Gynecology

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• QWhat are possible causes of painful menstrual cycles?

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  A Dr. Darcy N. Bryan, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Riverside Community Hospital

  

  Painful menstrual cycles can be because of a number of reasons. In this video, Darcy Bryan, MD, of Riverside Community Hospital, discusses why a woman might experience pain during her cycle.
• QWhat type of doctor should perform a hysterectomy?

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  A Dr. Hugo D. Ribot, MD , OBGYN (Obstetrics & Gynecology), answered

  Ideally, the type of doctor who should perform a hysterectomy would be not only a gynecologist, but a one with the ability to perform the procedure in a minimally invasive fashion.  
  
  Depending on the patient's medical and surgical history, her diagnosis, and the indications for doing the hysterectomy, the best technique might be a:

  • TVH (total vaginal hysterectomy) where the entire operation is performed through the vagina, without any abdominal incisions
  • TLH (total laparoscopic hysterectomy) where the entire procedure is done using tiny instruments which access the abdominal/pelvic cavity through small "Band-Aid" incisions, and the specimen is delivered through the vagina.

  Using technology and instrumentation that has been available since the early 1990s, a skilled surgeon can accomplish 99% of all their cases without resorting to a large, painful incision in the abdomen (the TAH or total abdominal hysterectomy). Though rare, there are some indications remaining for an abdominal approach to hysterectomy. 
  
  In addition, using various ancillary technical and pharmaceutical modifications, there are only very rare reasons why the vast majority of these hysterectomies cannot be done in a truly outpatient fashion, with the patient safely returning home the very same day as the operation.

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• QHow is a hysterectomy performed?

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  A Dr. Jack P. Ayoub, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Reston Hospital Center

  

  There are various types of hysterectomy surgeries, including those done robotically. Watch this video with Jack Ayoub, MD from Reston Hospital Center to learn about the different surgical options.

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• QWhat is a complete hysterectomy?

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  A Dr. Rodolfo E. Saenz, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Riverside Community Hospital

  

  A complete hysterectomy is the removal of the uterus only. In this video, Rodolfo Saenz, MD, an OB/GYN at Riverside Community Hospital, discusses other types of hysterectomies and what these procedures involve.
• QHow are breast cysts diagnosed?

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  A Johns Hopkins Medicine answered

  Breast cysts are benign (non-cancerous) sacs filled with fluid that occur in the breast. They are more common in younger women.
  If you find a lump in your breast, you should consult with a specialist.
  Your doctor may perform one of the following tests to diagnose a breast cyst and rule out the possibility that the lump is actually cancerous:

  • Clinical breast exam- In this exam, your doctor will feel your breast to check for abnormalities.
  • Mammogram - This is the standard imaging tool your doctor uses to diagnose breast cancer.
  • Ultrasound - This is an imaging tool your doctor uses to detect breast abnormalities.
  • Fine needle aspiration - In this procedure, your doctor will numb the affected area with anesthesia, insert a thin needle and remove the fluid from the cyst.

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• QHow are endometrial polyps treated?

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  A Dr. Anthony L. Komaroff, MD , Internal Medicine, answered

  Endometrial 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.

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• QWhat are the symptoms of uterine prolapse?

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  A Spotsylvania Regional Medical Center answered

  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, 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.
• QWhy do my gums bleed right before my period?

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  A Carol Jahn , Dentist, answered

  Hormonal changes make the gum tissue more sensitive to plaque and this can cause bleeding. The best way to prevent this from happening is to step up your daily oral care routine. Make sure you brush for two minutes and are cleaning in between your teeth every day. If flossing is difficult, there are many other effective, easy to use products available including interproximal brushes, toothpicks, floss aids, and a Water Flosser. The healthier your mouth is, the less likely for the tissue to become sensitive and bleed in response to your hormonal fluctuations.

• QHow is uterine prolapse diagnosed?

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  A Spotsylvania Regional Medical Center answered

  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.

• QWhat are the symptoms of cervical dysplasia?

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  A Dr. 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.

  

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