Advanced Gynecology (ob gyn) Colorado Springs Facebook Page Phone: 719-633-8773
Fax: 719-633-1905

OB Gyn Colorado Springs

Advanced Obstetrics and Gynecology
Phone: 719-633-8773

Monday 8:00am - 4:30pm
Tuesday 8:00am - 4:30pm
Wednesday 8:00am - 4:30pm
Thursday 8:00am - 4:30pm
Friday                         8:00am - 4:30pm

Saturday & Sunday

Closed

Ultrasounds, LEEP, Colposcopy 

and other common procedures

Office-based Procedures

InterStim® Therapy

Medtronic Bladder Control and Bowel Control Therapies (Sacral Neuromodulation), delivered by the InterStim® System, work with the sacral nerves located near the tailbone. These nerves control the muscles related to urinary and bowel function. The theory behind Medtronic therapies is that gentle electrical stimulation of the sacral nerves reduce signals to the nervous system which may cause bladder control symptoms or bowel incontinence. Essentially, Medtronic therapies act as a pacemaker for the bladder and bowel, and can be a permanent solution to bladder and bowel issues. You can learn more about InterStim at www.everyday-freedom.com.

Gynecologic and obstetric ultrasounds:

For gynecologic ultrasounds, the uterus, cervix, ovaries, and adnexae (fallopian tubes and tissues next to the uterus) are examined. This method of examining the pelvis can dectect fibroids, enlargement of the uterus or ovaries, ovarian cysts, polycystic ovaries, thickened endometrium (the inner lining of the uterus), or suggest possible endometrial polyps (growths on the inner lining of the uterus that are usually benign). Obstetric ultrasounds are performed in the office as well in the first trimester to confirm that the pregnancy is progressing normally and confirm viability (heart beat). This is also used to confirm that the pregnancy is in the correct place within the uterus and not an ectopic (outside the normal uterine implantation site) pregnancy. Second trimester ultrasounds can be performed in the clinic to measure cervical length when indicated to rule out or screen for preterm labor. We perform third trimester ultrasounds when medically indicated to look at the fluid volume around the baby (a sign of good blood flow through the placenta and umbilical cord), to measure fetal growth/size, or to simply confirm the presentation (e.g., breech versus head down).

Saline-infusion sonohysterography:

This imaging includes an ultrasound wherein a small catheter is introduced through the opening of the cervix into the uterine cavity. The inner cavity of the uterus is then filled with fluid so that the ultrasound images can get a good look at the uterine cavity to see if anything is pushing or protruding into it like a fibroid (benign muscular growth), adhesions (attachments or scarring from one side of the uterus to the other, otherwise known as Asherman’s Syndrome), or polyp (flesh-like growth, usually benign), or to dectect the presence of an abnormal contour of the inner lining of the uterus like in a Mullerian defect (abnormality of the uterus since birth due to things not developing quite right).

Complex urodynamic testing (for urinary incontinence):

Urodynamic testing is done to investigate for causes of urinary symptoms, particularly urinary incontinence or urgency. Through the use of small, pediatric size catheters, the pressures are measured in the bladder to distinguish between the most common causes of urinary incontinence: stress, urge, or overflow. Overflow incontinence is ruled out by doing an in and out catheter after urinating to measure how much remains, otherwise known as a “post-void residual.” This type of incontinence occurs when a woman is unable to empty her bladder fully and as urine collects, it eventually overflows as it passes the maximal capacity of the bladder. Stress incontinence occurs when, with increased abdominal pressures like with cough or sneeze, the bladder leaks urine. Urge incontinence presents itself as sudden urges to go to the bathroom as the bladder spontaneously spasms or contracts giving a sudden need to go and sometimes not making it to the bathroom on time. Each of these causes of urinary incontinence requires distinct treatment options; with urodynamic testing, we can more accurately distinguish the cause and, thus, target treatment most accurately as well.

Colposcopy and LEEP:

When a woman has an abnormal pap, it is often indicated to look in more detail to see if there are visible cellular changes on the cervix that may have caused the abnormality. The first step is colposcopy, wherein the cervix is visualized with a microscope and various solutions are applied to demonstrate where the abnormal areas are for more accurate biopsy. LEEP stands for loop electrosurgical excision procedure. It allows for excision of a portion of the cervix in order to both treat more severe, precancerous abnormalities as well as get a portion of tissue to a pathologist for more thorough diagnostic examination under a microscope to make sure that there is not a more severe diagnosis present.

Endometrial or vulvar biopsy:

Sometimes women experience symptoms that may be concerning for autoimmune/inflammatory disorders of the vulva (the area of skin around the vagina including the labia and perineum) or concerning for cancers of this area or the uterus. If you experience persistent external itching or burning sensation, skin changes, irregular vaginal bleeding (including between periods or after intercourse, aka postcoital bleeding) or bleeding after menopause, these symptoms warrant investigation by your gynecologist and may warrant biopsy. Biopsy is where a sample of tissue is taken, usually under local anesthesia, and is sent to a pathologist for further review and diagnosis using a microscope.

Endometrial cryoablation:

This procedure is used to treat heavy menstrual bleeding by freezing the inner lining of the uterus to essentially remove it. The goal is to minimize continued bleeding, though in some women the bleeding may stop all together. This is considered a minimally-invasive technique that may prevent a woman’s need for hysterectomy (removal of the uterus all together). The procedure should not be done if there is concern or high risk of endometrial cancer (cancer of the inner lining of the uterus).

Pessary fittings:

One treatment for pelvic organ prolapse (when there are bulges from the vagina or perineum behind the vagina) that has nearly zero risk is a pessary. Pessaries are devices made to be placed in the vagina to re-support whatever bulges may be present and may allow for delay or avoidance all together of the need for surgical repair. As every woman is different, fittings of various types of pessaries can be done in our clinic to maximize both comfort and support. Additionally, for women who are unable to manage the pessary at home, we offer in-office pessary management visits at a frequency of every 2-3 months depending on the situation.

Minor surgical procedures:

Some small procedures may be completed in the clinic under local anesthesia. These can include examples like treatments for genital condyloma (warts), removal of skin tags, or dealing with incision issues and closure.

Hospital-based Procedures

InterStim® Therapy

Medtronic Bladder Control and Bowel Control Therapies (Sacral Neuromodulation), delivered by the InterStim® System, work with the sacral nerves located near the tailbone. These nerves control the muscles related to urinary and bowel function. The theory behind Medtronic therapies is that gentle electrical stimulation of the sacral nerves reduce signals to the nervous system which may cause bladder control symptoms or bowel incontinence. Essentially, Medtronic therapies act as a pacemaker for the bladder and bowel, and can be a permanent solution to bladder and bowel issues. You can learn more about InterStim at www.everyday-freedom.com.

Hysterectomy (vaginal, total laparoscopic, supracervical laparoscopic, or abdominal approaches) with or without removal of tubes and ovaries:

Hysterectomy refers to the removal of the uterus and possibly cervix. The potential approaches to the surgery include through the vagina with an incision around the cervix, through laparoscopy (a scope surgery on the abdomen using small incisions and a camera), or an open abdominal surgery. The preferred approaches, if feasible given a specific case, are vaginal or laparoscopic because these allow for a shorter hospital stay and easier recovery. If the tubes and ovaries are also removed, these procedures are called salpingectomy for tubes or oophorectomy for ovaries, or salpingoopherectomy if both are removed. The decision for the latter procedures should be individualized based on discussion with your gynecologist concerning your indications for surgery, age, family history, and willingness to take hormone or estrogen replacement therapy. You can have a hysterectomy and keep your ovaries such that you would continue to produce natural female hormones until the age that you would have otherwise gone through menopause on your own. Please note, if you have Medicare or Medicaid that a special form must be signed at least 30 days before hysterectomy.

Operative laparoscopies (lysis of adhesions, removal of ovarian cysts or tubes/ovaries):

Minimally-invasive surgery is the norm at Advanced Obstetrics and Gynecology, so whenever possible, surgeries on the tubes and ovaries or related structures, including surgical treatment of endometriosis and infertility, are completed through a scope on the abdomen. This approach allows for shorter and possibly no overnight hospital stay as well as less pain and easier recovery postoperatively.

Robotic-assisted laparoscopic surgery:

On the cutting edge of surgical techniques, robot-assisted scope surgeries on the abdomen add to the depth of surgical approaches offered at Advanced Obstetrics and Gynecology. Operating with the assistance of the robot makes more difficult cases possible with a minimally-invasive technique that may have otherwise required an open abdominal procedure.

Endometrial ablation:

This is an outpatient procedure used to treat heavy menstrual bleeding wherein the inner lining of the uterus (the part that sheds with your period each month) is burned or frozen in an effort to remove it. The goal is to minimize continued bleeding, though in some women the bleeding may stop all together. This is considered a minimally-invasive technique that may prevent a woman’s need for hysterectomy (having the uterus removed all together). The procedure should not be done if there is concern or high risk of endometrial cancer (cancer of the inner lining of the uterus).

Tubal sterilization procedures (laparoscopic or hysteroscopic Essure):

When a woman no longer desires childbearing, a permanent procedure may be performed to prevent future pregnancies. One option is by a scope surgery on the abdomen during which the tubes are blocked by clips or burning and has the benefits of being effective immediately. The drawback of this method is slightly higher risk (since the surgery is on your abdomen rather than limited to inside the uterus) and a bit more pain during the recovery period. The hysteroscopic method, called Essure, utilizes a scope inside the uterus to place coils into each tubal opening. The key benefit of this method is the lower risk to abdominal organs and easier recovery; drawbacks include that sometimes it cannot be completed due to limited visibility or anatomic differences and that you must continue a reliable form of contraception for at least 3 months until a radiologic dye study called hysterosalpingogram can be done to confirm that both tubes are blocked. Please note, if you have Medicare or Medicaid that a special form must be signed at least 30 days before these procedures.

Microscopic tubal reanastomosis (reversal of tubal ligation):

Regret is unfortunately one of the leading complications of tubal ligation or sterilization. Fortunately, Advanced Obstetrics and Gynecology can offer potential reversal of tubal ligations in an attempt to restore childbearing capabilities by reattaching the remnants of the tubal segments to restore patency.

Pelvic organ prolapse repair (including vaginal vault suspension) and colpocleisis:

As a woman ages and with the stressors and pressures that her pelvic support goes through over a lifetime, portions of the vagina can begin to bulge down and outward. These bulges, or pelvic organ prolapse, can be treated in a stepwise approach including pelvic floor physical therapy or with pessaries, but treatment often culminates in surgical repair of the prolapse. There are a variety of procedures available to correct these defects or bulges, but the most common approach is through the vagina, leaving no abdominal incisions. Occasionally, additional support is needed beyond your own tissue to achieve a durable repair, so in these cases we may use graft material for additional support. Whenever possible, we prefer to use biologic grafts which will become part of your own tissue. These biologic materials have not been shown to cause the same rate of dramatic complications as the synthetic meshes you may have heard about in the news.

Operative hysteroscopy (removal of adhesions/Asherman’s syndrome, uterine septum, endometrial polyps, or fibroids/leiomyomata):

Problems can also arise within the lining of the uterus that may cause symptoms such as heavier periods or infertility. With advancements in equipment and technique, exploration and removal of these issues can usually be approached through a scope surgery on your uterus. These surgeries typically require no hospital stay and lend themselves to very rapid recovery and minimal pain.

Myomectomy:

Uterine fibroids, or myomas, are a very common ailment for women. They can cause increased menstrual bleeding, pelvic pressure as they enlarge, or even infertility and are a leading cause for hysterectomy in the United States. However, if you wish to retain your uterus or fertility, the fibroids themselves may be able to be removed in a surgery called myomectomy and the uterus reconstructed at the site of removal to treat your symptoms as well.

Tension-free vaginal tape (sling for urinary incontinence):

Two of the leading causes of stress urinary incontinence, urethral hypermobility and intrinsic sphincter deficiency, can be treated by placing a sling underneath the urethra (the muscular tube through which you urinate) to re-support and decrease, or hopefully stop altogether, continued incontinence with laughing, sneezing, coughing, or exercise. If you suffer from this issue, make sure to inquire about potential treatments because remarkable improvement may be possible.