7 AnswersDr. J A. Heit, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Overland Park Regional Medical CenterHysterectomy, or removal of the uterus, can be performed through the vagina (vaginal hysterectomy), abdominally (through a traditional abdominal incision), laparoscopically (small incisions), or with robot-assisted laparoscopy. Hysterectomy can also be performed by combining the above procedures such as laparoscopic-assisted vaginal hysterectomy in which part of the procedure is performed using the laparoscope then completed vaginally. Hysterectomies including the vaginal, laparoscopic or robot-assisted approaches are considered minimally invasive surgeries and are associated with reduced hospital stays and quicker return to normal activities.
The choice of hysterectomy should be individualized to each patient; factors include the type of gynecologic pathology present and if any additional procedures are required. In consultation with the patient, the procedure with the lowest risk of complication and the best outcome is chosen for each individual situation.
3 AnswersDr. Kimberly Crittenden, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Metropolitan Methodist Hospital
1 AnswerDr. Rodolfo E. Saenz, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Riverside Community Hospital
1 AnswerDr. Anthony L. Komaroff, MD , Internal Medicine, answeredEndometrial polyps are growths of the endometrium. This is the tissue that lines the cavity of the uterus.
The polyps range in size from a few millimeters to an inch or more in diameter. We don't know for sure what causes polyps. We do know that the tissue of the endometrium is normally active. It grows each month in response to hormones and then sheds as the menstrual period. Scientists think polyps may form when something interferes with this normal cycle.
Polyps often cause no symptoms. They are found by chance on an ultrasound examination of the uterus. When symptoms occur, abnormal bleeding is the most common. Polyps cause heavy and prolonged menstrual periods. They may also cause irregular bleeding in between periods. Occasionally a polyp causes cramping in the lower abdomen. A small number of polyps, about 1% to 2%, contain precancerous cells or cancer cells.
Some small polyps go away without treatment, but generally surgical removal is recommended. Removing polyps is a way to see if they are cancerous or not (benign). Surgery also treats any associated symptoms.
The surgery is done by inserting a small fiber optic scope (called a hysteroscope) into the uterus. The surgeon finds the polyp and then removes it with a grasping instrument or small wire cautery device.
A dilation and curettage (D&C) is often done to remove any residual abnormal tissue. The surgery is usually done as an outpatient (you don't have to stay overnight in a hospital). Complications from a D&C are uncommon.
The diagnosis of uterine prolapse is often suspected by symptoms suggesting that the uterus has fallen into the vaginal canal. It is confirmed when the doctor performs a pelvic examination. If the prolapse is not initially obvious, the doctor may ask you to stand or strain as if you are having a bowel movement because these maneuvers will make it more noticeable. Although not necessary for diagnosis, tests such as an ultrasound or magnetic resonance imaging (MRI) are sometimes done to determine the severity of the prolapse.
In its milder forms, uterine prolapse may produce no symptoms. As the condition becomes more severe, a woman with uterine prolapse can experience a feeling of pulling or fullness in the pelvic area, low back pain, a sensation that something is coming out of the vagina, or problems during sexual intercourse. Leaking of urine may also occur, as well as problems with passing urine or having a bowel movement. If the uterus extends out of the body through the vagina, it can be painful, especially when walking, and the exposed uterus can develop sores, bleed, produce a discharge, or become infected.
1 AnswerDr. Michael T. Murray, ND , Naturopathic Medicine, answered
Cervical dysplasia does not have any symptoms. It is discovered by a Pap smear. It is the presence of abnormal, but not yet cancerous cells. Cervical cancer, if untreated, can progress to cervical cancer, which also is asymptomatic until the late stages.
1 AnswerDr. David M. Heller, MD , Internal Medicine, answered
PMS can absolutely be prevented. Millions of women have successfully prevented the recurrence and occurrence of PMS symptoms, using natural remedies as simple as diet changes or lifestyle changes (for instance, exercise or stress management) as well as vitamins, minerals, and herbal supplements.
Some might also say that taking birth control or antidepressant drugs is a form of prevention, though because they only mask symptoms and do not address the cause of the problem, I would disagree.
The natural approach to PMS is all about prevention.
2 AnswersDr. Jill Rabin , OBGYN (Obstetrics & Gynecology), answered
Pelvic organ prolapse may have a genetic component; if one or more of your close female family members (mother/aunt) have experienced this, you may be faced with it as well. This should not stop you from reducing your risk however, remember that an ounce of prevention is surely better than a pound of cure.
For starters, beginning Pelvic Floor Muscle Exercises as early as possible is always a good idea. This will keep your muscles which support the bladder, uterus and rectum as toned as possible. Since 95% of the supports of these organs are the muscles of the pelvic floor this makes sense (only 5% is connective tissue which anchors these organs to the muscles, and these muscles to the bony pelvis).
To start, identify these muscles by tightening the vagina (same muscle as when you try and stop your urine flow). Once you've identified this you don't need to actually do these exercises while you're urinating since this is not especially helpful and may lead to bladder infections.
Hold this muscle for a count of 5 (5 'Mississippi), relax to a count of 10 and repeat this 5 times (a 'set'). Try and do up to 10 sets per day, then build to 20. You may notice a difference, especially if you've experienced a bit of prolapse before initiating this program. It takes about 6 weeks to actually notice a difference, so don't be discouraged. Your doctor can also prescribe pelvic floor physical therapy for you; there are even vaginal weights or cones to help motivate you!
Of course, not smoking or quitting smoking is a good idea for so many health reasons (for you and your family); the chronic cough which usually results plays havoc with your pelvic muscles and really stresses and weakens them.
Other good tips include keeping as optimal a weight as possible (this reduces the stress on your pelvic muscles from above-reduced pressure from your abdominal cavitiy), hydrating enough to avoid constipation (pushing stool out also weakens the pelvic floor), and avoiding repetative heavy lifting (same reason as above).