OB/GYN Surgical Procedures and Treatments
Hysterectomy refers to the surgical removal of the uterus and cervix. Removal of the ovaries and fallopian tubes is a separate procedure (although may be performed at the same time as a hysterectomy) called a bilateral salpingo-oophorectomy (BSO). A supracervical hysterectomy refers to removal of the uterus but not the cervix.
Hysterectomies may be performed through an abdominal incision or through the vagina. It is important to understand that the reproductive hormones (estrogen, progesterone and testosterone) are mainly produced in the ovaries and not in the uterus.
Unless performed for life threatening hemorrhage or cancer, a hysterectomy is considered an elective procedure. Some indications for elective hysterectomy include uterine prolapse, heavy or irregular uterine bleeding, symptomatic uterine fibroids, disabling menstrual cramps, severe endometriosis and pelvic pain unresponsive to medical therapy.
Before embarking on a major surgery it is important to have excluded non-uterine causes for pain, have had appropriate testing and have thoroughly reviewed medical treatments for the particular condition. For example, abnormal uterine bleeding may be treated with medication or with less invasive surgery such as endometrial ablation (where only the uterine lining is removed).
Urogynecology refers to the evaluation and management of urinary incontinence and pelvic prolapse. It is a rapidly growing area of women’s health. Pelvic prolapse occurs when the pelvic organs, uterus, bladder and rectum, become displaced from their normal positions. This may be accompanied by urinary or fecal incontinence. Pelvic prolapse can cause significant discomfort to affected women; fortunately effective treatment is available. There are several procedures, from non-surgical to surgical which can help with pelvic prolapse and urinary incontinence.
Dilation and Curettage
Dilation and curettage (D&C) is a surgical treatment for bleeding disorders involves dilating the opening of the cervix and scraping the lining of the uterus.