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:
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 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:
Things that make you more likely to have complications from tubal ligation include:
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:
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:
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:
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:
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.
A 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:
Who Might Get It
In women, doctors can use a pelvic ultrasound to:
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:
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:
Your doctor will let you know if you need these or other tests.
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
Call your doctor if you have any of the following symptoms 2 to 3 days before your procedure:
During Your Procedure
After Your Procedure
Before you leave, your nurse will explain how to care for yourself at home. Here are some guidelines to follow:
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 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.
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.
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.
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.
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.
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.
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.
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
Call your doctor if you have any of the following symptoms 2 to 3 days before your procedure:
During Your Procedure
After Your Procedure
Before you leave, your nurse will explain how to care for yourself at home. Here are some guidelines to follow:
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:
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