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BioTE Hormone Replacement

WHO IS BIOTE® MEDICAL BioTE Medical is a leading innovator in Precision and Preventative Medicine. We have translated over 80 years of scientific insight into clinically validated medical protocols that identify and treat the earliest indicators of aging. Exclusively for the use of healthcare providers, we create patient-centric strategies with reproducible clinical outcomes that optimize hormones and extend healthspans for both women and men. Our community of leading physicians, researchers, and strategic partners collaborate across the BioTE network to transform healthcare and change how medicine is practiced every day.

THE BIOTE® MISSION We do not believe in anti-aging, we believe in healthy aging and understand that the aging process for patients is unique. BioTE’s mission is to help transform healthcare by continually developing innovative educational programs and treatment options to help providers effectively treat the early indicators of aging on a patient-by-patient basis.

Please call our office for prices and more information.


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Robotic Hysterectomy

A hysterectomy is surgery to remove your uterus (partial hysterectomy) or your uterus plus your cervix (total hysterectomy).

If you need a hysterectomy, your doctor might recommend robot-assisted (robotic) surgery. During robotic surgery, your doctor performs the hysterectomy with instruments that are passed through small abdominal cuts (incisions). The magnified, 3D view makes possible great precision, flexibility and control.

When you have a minimally invasive hysterectomy, you’re likely to have less pain and lose less blood than is typical with open abdominal surgery. You’ll probably be able to resume normal daily activities more quickly than you could after open surgery.

Why it’s done

Doctors perform hysterectomies to treat conditions such as:

  • Uterine fibroids
  • Endometriosis
  • Cancer or precancer of the uterus, cervix or ovaries
  • Uterine prolapse
  • Abnormal vaginal bleeding
  • Pelvic pain

Laparoscopy Surgery

Laparoscopic gynecological surgery is a minimally invasive approach that allows the surgeon to operate without making a large incision. A thin, lighted tube with a camera on the end, known as a laparoscope, is inserted into the abdomen through a small incision. The camera sends images of the inside of the body to a TV monitor in the operating room, allowing the surgeon to see and operate on the pelvic organs without having to use a long incision.

Other small incisions may be made in the abdomen to insert very fine specialized surgical instruments.

Benefits of laparoscopic gynecological surgery can include less pain compared to open abdominal surgery, fewer complications, less scarring, shorter hospital stays, and faster recovery. Many patients go home the same day (outpatient surgery) or the next morning.

Laparoscopic surgery can be used to treat a variety of gynecologic conditions that previously required large incisions, including endometriosis, fibroids, ovarian cysts, ectopic pregnancy, sterilization, pelvic problems such as urinary incontinence and pelvic support problems such as uterine prolapse. It can also be used for a variety of procedures, including a laparoscopic hysterectomy and a laparoscopically assisted vaginal

Tubal Ligations

Tubal ligation — also known as having your tubes tied or tubal sterilization — is a type of permanent birth control. During tubal ligation, the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy.

Tubal ligation prevents an egg from traveling from the ovaries through the fallopian tubes and blocks sperm from traveling up the fallopian tubes to the egg. The procedure doesn’t affect your menstrual cycle.

Tubal ligation can be done at any time, including after childbirth or in combination with another abdominal surgery, such as a C-section. Most tubal ligation procedures cannot be reversed. If reversal is attempted, it requires major surgery and isn’t always effective.

 

Why it’s done

Tubal ligation is one of the most commonly used surgical sterilization procedures for women. Tubal ligation permanently prevents pregnancy, so you no longer need any type of birth control. However, it does not protect against sexually transmitted infections.

Tubal ligation may also decrease your risk of ovarian cancer, especially if the fallopian tubes are removed.

Tubal ligation isn’t right for everyone, however. Talk with your doctor or health care provider to make sure you fully understand the risks and benefits of the procedure.

Your doctor may also talk to you about other options, including long-acting reversible contraceptives such as an intrauterine device (IUD) or a birth control device that’s implanted in your arm.

Risks

Tubal ligation is an operation that involves making incisions in your abdomen. It requires anesthesia. Risks associated with tubal ligation include:

  • Damage to the bowel, bladder or major blood vessels
  • Reaction to anesthesia
  • Improper wound healing or infection
  • Continued pelvic or abdominal pain
  • Failure of the procedure, resulting in a future unwanted pregnancy

Things that make you more likely to have complications from tubal ligation include:

  • History of pelvic or abdominal surgery
  • Obesity
  • Diabetes

How you prepare

Before you have a tubal ligation, your health care provider will talk to you about your reasons for wanting sterilization. Together, you’ll discuss factors that could make you regret the decision, such as a young age or change in marital status.

Your health care provider will also review the following with you:

  • Risks and benefits of reversible and permanent methods of contraception
  • Details of the procedure
  • Causes and probability of sterilization failure
  • Ways to prevent sexually transmitted infections
  • The best time to do the procedure — for instance, shortly after childbirth or in combination with another abdominal surgery, such as a C-section

If you’re not having a tubal ligation shortly after childbirth or during a C-section, consider using contraception for at least one month before the procedure and continue using a reliable form of contraception until your tubal ligation procedure is performed.

What you can expect

Tubal ligation can be done:

  • Following a vaginal birth using a small incision under the belly button (mini-laparotomy)
  • During a C-section
  • Anytime as an outpatient procedure using a laparoscope and short-acting general anesthesia (interval tubal ligation)

Before the procedure

You may be asked to take a pregnancy test to make sure you’re not pregnant.

During the procedure

If you have an interval tubal ligation as an outpatient procedure, either a needle is inserted or an incision is made through your belly button so your abdomen can be inflated with gas (carbon dioxide or nitrous oxide). Then a laparoscope is inserted into your abdomen.

In most cases, your doctor will make a second small incision to insert special instruments through the abdominal wall. Your doctor uses these instruments to seal the fallopian tubes by destroying parts of the tubes or blocking them with plastic rings or clips.

If you have a tubal ligation after vaginal childbirth, your doctor will likely make a small incision under your belly button, providing easy access to your uterus and fallopian tubes. If you have a tubal ligation during a C-section, your health care provider will use the incision that was made to deliver the baby.

After the procedure

If gas was used during tubal ligation, it will be removed when the procedure is done. You may be allowed to go home several hours after an interval tubal ligation. Having a tubal ligation immediately following childbirth doesn’t usually involve a longer hospital stay.

You’ll have some discomfort at the incision site. You might also have:

  • Abdominal pain or cramping
  • Fatigue
  • Dizziness
  • Gassiness or bloating
  • Shoulder pain

Your health care provider will discuss management of any post-procedure pain with you, before you go home from the hospital.

You may bathe 48 hours after the procedure, but avoid straining or rubbing the incision. Carefully dry the incision after bathing.

Avoid heavy lifting and sex until your health care provider informs you that it’s safe to do so. Resume your normal activities gradually as you begin to feel better. Your stitches will dissolve and won’t require removal. Check with your health care provider to see if you need a follow-up appointment.

If you have any concerns that you aren’t healing properly, call your doctor. Call your health care provider immediately if you have:

  • Temperature of 100.4 F (38 C) or greater
  • Fainting spells
  • Severe abdominal pain that continues or gets worse after 12 hours
  • Bleeding from your wound through your bandage
  • Discharge from your wound that is foul smelling

Results

Tubal ligation is a safe and effective form of permanent birth control. But it doesn’t work for everyone. Fewer than 1 out of 100 women will get pregnant in the first year after the procedure. The younger you are at the time it’s done, the more likely it is to fail.

If you do conceive after having a tubal ligation, there’s a risk of having an ectopic pregnancy. This means the fertilized egg implants outside the uterus, usually in a fallopian tube. An ectopic pregnancy requires immediate medical treatment. The pregnancy cannot continue to birth. If you think you’re pregnant at any time after a tubal ligation, contact your health care provider immediately.

Keep in mind that although tubal ligation reversal is possible, the reversal procedure is complicated and may not work.

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Onsite Ultrasounds

pelvic ultrasound is a test that uses sound waves to make pictures of the organs inside your pelvis. Your doctor might order this test to diagnose a condition, or to check the health of your baby while still in the womb.

In women, a pelvic ultrasound is used to view the:

This test is called by a few other names, including:

  • Gynecologic ultrasound
  • Pelvic scan
  • Pelvic sonography
  • Transabdominal ultrasound
  • Transvaginal ultrasound
  • Transrectal ultrasound
  • Endovaginal ultrasound

Who Might Get It

In women, doctors can use a pelvic ultrasound to:

  • Find problems with the structure of your uterus or ovaries
  • Look for cancer in your ovaries, uterus, or bladder
  • Find an intrauterine device (IUD)
  • Look for growths like noncancerous tumors, fibroids, or cysts
  • Discover the cause of abnormal bleeding or pain
  • Evaluate or treat fertility problems
  • Monitor your baby’s growth during pregnancy
  • Check for pelvic inflammatory disease (PID — an infection of your uterus, ovaries, or fallopian tubes)
  • Diagnose an ectopic pregnancy (a fertilized egg that grows outside of the uterus)
  • Find a tissue sample to remove from your uterus during an endometrial biopsy

 

Preparation

If you are having a transabdominal ultrasound, your bladder will need to be full. You’ll drink about 32 ounces — or four 8-ounce glasses — of water or another clear fluid at least 1 hour before the test. A full bladder makes your organs show up more clearly on the picture. You can use the bathroom after the procedure.

A transvaginal ultrasound is done with an empty bladder. You’ll use the bathroom before the test.

Wear lose, comfortable clothes to the exam. You might need to wear a gown during the procedure.

How It’s Done

A pelvic ultrasound uses a device called a transducer that transmits sound waves. These sound waves bounce off your organs and tissues, and then echo back to the transducer. A computer converts the sound waves into a picture of your organs, which appear on a video screen.

Your doctor can do this test in one of three ways:

  • Transabdominalultrasound is done through your abdomen. You lie on your back on an exam table. The technician puts a little bit of gel on the transducer. The gel helps the transducer move more smoothly and prevents air from getting between the device and your skin. The technician gently runs the transducer back and forth over the skin of your belly.
  • Transvaginal ultrasound is done through the vagina. You lie on your back on an exam table. You might have your feet up in stirrups. The transducer is covered in gel and a plastic or latex covering. Then it’s inserted into your vagina, much like a tampon.
  • Transrectal ultrasound in men is done through the rectum. You lie on your side, facing away from the technician. Your doctor places a cover over the transducer. Then it goes inside your rectum.

A Doppler ultrasound is another type of ultrasound. It measures the speed and direction of blood as it flows through arteries and veins in your abdomen. Your doctor can use this test to look for narrowing or blockages in your blood vessels. You might hear a “whooshing” sound as a Doppler ultrasound is done.

Risks

The test itself doesn’t have risks. Unlike X-rays, an ultrasound doesn’t use radiation.

A transabdominal ultrasound shouldn’t hurt. You might feel some discomfort during a transvaginal or transrectal ultrasound when the transducer is inserted.

After the Ultrasound

A radiologist will analyze the ultrasound images and send a report to your doctor. This report will show any problems with your pelvic organs, blood vessels, or unborn baby.

Your doctor will explain the test results to you. Make sure you understand what your results mean, and how they will affect your treatment.

Your doctor might recommend other tests to check the health of your pelvic organs, including these:

  • Hysteroscopy inserts a thin, lighted device through the vagina and into the uterus to look for problems in the uterus.
  • Laparoscopy uses a thin, lighted tube that goes through your abdominal wall to view organs in your pelvis.

Your doctor will let you know if you need these or other tests.

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In-Office Procedures

Leeps Procedure performed by Dr. Stephens

This information explains what to expect during and after your loop electrosurgical excision procedure (LEEP).

A LEEP is a procedure to remove abnormal tissue from your cervix (the bottom part of your uterus, located at the top of your vagina). It may be done to confirm a cancer diagnosis or treat precancerous conditions of your cervix. During a LEEP, a thin wire loop is used to excise (cut out) abnormal tissue. Your cervix is then cauterized (burned) to stop any bleeding. The area usually heals in 4 to 6 weeks.

The procedure will take about 10 minutes. You’ll be in the procedure room for about 30 minutes. You’ll have little or no discomfort from the procedure.

Before Your Procedure

  • Don’t take aspirin or any medications that contain aspirin for 7 days before your procedure.
  • Eat and drink as you normally would. You won’t need to change your diet the day of your procedure.
  • Schedule your procedure for 1 week after your period. This will help your doctor know the difference between vaginal bleeding caused by your procedure and vaginal bleeding during your period.
  • If you think you may be pregnant, tell your doctor.

Call your doctor if you have any of the following symptoms 2 to 3 days before your procedure:

  • A fever of 101° F (38.3° C) or higher
  • Chills (feeling cold and shivering)
  • Abnormal vaginal bleeding

During Your Procedure

  • If you’re between the ages of 11 and 50, your doctor will ask you to take a urine (pee) pregnancy test before your procedure.
  • You’ll meet with a nurse and patient care technician. They will show you the LEEP equipment.
  • Your doctor will talk to you about the procedure, answer your questions, and ask you to sign a consent form.
  • The nurse or technician will help you get into position for the procedure. You’ll be in the same position that you would be in for a regular pelvic exam. Since the procedure uses electricity, a grounding pad will be placed on your thigh. This is used to keep you from getting shocked and to protect you from getting hurt.
  • Your doctor will numb your cervix by injecting it with a numbing medication called lidocaine. You may feel some pressure and slight burning as it’s injected. The medication may also make your heart beat a little faster.
  • Your doctor will turn on the LEEP equipment. The equipment makes a loud noise that sounds like a vacuum.
  • Once your cervix is numb, your doctor will pass the thin wire loop through the surface of your cervix to remove the abnormal cells. Sometimes, your doctor may need to do it a second time.
  • Your cervix will be cauterized to stop any bleeding.
  • Your doctor will place a special solution on your cervix. This will prevent any further bleeding.
  • The equipment will be removed. You’ll be helped into a comfortable resting position. We will ask you to rest for 10 to 15 minutes.

After Your Procedure

Before you leave, your nurse will explain how to care for yourself at home. Here are some guidelines to follow:

  • Rest for the rest of the day after your procedure. You can go back to work or school 1 or 2 days after your procedure.
  • Take acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) if you have any discomfort.
  • You can shower as usual, but don’t take a bath until your doctor says it’s okay.
  • Don’t place anything inside your vagina (such as tampons or douches) or have vaginal intercourse for at least 4 weeks after your procedure. It usually takes about this long for your cervix to heal. During your follow-up appointment, your doctor will examine you and see if your cervix has healed.
  • You may notice a brown discharge for 1 to 2 days after your procedure. This is from the solution put on your cervix after your procedure. You can use a sanitary pad for vaginal discharge.
  • You may also have vaginal bleeding that looks like menstrual flow for 1 to 4 days after your procedure. You may notice more vaginal bleeding 10 to 12 days later as you’re healing. The amount of discharge and bleeding varies for every woman. Use sanitary pads for vaginal bleeding.
  • Don’t do any strenuous activity (such as running or aerobics) for 1 week after your procedure.
  • You may have a late or heavy period after your procedure. This is normal.

If you don’t already have a follow-up exam scheduled, call your doctor’s office to set up an appointment for 4 weeks after your procedure.

Call Your Doctor or Nurse if You Have:

  • A fever of 101° F (38.3° C) or higher
  • Chills
  • Blood clots or heavy vaginal bleeding (needing to change your sanitary pad every 1 to 2 hours) that isn’t because of your period
  • Pain that doesn’t get better after taking medication
  • Any unexpected or unexplained problems

 

Colposcopy

1. What’s a colposcopy and why do I need one?

A colposcopy is used to find cancerous cells or abnormal cells that can become cancerous in the cervix, vagina, or vulva. These abnormal cells are sometimes called “precancerous tissue.” A colposcopy also looks for other health conditions, such as genital warts or noncancerous growths called polyps. A special instrument called a colposcope gives your doctor a lighted, highly magnified view of the tissues that make up your cervix, vagina, and vulva. The colposcope is placed close to the body, but it does not enter the body.

  1. How is a colposcopy different than a pap test?

A pap test, also called a pap smear, involves gathering a sample of cells from your cervix and testing them for early changes that can lead to cervical cancer. If your pap test showed some abnormal cells and you tested positive for HPV, a colposcopy can help confirm and diagnose potential problems. HPV, or human papillomavirus, is a virus that may raise your risk for certain types of cancer, including cervical, vaginal, and vulvar cancers. Your doctor may also recommend a colposcopy if you have symptoms or signs of cervical, vaginal, or vulvar cancer.

  1. What happens during a colposcopy?

A colposcopy can be done in the office of your primary care doctor or your gynecologist. After lying down on the exam table, you’ll place your heels in the stirrups at the end of the table. An instrument called a speculum will be inserted inside your vagina to open it up and give your doctor a clearer view of your cervix. Your cervix, vagina, and vulva will be lightly wiped with a vinegar or iodine solution that helps your doctor better see abnormal areas. The colposcope is positioned between your legs as close to your vagina as possible, but it never goes inside your body.

  1. What happens if my doctor sees an abnormal area during the colposcopy?

During the colposcopy, your doctor may perform a biopsy on areas that look unhealthy. A biopsy is the removal of a small amount of tissue for examination by a pathologist. A pathologist can identify abnormal cells by looking at the tissue sample under a microscope. While a colposcopy can suggest that you have cancer or precancerous tissue, only a biopsy can actually make a diagnosis. If an abnormal area is small, your doctor may be able to remove all of it during the biopsy.

The type of biopsy you’ll have will depend on the location of the tissue being biopsied. For example, 1 common biopsy method of cervical tissue uses an instrument to pinch off small pieces of suspicious areas. The doctor may also do an endocervical curettage biopsy to check an area inside the opening of the cervix that can’t be seen during a colposcopy. You may feel pinching or discomfort similar to menstrual cramps during some biopsy types. Sometimes a local anesthetic is used to numb the area before the biopsy. Ask your doctor about the different types of biopsies that could potentially be done during your colposcopy.

  1. What should I do before a colposcopy?

Your doctor may suggest that, for 24 to 48 hours before a colposcopy, you stop using vaginal medicines, creams, powders, or foams. During this period, you should also stop having vaginal sex, using tampons, or placing any other products in your vagina. Don’t schedule a colposcopy during the week of your period, and be sure to let your doctor know if you’re pregnant or might be pregnant before your appointment. You may also want ask your doctor if you should take an over-the-counter pain medication before the examination in case you have a biopsy.

  1. Will I have any side effects from the colposcopy?

There are no direct side effects that a colposcopy will cause. However, if you have a biopsy during a colposcopy, then you could have a dark vaginal discharge for a few days. This comes from the solution doctors use to reduce bleeding that can happen with a biopsy. You may also have some bleeding, cramping, or soreness. If these or other symptoms get worse or don’t go away, or you have extremely heavy bleeding, severe pain in your lower abdomen or pelvis, or a fever after the examination, call your doctor immediately. Like before the colposcopy, don’t have vaginal sex or use any type of products or medications that go inside the vagina until your doctor says it’s OK.

  1. What happens when the biopsy results come back?

If a biopsy taken during your colposcopy shows that you have precancerous tissue, the tissue may need to be removed to keep cancer from developing. Your doctor will explain the different removal methods that may be right for you. If the biopsy shows that cancer is present, you may need to have more tests before you begin treatment. Your doctor will likely refer you to a gynecologic oncologist, who specializes in treating gynecologic cancer. During treatment for any precancerous tissue or cancer, you may have additional colposcopies to see how well a treatment is working and to look for additional abnormal changes over time.

LEEP Procedure

Leeps Procedure performed by Dr. Stephens

This information explains what to expect during and after your loop electrosurgical excision procedure (LEEP).

A LEEP is a procedure to remove abnormal tissue from your cervix (the bottom part of your uterus, located at the top of your vagina). It may be done to confirm a cancer diagnosis or treat precancerous conditions of your cervix. During a LEEP, a thin wire loop is used to excise (cut out) abnormal tissue. Your cervix is then cauterized (burned) to stop any bleeding. The area usually heals in 4 to 6 weeks.

The procedure will take about 10 minutes. You’ll be in the procedure room for about 30 minutes. You’ll have little or no discomfort from the procedure.

Before Your Procedure

  • Don’t take aspirin or any medications that contain aspirin for 7 days before your procedure.
  • Eat and drink as you normally would. You won’t need to change your diet the day of your procedure.
  • Schedule your procedure for 1 week after your period. This will help your doctor know the difference between vaginal bleeding caused by your procedure and vaginal bleeding during your period.
  • If you think you may be pregnant, tell your doctor.

Call your doctor if you have any of the following symptoms 2 to 3 days before your procedure:

  • A fever of 101° F (38.3° C) or higher
  • Chills (feeling cold and shivering)
  • Abnormal vaginal bleeding

During Your Procedure

  • If you’re between the ages of 11 and 50, your doctor will ask you to take a urine (pee) pregnancy test before your procedure.
  • You’ll meet with a nurse and patient care technician. They will show you the LEEP equipment.
  • Your doctor will talk to you about the procedure, answer your questions, and ask you to sign a consent form.
  • The nurse or technician will help you get into position for the procedure. You’ll be in the same position that you would be in for a regular pelvic exam. Since the procedure uses electricity, a grounding pad will be placed on your thigh. This is used to keep you from getting shocked and to protect you from getting hurt.
  • Your doctor will numb your cervix by injecting it with a numbing medication called lidocaine. You may feel some pressure and slight burning as it’s injected. The medication may also make your heart beat a little faster.
  • Your doctor will turn on the LEEP equipment. The equipment makes a loud noise that sounds like a vacuum.
  • Once your cervix is numb, your doctor will pass the thin wire loop through the surface of your cervix to remove the abnormal cells. Sometimes, your doctor may need to do it a second time.
  • Your cervix will be cauterized to stop any bleeding.
  • Your doctor will place a special solution on your cervix. This will prevent any further bleeding.
  • The equipment will be removed. You’ll be helped into a comfortable resting position. We will ask you to rest for 10 to 15 minutes.

After Your Procedure

Before you leave, your nurse will explain how to care for yourself at home. Here are some guidelines to follow:

  • Rest for the rest of the day after your procedure. You can go back to work or school 1 or 2 days after your procedure.
  • Take acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) if you have any discomfort.
  • You can shower as usual, but don’t take a bath until your doctor says it’s okay.
  • Don’t place anything inside your vagina (such as tampons or douches) or have vaginal intercourse for at least 4 weeks after your procedure. It usually takes about this long for your cervix to heal. During your follow-up appointment, your doctor will examine you and see if your cervix has healed.
  • You may notice a brown discharge for 1 to 2 days after your procedure. This is from the solution put on your cervix after your procedure. You can use a sanitary pad for vaginal discharge.
  • You may also have vaginal bleeding that looks like menstrual flow for 1 to 4 days after your procedure. You may notice more vaginal bleeding 10 to 12 days later as you’re healing. The amount of discharge and bleeding varies for every woman. Use sanitary pads for vaginal bleeding.
  • Don’t do any strenuous activity (such as running or aerobics) for 1 week after your procedure.
  • You may have a late or heavy period after your procedure. This is normal.

If you don’t already have a follow-up exam scheduled, call your doctor’s office to set up an appointment for 4 weeks after your procedure.

Call Your Doctor or Nurse if You Have:

  • A fever of 101° F (38.3° C) or higher
  • Chills
  • Blood clots or heavy vaginal bleeding (needing to change your sanitary pad every 1 to 2 hours) that isn’t because of your period
  • Pain that doesn’t get better after taking medication
  • Any unexpected or unexplained problems
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Mammogram and Dexa

Coming Soon!

Susan S. Westerlund, M.D.
Richard E. Stephens, Jr., M.D.
Gynecology, Women’s Health and Wellness

860 Brookstone Centre Parkway,
Columbus, GA 31904
706-507-4243 706-507-4224
Hours of Operation 7am-5pm Monday through Thursday
7am-12pm on Friday
Closed Saturday and Sunday

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