbs does not properly return to the heart but instead pools up in the distended veins. More than 25 million Americans suffer from venous reflux disease. The symptoms can include pain and fatigue in the legs, swollen ankles and calves, burning or itching skin, skin discoloration and leg ulcers. In less severe cases, thin, discolored vessels – “spider veins” – may be the only symptom. The Vascular Surgery Center at the DMC provides advanced treatment of varicose veins, including the VNUS Closure™ procedure, a clinically proven, minimally invasive procedure that treats varicose veins and their underlying cause, venous reflux, with little or no pain. Closure patients can usually walk away from the vein procedure and be back to everyday activities — either at home or at work — typically within a day.
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Minimally Invasive Gynecologic Procedures
• Laparoscopic Supracervical Hysterectomy
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During this type of hysterectomy, the uterus is removed and the cervix is left intact. This procedure usually results in shorter recovery time and less pain. Most patients leave the hospital the next day and require only oral pain medications. And since it leaves the cervix intact, the procedure may result in better bowel and bladder function and better sexual function compared to traditional hysterectomy. Supracervical laparoscopic hysterectomy is an excellent option for some women, but not every woman is a candidate. Since the procedure leaves the woman’s cervix intact, it is only offered to women who have no history of cervical cancer or cervical dysplasia.
• Total Laparoscopic Hysterectomy (TLH)
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During this type of hysterectomy, the physician removes the entire uterus and cervix, but leaves the fallopian tubes and ovaries intact. Years ago, this type of procedure was sometimes called a “partial” hysterectomy since it left the tubes and ovaries intact. Today, the removal of the fallopian tubes and ovaries is considered a separate procedure called a Bi-lateral Salpingo Oophorectomy.
• Myomecomy
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A mymomectomy is a surgical procedure that removes fibroids but leaves the uterus intact. In a hysteroscopic myomectomy, the doctor inserts a flexible fiber-optic scope (hysteroscope) into the uterus through the vagina and cervix and removes the fibroids using special surgical tools fitted to the scope.
• Uterine or vaginal vault prolapse by Sacrocolopopexy
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Prolapse (or dropping) of any pelvic floor organ (vagina, uterus, bladder or rectum) occurs when the connective tissues or muscles within the body cavity are weak and unable to hold the pelvis in its natural orientation. The weakening of connective tissues accelerates with age, after child birth, with weight gain and strenuous physical labor. Women with moderate to severe uterine or vaginal vault prolapse can experience prolapse through their vagina (externally). Women experiencing pelvic organ prolapse typically report feeling or seeing a vaginal bulge and may also have problems with urinary incontinence, vaginal ulceration, sexual dysfunction and/or having a bowel movement. Sacrocolpopexy is a procedure to surgically correct vaginal vault or uterine prolapse where mesh is used to hold the vagina in the correct anatomical position.
• Robotic Sacrocolpopexy: A Less Invasive Surgical Procedure
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If your doctor recommends sacrocolpopexy, you may be a candidate for da Vinci Sacrocolpopexy. This procedure uses a state-of-the-art surgical system designed to help your surgeon perform a minimally invasive surgery through small incisions. Through these tiny, 1-2 cm incisions, surgeons using the da Vinci System* can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and maintaining excellent clinical outcomes. What are the advantages of this approach? For most women, da Vinci Sacrocolpopexy offers numerous potential benefits over a traditional open approach, including:
• Significantly less pain
• Less blood loss and need for transfusions
• Less risk of infection
• Less scarring
• Shorter hospital stay
• Shorter recovery time
• Quicker return to normal activities
• Laparoscopic Salpingo-oophorextomy
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Laparoscopic bilateral salpingostomy is a minimally invasive procedure to remove an ectopic pregnancy or other blockage from both fallopian tubes while leaving the tubes and ovaries intact to restore fertility; a tiny video camera (laparoscope) and other instruments are inserted into several small "keyhole" incisions in the lower abdomen.
• Endometriosis pelvic pain treatment
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Endometriosis is a condition where endometrium (the lining of the uterus) is founding location outside the uterus. DMC gynecologists are experts in the surgical and non-surgical treatment of endometriosis.
• Uterine artery embolization to control uterine bleeding
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Also know as uterine fibroid embolizaion, this minimally invasive procedure blocks the arteries that supply blood to uterine fibroids. Using a catheter, small particles are injected into the uterine arteries. The particles block the arteries that feed the fibroids and cause degeneration of the fibroids.
• Hysteroscopic Myomectomy
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A mymomectomy is a surgical procedure that removes fibroids but leaves the uterus intact. In a hysteroscopic myomectomy, the doctor inserts a flexible fiber-optic scope (hysteroscope) into the uterus through the vagina and cervix and removes the fibroids using special surgical tools fitted to the scope.
• Endometrial Ablation
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Ablation procedures can be very effective in controlling heavy menstrual bleeding from benign causes. By destroying the endometrial lining of the uterus, bleeding can be stopped while leaving the uterus in place. DMC physicians use a hysteroscope inserted through the vagina to destroy the endometrial lining with extreme heat, extreme cold or a special cutting device.
• Permanent birth control
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Women today have a wide variety of highly effective, long-term and permanent birth control options. Some require minimally invasive surgical procedures. Others require no surgery, no hormones and no anesthesia. The experts at the DMC can help you determine which birth control option is best for you.
• Long Term Options
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Long-term birth control options include intrauterine devices (IUDs) — small flexible devices made of metal or plastic which prevent pregnancy when inserted into the uterus. IUDs can be used for up to 10 years and are highly effective. Some types of IUDs release small amounts of hormones while others are hormone free.
ParaGard® — The ParaGard® IUD is a simple, t-shaped piece of soft, flexible plastic wrapped in natural copper. Designed to fit comfortably in the uterus, it’s 99.4% effective, simple to use and hormone free. ParaGard can be used safely for up to 10 years and it’s very affordable.
Mirena® — One popular IUD, Mirena®, is actually more effective in preventing pregnancy than tubal ligation. This small, t-shaped IUD can be used for up to five years and can be removed at any time. Mirena is made of soft plastic that releases a tiny amount of the hormone levonorgestrel into the lining of the uterus. The primary benefit of an IUD is that it can be removed if birth control is no longer desired. Some women also like the fact that IUDs can be inserted without incisions.
• Permanent Options
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Minimally invasive laparoscopic tubal ligation (or tubal occlusion) is the most common form of permanent birth control in the United States. But several new hysteroscopic procedures — which do not require abdominal incisions — are gaining popularity.
Minimally Invasive Tubal Ligation/Occlusion
In tubal ligation/occlusion procedures — known to many as “having your tubes tied” — the fallopian tubes are occluded (blocked or cut) to prevent sperm from fertilizing an egg. At the DMC, tubal ligation/occlusion is most often performed with a minimally invasive laparoscopic procedure. Compared to open surgical procedures, the minimally invasive method results in smaller scars, less pain and a faster return to normal activities. Recovery time for a minimally invasive laparoscopic tubal ligation/occlusion is about one week or less.
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