Minimally Invasive Gynecologic Procedures in San Francisco, CA

Endometrial Ablation

Endometrial ablation is usually an office-based, minimally invasive, quick global endometrial ablation to treat the lining of the uterus (endometrium) in women experiencing heavy menstrual periods. Your physician may recommend a procedure when birth control such as pills, Mirena intrauterine device, or another procedure have been ineffective and/or have produced undesirable effects such as weight gain, moodiness, continued bleeding, etc. These procedures are for women who have completed childbearing.

NovaSure®

NovaSure is a safe procedure using radio frequency energy (radio waves) to permanently remove the uterine lining (endometrium). The procedure is performed by your physician, after a diagnostic hysteroscopy. She gently inserts a thin wand, with a mesh array, into the uterus. Once the mesh has conformed to the uterine wall, a radio frequency is generated for about 90 seconds and the wand with the array is then removed. The uterine lining will be shed over the next week to 10 days. Results have included a significant reduction in menstrual bleeding, stopped periods, and reduced pain and cramping. From studies, 94% of women have their heavy bleeding resolved and 70% experience no further periods.

Note: Pregnancy after any form of endometrial ablation is a rare but possible event and the risk of complications is increased. Ablation is not birth control.

Hysteroscopy

Hysteroscopy is an office or hospital based procedure that is used to look inside the uterus. It utilizes a hysterscope, a slender camera telescope-like device, which is inserted through the cervix into the uterus. The procedure is commonly used to:

• diagnose or treat uterine problems associated with abnormal bleeding
• to help with the diagnosis of frequent miscarriages
• to locate an lost or imbedded intrauterine device
• remove adhesions caused by infection or past surgeries
• perform sterilization procedures

Women who are pregnant should not have the procedure.

LEEP

Persistent abnormal pap smears which represent cervical cells or pre-cancer results, an in office procedure is performed which shaves off the tip of the cervix for diagnosis and treatment. Loop Electrical Excision Procedure provides some tissue for the pathologist to definitively check on the type of cells present and to make sure that they are all present in the specimen. The cervix does heal and grow back over the next few months with usually healthy tissue. We will continue to follow you with pap smears periodically to make sure that the cervix is healthy. We will also follow you in pregnancy for the small possibility of preterm labor due to a weakened cervix that occurs in a few patients who have had LEEP.

Dilation and Curettage (D&C)

Abnormal bleeding, especially if the bleeding is heavy, thinning the uterine lining is necessary to stop the source of the blood flow. The cervix may need to be dilated to allow a small instrument in that is used to thin down this lining in the uterus.

Cystoscopy

Like hysteroscopy, a small camera on a thin telescope like want is placed into the bladder to help diagnose bladder pathology.

Pelvic Floor Therapy:

• Physical Therapy
• Electronic Stimulation
• Biofeedback
• Bladder Retraining

A variety of services are available in office to help patients with urinary frequency, urgency, incontinence, or retention.

Other Minimally Invasive Procedures

• Pelvic reconstructive surgery
• Mid-urethral slings
• Prolapse Repair of cystocele and rectoceles
• Risk reducing robotic and laparoscopic bilateral salpingo- oophorectomy for HBOC patients
• Labiaplasty