If you are finished bearing children, you may choose to have an endometrial ablation after we have diagnosed the cause of your heavy and/or irregular bleeding. An endometrial ablation can be conveniently done in the office with a paracervical block and intravenous sedation. If you are having sedation, you can not have anything to eat or drink from midnight the night before your procedure. You will meet with the anesthesiologist in the office before the procedure. You will then go to sleep before a speculum is placed. I will place an appropriately sized speculum and numb your uterus. I will stabilize your cervix with an instrument and then introduce a camera into the uterus. Then, the ablation will be performed. The entire procedure takes only a few minutes. All instruments are then removed and you will have time to recover before going home. Someone will need to bring you to the office, bring you home and care for you for the remainder of the day.
If you have precancerous cells on your cervix, you may need a LEEP. A LEEP is done for diagnosis and for treatment. It provides the pathologist with a large specimen that hopefully contains all or most of the abnormal cells. A grounding pad will be placed on your leg. Your practitioner will introduce an appropriate size coated speculum and repeat the colposcopy. We will then numb your cervix with lidocaine and use a thin electric wire to remove a circumferential section of your cervix. This will probably cause cramping. Generally, the cramping resolves in a few minutes. A combination of cautery and iron solution are used to stop any bleeding. You should not put anything into your vagina for two weeks following this procedure.
Myomectomy means removing fibroids without removing the uterus. For fibroids within the uterine cavity, this can often be done with a hysteroscope, using the cervix to enter the uterus. A hysteroscopic myomectomy is an outpatient procedure and does not involve any incisions. Fibroids in the body of the uterus can be removed by traditional or minimally invasive methods. Dr. Schapiro is an expert in myomectomies and will be happy to discuss which of these options is best for you. Below is a video of a noninvasive myomectomy. https://youtu.be/sBc9yXZTBKg
Pelvic pain can be debilitating. Let our practitioners evaluate what might be causing your pelvic pain and work with you to come up with a treatment plan. After a thorough investigation, the plan may run the gamut from a change in diet, acupuncture, medication or even surgery. If you are coming in for pelvic pain, please let the scheduler know so that we can put on the ultrasound schedule to make the most of your time with us.