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 N. 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
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. 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.
1 AnswerDr. Anthony L. Komaroff, MD , Internal Medicine, answeredEndometritis is a condition characterized by inflammation of the tissue that lines the uterine cavity. This tissue is called the endometrium.
The condition is classified as acute or chronic.
Acute endometritis is often caused by a bacterial infection. It may be part of a general pelvic infection, such as pelvic inflammatory disease.
Some cases of chronic endometritis are due to infection, but the bacteria involved tend to be different from those that cause acute infection. Examples include chlamydia and, much less often, tuberculosis. Other cases are due to inflammation that results when there is a foreign body in the uterine cavity. An example would be an intrauterine device. This form of birth control causes an inflammatory reaction in the uterus. This action probably contributes to its effectiveness as a contraceptive.
Uterine growths such as polyps and fibroids that arise in the endometrium can also cause chronic endometritis.
Chronic endometritis may cause no symptoms or result in irregular uterine bleeding. Pelvic pain may occur, but pain and fever are usually more typical of acute endometritis.
Treatment of chronic endometritis depends on the cause. If there is no identified cause or if the doctor suspects infection, then antibiotics are given. If a growth or foreign body is present, removing it will usually make the symptoms go away.
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 AnswerCarol 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.