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Good prenatal and obstetrical care is the single most important thing you can do foryourself and your baby. Talk to your doctor or midwife about your desire to become pregnant or, if you are already pregnant, about the many changes you are experiencing and how to deal with them. Mood swings, weight gain, problems sleeping, any changes in food tastes, heartburn, and more, are all normal changes your body may experience while you are pregnant. Maintain good prenatal health and learn how to feel good about yourself, your pregnancy, and your baby.

Please review the Alliance Obstetrical Patient Visit Guidelines below and read the information provided regarding taking medications during your pregnancy. These guidelines may differ depending on your obstetrical or medical condition.  Click the links below to learn more about Prenatal Care.

OB Maternity Virtua Hospital Pre-registration

www.virtuababy.org

www.obfocus.com

OBSTETRICAL PATIENT VISIT GUIDELINES

Weeks Visit Highlights
Weeks Visit Initial OrientationGeneral history and information
NOB Packet – lab testing, risk screening
Resources, Prenatal VitaminsLab:

Blood type, Rh, Hepatitis, HIV,
Syphilis, Rubella, Cystic Fibrosis
Screening and other screening tests.
Visits will be scheduled as follows:

 

0-28 wks
28-35 wks
36 + wks
every 4 weeks
every 2 weeks
weekly till delivery
10 – 12 weeks OB Complete physical exam – including
PAP smear as indicated
Hear fetal heartbeat
Sonogram for dates
First Trimester screening option
Sequential screening

Risk factors discussed – follow–up plan implemented
15 – 20 weeks OB tummy check
Quad Screen
Schedule fatal anatomy ultrasound@ 18 wks
20 weeks OB tummy check
Review sonogram and test results
Send in hospital admission forms
24 weeks OB tummy check
Last trimester information
Preterm birth prevention
Discuss Pediatrician list
Prenatal classes/Hospital tour
28 weeks OB tummy check
Glucose test for gestational diabetes
Hemoglobin test for anemia
3rd trimester HIV test
Antibody screen if Rh negative
Fetal movement
RHOGAM if Rh negative
30 – 34 weeks OB tummy check
Discuss contraceptive methods and birth control options
Fetal movement counting
Preterm labor signs
Meet the doctors
36 weeks OB tummy check
Culture for Group B Strep (GBS)
Internal pelvic exam
Discuss Labor and delivery
37- 41 weeks Weekly OB tummy check
Discuss induction

 

MEDICATIONS DURING PREGNANCY

During your pregnancy, we encourage you NOT to drink alcohol or take any medications other than those that are necessary. Most often, small problems may be relieved with rest and relaxation and/or adjustments to our diet.

It is recommended that you consult with us before taking any medications and we request that you contact us beforehand. There are a few medications, however, that we feel are safe to use with discretion.

FOR INDIGESTION, HEARTBURN and GAS: Heartburn may be very common during pregnancy. Sometimes it is helpful to try and determine when you experience indigestion. Is it before meals, when you stomach is empty? Is it when you have just finished a large meal? Is it in the evening? Is it in the morning or all of the time? Often this situation is relieved by eating smaller, more frequent meals or avoiding specific irritating foods and having less in your stomach at bedtime. In addition, trying to remain upright for 2-3 hours after eating may be helpful. If these suggestions do not relieve your symptoms, the use of antacids is generally thought to be safe during pregnancy. Calcium carbonate (TUMS® and others) is probably the safest antacid, since the baby and mother both need calcium to develop properly and maintain health. We suggest you discuss this problem and the best method or antacid that would be helpful. To relieve your symptoms, you may try; TUMS®, MYLANTA® Tablets or Liquid, ROLAIDS®, MAALOX®, GAS-X®, TAGAMENT®, ZANTAC®, RIOPAN or MYLANTA® (safe to use for the first 12 weeks).

DO NOT USE PEPTO-BISMOL® as this contains Aspirin.

If there is an increasing problem with heartburn or regurgitation after meals, GAVISCON® liquid or tablets may be quite helpful for these symptoms.

FOR NAUSEA OR “MORNING SICKNESS”: Again, we suggest that you consider your diet and the time of day that you eat your meals. During pregnancy, it is thought that there may be an increase in gastric stomach secretions, and perhaps a cracker or piece of toast before getting out of bed may be helpful. You might also try eating smaller, more frequent meals and try never to skip meals. EMETROL®, an over-the-counter product, is acceptable to use any time during pregnancy for nausea or morning sickness. If none of these remedies seem to help, the doctor maybe prescribes Vitamin B6.

FOR DIARRHEA: A clear liquid diet for 24 hours is recommended followed by a soft, bland diet over the next 24-48 hours. The BRAT Diet (i.e., bananas, rice, applesauce, and toast as well as crackers or oatmeal) may be helpful. If dehydration and/or fever develop, please contact us or your family doctor for evaluation of possible viral gastroenteritis. KAOPECTATE ® is acceptable and may be used as directed and IMMODIUM® (one dose is acceptable). If it persists, please notify the office.

FOR NAUSEA and VOMTING: For vomiting, due specifically to an intestinal flue or GI irritation, it is recommended to take a clear liquid diet for 24-36 hours. Basically any liquid that you can see through would be considered a clear liquid. Patients may then proceed to crackers, applesauce, bananas, and toast. Patients are recommended to avoid any milk products for at least 48 hours and then eat a soft bland diet for an additional 24 hours until the cramping has ceased. If you cannot keep anything down for more than 48 hours, please call us or your family physician. To summary, eat small frequents meals, drink Ginger Ale or 7-Up® soft drinks, broth or bouillon, sweet fruit syrup from canned fruits (i.e., pears, peaches, etc.) hot tea (with lemon or sugar), eat Jell-O® gelatin. An addition, Vitamin B6 or Sea Bands (form of acupuncture on wrists) may be beneficial.
DO NOT USE: Sweet ‘N Low

FOR PAIN: Regular or extra-strength TYLENOL® (acetaminophen) is certainly safe and acceptable for all types of pain during pregnancy.

DO NOT USE Aspirin®, Motrin®, Advil® or Aleve® products.

FOR DENTAL WORK: Local anesthesia (i.e. LIDOCAINE® or NOVACAINE®), is always acceptable during pregnancy unless you are allergic to these drugs. X-rays should be avoided until after pregnancy.

FOR CONSTIPATION: There are many reasons or causes for constipation during pregnancy. Sometimes, it is due to the iron in your vitamins, the increasing size of your uterus, the lack of bulk or roughage and/or the lack of enough fluids in your diet. Try to increase the bulk and roughage in your diet with bran cereal, whole wheat crackers, wheat bread, leafy green vegetables, fresh and/or dried fruit. If these suggestions do not seem to improve the situation, as Stool Softeners, you may take METAMUCIL®, FIBERMED®, COLACE®. As mild laxatives, you may use SENOKOT®, PERI-COLACE®, or DOXIDAN®.

FOR HEMORRHOIDS: Usually when there is a problem with bowel eliminations, hemorrhoids develop. Hemorrhoids are enlarged veins at the rectal opening. Usually burning, itching, and irritation occur with hemorrhoids. The treatment for this problem is keeping bowel movements soft and regular, avoid straining and also avoid standing for long periods of time. You may try taking warm tub baths two to three times a day using WHICH HAZEL, TUCKS®, ANUSOL® suppositories, or PREPARATIOIN H® after bowel movements. This will relieve the swelling and itching. Should you have significant rectal bleeding, please let us know.

FOR HEADACHES: As you know, headaches may be caused by a number of reasons such as stress, being overworked or overtired, or changes in hormonal levels occurring during pregnancy. Be sure to get enough sleep and take a break during daily activities. You may use either regular or extra-strength TYLENOL® (acetaminophen) for something light to eat may also be helpful. You should call the office if you have persistent, severe headaches that do not go away with TYLENOL® or, if your headache cause you problems with your vision, such as spots in front of your eyes.

FOR COLDS, CONGESTION OR FLU: Although it is not always possible to avoid this situation, it may be helpful to drink fluids, and get plenty of rest. Most decongestants and antihistamines like CHLORTRIMETON® and SUDAFED® (pseudo-ephedrine) have been found to be safe and effective during pregnancy. (if you have a history of increased blood pressure and have pregnancy induced hypertension, consult with our physician before taking these products). After the third month, DAMETAPP®, ORNADE®, ACTIFED®, BENADRYL®, and almost all over-the-counter antihistamines/decongestant products are considered safe and effective. For a “stuffy nose”, OCEAN NASAL MIST® nasal spray, or NASAL, is safe throughout pregnancy. For a cough, we suggest any over-the-counter cough syrup with minimal amounts of alcohol, such as CONTACT® COUGH SYRUP. If you are less than three (3) months pregnancy, contact your doctor first before using ROBITUSSIN® (no more than 4% alcohol). For a sore throat, you may use CHLORASEPTIC® or CEPACOL® gargle or lozenges. SUCRETS® and TYLENOL® may also be helpful. These products should only be used for a short time. If the cough or cold persists, please consult your physician. Should your temperature rise above 101ͦ , you should either consult your family physician or contact us so we may suggest further treatment as necessary. Other comfort measures such as using a humidifier to relieve congestion, and/or gargling with warm salt water for a sore throat may help as well.

MUSCLE CRAMPS: If you are having muscle cramps, particularly at night, you may need to increase our intake of calcium per day. Any over-the-counter calcium product is acceptable or you may need to increase your milk or milk0containing foods in your diet. If these muscle aches and pains are secondary to over-exertion or muscle strain, warm, moist soaks may be helpful.

VAGINAL DISCHARGE: An increase in vaginal discharge may be normal in pregnancy. This happens because of the increased hormones in your blood when you are pregnant. Common relief measures can include wearing cotton panties – not nylon. Avoid wearing tight, constricting clothing and always remember to wipe from front to back after using the toilet. You should avoid douching and the use of perfumed products like vaginal deodorants. Call the office if your discharge has a foul odor, if you feel itching or burning, or if your discharge is discolored (brown or green).

If you suspect that your partner has an infection or he is experiencing a discharge, please call the office. If you notice any sores around the opening of your vagina, you need to call the office as well.

If you have any questions about medications you may have taken or need to take during this pregnancy, please do not hesitate to consult with us.

Offering you complete, comprehensive gynecology and obstetric care for every stage in life is our goal at Alliance Obstetrics and Gynecology Associates. We schedule appointments from 8:45 a.m. to 4:45 p.m., Monday through Friday, but are also available to you 24-hours-a-day for emergencies.

In addition to routine gynecology and obstetric care, our experienced and dedicated OBGYN physicians and staff also specialize in the most current methods of diagnosis and in-clinic treatment of a wide range of women’s health issues including:

  • Well Woman Exam
  • Ultrasounds
  • Fertility Services & IVF
  • Pregnancy & Prenatal Care
  • Endometriosis Treatment
  • Birth Control Consultations
  • Tubal Sterilization
  • Osteoporosis Treatment
  • Menopause
  • Hysterectomy Procedures
  • Incontinence Treatments
  • Treatment for Heavy Periods
  • Pelvic Reconstruction
  • And more

We also offer complete infertility services from initial evaluation through reproductive surgery and in-vitro fertilization. We address infertility issues with a mind-body approach with the assistance of our certified specialist. We assist couples experiencing these issues to better physically and emotionally handle the stresses involved. To learn more about stress and its effect on fertility.

We have access to the latest technology at our OBGYN clinic including:

  • cystometrics for the evaluation of urine leakage
  • sonography for the evaluation of the reproductive tract in infertility and obstetrics
  • laser and LEEP therapy for abnormal Pap smears
  • bone densitometry for the evaluation of osteoporosis
  • all types of infertility treatments including IVF surgical therapies
  • all types of gynecologic surgeries including laser laparoscopy, hysteroscopy, tubal reversals, hysterectomies and bladder suspensions.

We Look Forward to Caring for You at One of Our OBGYN clinics. Click here for office locations, phone numbers and directions.

Prescription Refills

Please call your pharmacy if you need a routine prescription refill. If you need a new prescription or need to change your pharmacy information, please call during office hours when the physician and nurse will have access to your chart to ensure the best course of treatment. Please have the phone number of your pharmacy available when you call.

Ready to  Get Started?  Click here to Schedule your Appointment.

The physicians of Alliance OB/GYN are specialists in minimally invasive and robotic surgery.  Physicians are usually successful at treating a variety of gynecologic conditions – particularly those affecting the uterus – with surgery. In spite of growing demand for minimally invasive procedures, the majority of these operations are still performed using large, abdominal incisions. These surgeries typically result in significant blood loss, and may mean several days in the hospital followed by weeks of recovery time.

Today, a less invasive surgical treatment option is available. If your doctor recommends surgery for your condition, you may be a candidate for one of three new, minimally invasive procedures – da Vinci®Hysterectomy, da Vinci® Myomectomy and da Vinci®Sacrocolpopexy.

These procedures use the state-of-the-art da Vinci® Surgical System, designed to help your surgeon perform a more precise, less invasive procedure. For most patients, minimally invasive procedures performed with the da Vinci® Surgical System can offer numerous potential benefits over traditional surgery, including:

  • Shorter hospital stay
  • Less pain and scarring
  • Less risk of infection
  • Less blood loss and fewer transfusions
  • Faster recovery
  • Quicker return to normal activities.

Hysterectomy

A wide variety of conditions affect the uterus, or womb. The uterus is a hollow, muscular organ which holds and feeds a fertilized egg. Traditionally, many conditions affecting the uterus are treated with hysterectomy – the surgical removal of the uterus. U.S. doctors perform about 600,000 hysterectomies every year, making it the second most common surgical procedure.

Hysterectomy may offer a life-saving treatment for serious conditions such as cancer or uncontrollable bleeding. In most cases, however, hysterectomy is an elective procedure performed to relieve chronic pain, bleeding or other disabling conditions. These may be caused by fibroids (noncancerous tumors); endometriosis (non-cancerous growth of the uterine lining) or prolapse (falling or slipping of the uterus).

Hysterectomy can sometimes be performed through the vagina. However, when the uterus is enlarged – for example, from fibroids or cancer – an abdominal hysterectomy is preferable. This requires a 6-12 inch incision. In some cases, doctors also remove the ovaries because they are thought to release hormones contributing to the condition.

While hysterectomy is relatively safe, it may not be appropriate or necessary for all individuals or conditions. Alternative treatments that can preserve the uterus and ovaries may be available. Always ask your doctor about all treatment options, as well as the risks and benefits.

da Vinci® Hysterectomy

If your doctor recommends a hysterectomy, you may be a candidate for a new, less invasive surgical procedure called da Vinci® Hysterectomy. This procedure uses a state-of-the-art surgical system designed to help your surgeon perform a more precise, minimally invasive procedure.

In some cases, surgeons may be able to offer a uterine-preserving procedure as an alternative to hysterectomy. These include myomectomy or sacrocolpopexy, which can also be performed using the da Vinci® Surgical System in a minimally invasive approach.

Uterine Fibroids

A uterine fibroid is a common type of benign (non-cancerous) tumor that develops within the uterine wall. Uterine fibroids occur in up to one third of all women and are the leading reason for hysterectomy (removal of the uterus) in the United States. One in five women older than 35 years has a uterine fibroid. An estimated 600,000 hysterectomies are performed in the United States annually, and at least one third are for fibroids.

Uterine fibroids may grow as a single tumor or in clusters. They often increase in size and frequency with age, but then revert in size after menopause. While not all women with fibroids experience symptoms, some experience excessive menstrual bleeding, pelvic pain and infertility.

Myomectomy

A common alternative to hysterectomy is myomectomy – or surgical removal of uterine fibroids. This procedure preserves the uterus, and may be recommended for women who with to become pregnant. About 65,000 myomectomies are performed annually in the United States.

Myomectomy is often performed through a large abdominal incision. After removing each fibroid, the surgeon carefully repairs the uterus, to minimize potential bleeding, infection and scarring. Proper repair of the uterus is critical to reducing the risk of uterine rupture during pregnancy.

da Vinci® Myomectomy: A Less Invasive Surgical Procedure

If your doctor recommends surgical treatment, you may be a candidate for a new, less invasive surgical procedure called da Vinci® Myomectomy. This procedure uses a state-of-the-art surgical system designed to help your surgeon perform a more precise, minimally invasive procedure designed to preserve the uterus. For most women, da Vinci® Myomectomy offers numerous potential benefits over traditional surgical approaches, including:

  • Shorter hospital stay
  • Less pain and scarring
  • Less risk of wound infection
  • Less blood loss and fewer transfusions
  • Faster recovery
  • Quicker return to normal activities
  • Uterine preservation

As with any surgery, these benefits cannot be guaranteed, as surgery is patient- and procedure-specific.

To learn more about da Vinci® Myomectomy, talk with your doctor.

da Vinci® Sacrocolpopexy for Uterine or Vaginal Vault Prolapse

The Condition:

120,000+ cases of uterine and vaginal vault prolapse are surgically treated each year in the U.S. Prolapse (or falling) of any pelvic floor organ (vagina, uterus, bladder or rectum) occurs when the connective tissues or muscles within the body cavity are weak and unable to hold the pelvis in its natural orientation.

The weakening of connective tissues accelerates with age, after child birth, with weight gain and strenuous physical labor. Women experiencing pelvic organ prolapse typically have problems with urinary incontinence, vaginal ulceration, sexual dysfunction and/or having a bowel movement.

The Treatment:

Sacrocolpopexy is a procedure to surgically correct vaginal vault prolapse where mesh is used to hold the vagina in the correct anatomical position. This procedure can also be performed following a hysterectomy to treat uterine prolapse to provide long-term support of the vagina.

Sacrocolpopexy has traditionally been performed as an open surgery. A 15-30cm horizontal incision is made in the lower abdomen in order to manually access the inter-abdominal organs, including the uterus.

da Vinci® Sacrocolpopexy

If your doctor recommends sacrocolpopexy, you may be a candidate for a new surgical procedure called da Vinci® Sacrocolpopexy. This procedure uses a state-of-the-art surgical system designed to help your surgeon perform a minimally invasive surgery through small incisions.

For most women, da Vinci® Sacrocolpopexy offers numerous potential benefits over a traditional open approach:

  • Significantly less pain
  • Less blood loss and need for transfusions
  • Less risk of infection
  • Less scarring
  • Shorter hospital stay
  • Shorter recovery time
  • Quicker return to normal activities

As with any surgery, these benefits cannot be guaranteed, as surgery is patient- and procedure- specific.

Ready to  Get Started?  Click here to Schedule your Appointment.

Patient testimonies and video:

www.orlive.com/davinci/videos/da-vinci-hysterectomy
www.davincisurgery.com
www.hystersisters.com

The care of the patients is a priority for the doctors and staff at Alliance ObGyn Consultants.  Follow the instructions provided by your physician will ensure you receive the optimal results from your procedure. Please use the links below to review general Pre-Operation and Post Operation Instructions.

Uterine fibroids (leiomyomata) are non-cancerous growths that develop in or just outside a woman’s uterus (womb). Uterine fibroids develop from normal uterus muscle cells that start growing abnormally. As the cells grow, they form a benign tumor.

Who Gets Uterine Fibroids?

Uterine fibroids are extremely common. In fact, many women have uterine fibroids at some point in life. Uterine fibroids in most women are usually too small to cause any problems, or even be noticed.

No one knows what causes uterine fibroids, but their growth seems to depend on estrogen, the female hormone. Uterine fibroids don’t develop until after puberty, and usually after age 30. Uterine fibroids shrink or disappear after menopause, when estrogen levels fall.

African-American women tend to get uterine fibroids two to three times as often as white women, and also tend to have more symptoms from uterine fibroids.

Other factors may influence development of uterine fibroids:

  • Pregnancy: Women who have had children are less likely to get fibroids
  • Early menstruation: Women whose first period was before age 10 are more likely to have uterine fibroids
  • Women taking birth control pills are less likely to develop significant uterine fibroids
  • Family history: Women whose mothers and sisters have uterine fibroids are more likely to have them, too.

Types of Uterine Fibroids

All uterine fibroids are similar in their makeup: all are made of abnormal uterus muscle cells growing in a tight bundle or mass.

Uterine fibroids are sometimes classified by where they grow in the uterus:

  • Myometrial (intramural) fibroids are in the muscular wall of the uterus.
  • Submucosal fibroids grow just under the interior surface of the uterus, and may protrude into the uterus.
  • Subserosal fibroids grow on the outside wall of the uterus.
  • Pedunculated fibroids usually grow outside of the uterus, attached to the uterus by a base or stalk.

Uterine fibroids can range in size, from microscopic to several inches across and weighing tens of pounds.

Symptoms of Uterine Fibroids

Most often, uterine fibroids cause no symptoms at all — so most women don’t realize they have them. When women do experience symptoms from uterine fibroids, they can include:

  • Prolonged menstrual periods (7 days or longer)
  • Heavy bleeding during periods
  • Bloating or fullness in the belly or pelvis
  • Pain in the lower belly or pelvis
  • Constipation

Some experts believe that some uterine fibroids can occasionally interfere with fertility and pregnancy. Rarely, a uterine fibroid projecting into the uterus might either block an embryo from implanting there, or cause problems with the pregnancy later.

Diagnosis of Uterine Fibroids

Moderate and large-sized uterine fibroids are often felt by a doctor during a manual pelvic examination. Imaging tests are often done to confirm the presence of uterine fibroids.

Ultrasound

An ultrasound probe is inserted into the vagina or over the pelvis on the abdomen, and high-frequency sound waves reflect off the uterus and pelvic structures. The uterus and any uterine fibroids are displayed on a video screen.

Magnetic resonance imaging (pelvic MRI)

An MRI scanner uses a high-powered magnet and a computer to create highly detailed images of the uterus and other pelvic structures. Pelvic MRI can confirm the presence of uterine fibroids, if the diagnosis is unclear.

Uterine biopsy

Occasionally, a doctor may be concerned that a mass in the uterus is cancer, not a uterine fibroid. A small piece of tissue (biopsy) taken from the uterus can usually tell a fibroid from cancer. A uterine biopsy may be done through the vagina, or may require surgery

Hysterosalpingogram

Dye is injected into the uterus through the vagina and cervix, and X-ray films show an outline of the uterus and fallopian tubes. Hysterosalpingogram is usually done in women with uterine fibroids who are trying to become pregnant.

Sonohysterogram

A water solution is injected into the uterus through the vagina and cervix, and an ultrasound is then done. Sonohysterogram may show uterine fibroids or other growths not visible on a traditional ultrasound.

Hysteroscopy

A tube with a lighted viewer on its tip (endoscope) is advanced into the uterus, and a video screen shows the uterus interior. Hysteroscopy can detect uterine fibroids projecting into the uterus, but cannot see any part of a fibroid in the uterus wall or outside the uterus.

Not all women will need extensive testing for uterine fibroids. In most women, a pelvic exam and ultrasound are sufficient to make the diagnosis of uterine fibroids.

Treatment of Uterine Fibroids

Most uterine fibroids don’t need any treatment, because they don’t cause symptoms or problems. Uterine fibroids causing problems may be treated with non-surgical or surgical options.

Non-Surgical Treatment Options

Watchful waiting: A minority of fibroids will naturally shrink over time. Most uterine fibroids will either stay the same size or grow, however.

Oral contraceptives (birth control pills): These contain hormones (estrogen, progesterone, or a combination) that can help reduce heavy periods caused by uterine fibroids.

Lupron: This hormone treatment stops menstrual periods and shrinks uterine fibroids. Lupron is usually used as a temporary treatment before surgery.

Intrauterine device (IUD) with levonorgestrel: Mirena is an IUD that releases a hormone that reduces heavy periods.

Pain relievers: Motrin or Aleve can reduce the pain caused by uterine fibroids.

Iron: Heavy periods caused by uterine fibroids can lead to iron-deficient anemia. Iron tablets can help the body replace the blood lost during menstruation.

Surgical Treatment Options

Myomectomy: Surgery to remove uterine fibroids while leaving the uterus in place. Myomectomy is often done for women wishing to have children. New uterine fibroids may grow, requiring a later procedure in up to a third of women after myomectomy.

Hysterectomy: Surgery to remove the entire uterus and all uterine fibroids. Hysterectomy cures uterine fibroids and prevents them from ever returning. Women with symptoms from uterine fibroids who don’t want a future pregnancy often undergo hysterectomy.

Surgeons perform myomectomy and hysterectomy through different techniques. These can determine time in the hospital, healing time, and scarring.

  • Open abdominal surgery: A surgeon makes a 5-inch to 7-inch incision either up and down or side to side across the belly. The fibroids (and/or the uterus) are removed through this incision.
  • Vaginal approach: The surgeon makes a cut in the vagina and removes the uterus through this incision. The incision is closed, leaving no visible scar on the abdominal wall.
  • Laparoscopy: Several small cuts are made in the belly, and a lighted camera and surgical tools are inserted through these incisions. The surgeon operates from outside the body and removes the fibroids or fibroids and uterus, viewing the operation on a video screen.
  • Robot-assisted laparoscopy: This procedure is similar to laparoscopy, but the surgeon controls a sophisticated robotic system of surgical tools from outside the body. Advanced technology allows the surgeon to use natural wrist movements and view the surgery on a three-dimensional screen.
  • A less invasive type of myomectomy uses a hysteroscope — the long, thin lighted tube mentioned above — to enter the uterus through the vagina and cervix. Fibroids can then be removed by a tool inserted through the hysteroscope.

The vaginal approach, laparoscopy, and robot-assisted laparoscopy are minimally invasive procedures or MIPs. MIPs offer certain benefits over the more traditional open surgery approach. In general, an MIP allows for faster recovery, shorter hospital stays, and less pain and scarring than does an open abdominal surgery.

One recent study of hysterectomies showed a higher rate of postoperative infection in patients with open abdominal surgery. And the average length of time in the hospital for patients undergoing an MIP ranged from 1.6 days to 2.2 days compared to 3.7 days for abdominal hysterectomies. With an MIP, women are generally able to resume their normal activity within a much shorter period of time than they are after an open surgery. And the costs associated with an MIP are considerably lower than the costs associated with open surgery. There is also less risk of incisional hernias with an MIP.

Not every woman is a good candidate for a minimally invasive procedure. The presence of scar tissue from previous surgeries, obesity, and health status can all affect whether or not an MIP is advisable. You should talk with your doctor about whether you might be a candidate for an MIP.

Uterine artery embolization (UAE): A procedure that cuts off blood flow to a uterine fibroid, causing it to shrink. UAE is not a surgical procedure. It is a minimally invasive procedure during which a thin tube — catheter — is inserted into an artery in the groin and guided using X-ray cameras to arteries that feed the uterus. Once it’s there, the doctor injects very small particles through the tube. The particles clog the blood vessels that feed the fibroid tumor. That causes them to shrink over time and brings about an improvement in the woman’s symptoms.

Because it is a minimally invasive procedure, some women go home the same day. Most often, an overnight stay in the hospital is required. The procedure can cause cramping and pelvic pain that may last a few days. But typically, women can return to work and their normal activities after about one week.

o   Fibroid Facts

o   Non-Surgical Treatments

o   Surgical Treatments

Urinary incontinence is a common problem.  Many women ignore the symptoms or think they have resolved the problem of incontinence by wearing a pad or adult diaper.  While this gives you protection, it can also irritate your skin and cause urinary tract infections (UTI).

Too many women delay seeking medical care until more severe symptoms arise.  It is important to understand why leakage occurs and how to avoid it.  Behavioral treatment may mean learning simple exercises (known as the Kegal exercise) which often include bladder re-training and pelvic muscle squeezing.

Medications (cream, pills, or patch) are also used to strengthen muscles, replace estrogen, or treat a UTI.  In certain cases, a special device may be required to strengthen the pelvic muscles.  Surgical treatment options are also available.

Tell your doctor if the symptoms of urinary incontinence disrupt your daily life.  In most cases, urinary incontinence can be successfully treated following a complete and thorough exam to determine the cause of the problem.  You and your doctor will discuss the option that is right for you.

Many people have unsightly spider veins and varicose veins that have never known may be a sign of Venous Reflux Disease.  More than 40 million people have venous reflux disease in the US alone- and women are 2x more likely to have the disease than men. In most cases symptoms go undiagnosed for years as many women consider vein treatment as a cosmetic procedure. If you answer yes to any of the symptoms below, schedule your FREE Vein Consultation today.  Our doctors will provide a free examination to find out if you are at risk of venous reflux disease and offer treatment options.

Do you suffer from:

  •  Leg pain associated with Swelling?
  •  Skin marks or discoloration?
  •  Varicose veins?
  •  Leg pain or fatigue?
  •  Restless Legs?

What are Varicose Veins?

Varicose veins are the blue or purplish enlarged veins you typically see bulging out of one’s leg. The word “varicose” is derived from the Latin root word “varix,” which is translated in English as “twisted.” Any vein in your body may become varicose, however, its important to note that this condition or varicose veins exists most often in the legs and feet. Varicose veins occur in the legs and lower extremities because standing and walking increases the pressure in the veins in the lower half of your body.
Is it only a cosmetic concern? For many men and women, varicose veins and spider veins (these are the smaller and more common variation of varicose veins) makes them feel less attractive. However, it’s important to note that for others, varicose veins cause aching pain and discomfort. This condition may lead to serious problems if not treated. Moreover, varicose veins may also serve as an indication that the individual is at a higher risk of other disorders of the circulatory system.
As with many other health related issues, self-help measures work well for prevention; compression stockings and changing certain aspects in one’s lifestyle.

Pregnancy and Varicose Veins

Pregnant women sometimes complain of developing varicose veins. This is true. Pregnancy increases the volume of blood in a woman’s body, however, it decreases the flow of blood from the legs to the pelvis. This change in circulation is designed to support the growing baby, but it can produce an unfortunate side effects such as enlarged veins in the legs. Varicose veins may appear for the first time during pregnancy. It has been observed that the varicose veins may worsen during late pregnancy because the uterus exerts greater pressure on the veins in your legs.

Hemorrhoids and Varicose Veins?

Some are very surprised to learn that hemorrhoids are actually varicose veins located in and around the anus. Moreover, this condition is very common in the United States. By age 50, about half of adults have had to deal with the itching, bleeding and pain that often signal the presence of hemorrhoids.
Hemorrhoids, also known as “piles”, are swollen veins in your anus and rectum. The causes include straining during a bowel movement or the increased pressure during pregnancy.
Effective medications and procedures are readily available to treat hemorrhoids. Fortunately, in many cases hemorrhoids may require only lifestyle changes.

Symptoms

A number of people do not experience any discomfort with varicose veins, however, certain people do. For those that do experience discomfort, below are some of the symptoms

  • Achiness or heavy feeling in one’s legs; burning, throbbing, muscle cramping and swelling in the lower legs.
  • Itching around one or more of your veins in the legs.
  • Skin ulcers near your ankle, which represent a severe form of vascular disease and require immediate attention.

If you have varicose veins, typically prolonged sitting or standing tends to make your legs feel worse. The varicose veins are easy to spot because they are dark purple or blue in color and sometimes appear twisted and bulging. The most common spot they appear is on the inside of the leg or on the backs of calves. But don’t let that fool you, they can form anywhere on your legs, from your groin to your ankle.

Risk Factors that Increase your Chances of Developing Varicose Veins

  • Standing for long periods of time. Blood doesn’t flow as well if you’re in the same position for long periods of time because your muscles are not contracting to push the blood back to the heart.
  • Obesity. Extra weight puts more pressure on your veins.
  • Age. The normal processing of aging causes wear and tear on the valves in your veins which regulate blood flow. The wear and tear may causes the valves to malfunction.
  • Sex. Women have a higher chance than men are to develop varicose veins and spider veins. This is attributed to hormonal changes during pregnancy, and also premenstruation or menopause may be a factor. Some researchers have found that female hormones may
  • Genetics. Check to see whether your family members have varicose veins, heredity plays a big role.

Screening and diagnosis by a Physician

Prior to making a diagnosis, your doctor will most likely examine your legs while you’re standing and will look for swelling. Also, he or she may ask you if you have any of the varicose vein symptoms listed above. As an ancillary test, your doctor may do an ultrasound test to see if the valves in your veins are working normally or if there’s any evidence of a blood clot. Ultimately, it is smart to see a specialist for varicose veins and spider vein treatment.

Ulcers

Painful ulcers may form on the skin near varicose veins, particularly near the ankles. Increased pressure of blood within the affected veins can cause “water logging” which is a cause of the ulcers. Sometimes there is a brownish pigmentation prior to developing the ulcer. It is important to see a physician immediately if you suspect you’ve developed an ulcer

Sudden Swelling of the Leg

If you have considerable swelling in the leg (caused by the enlarging of veins deep within the legs) you must see a doctor immediately. Any sudden leg swelling requires urgent medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.

Varicose Vein Treatment Options

Most physicians will say that hospital stay was thing in the past. Treatment today usually doesn’t mean a hospital stay or a time consuming, uncomfortable recovery. Less invasive techniques are available that can be done fairly quickly.
The use of compression stockings may prove effective for your condition.
Prior to getting treatment for your varicose veins, you should ask a physician about the affects of: compression stockings, exercising, losing weight, not wearing tight clothes, elevating your legs, avoiding long periods of standing or sitting. These are helpful in prevention and slowing the progression of the condition.
If you are pregnant and have varicose veins, please note that varicose veins that develop during pregnancy generally improve without treatment within a few months after delivery. However, it is never a bad idea to ask a specialist.
If you are pregnant and have varicose veins, please note that varicose veins that develop during pregnancy generally improve without treatment within a few months after delivery. However, it is never a bad idea to ask a specialist.
Below are some procedures that your physician may recommend:
Sclerotherapy
This form of treatment is a non-surgical procedure in which a solution is injected into the problem varicose veins or spider veins in order to cause its disappearance.
Endovenous Laser Treatment (EVLT)
EVLT works by heating the inside of the vein, which causes it to seal shut and disappear. This treatment requires that a very thin laser fiber be inserted into the damaged underlying vein.
Radiofrequency Occlusion also known as VNUS
This method treats the vein by heating them, causing the vein to contract and then close.
Laser and Pulsed Light Treatments
This form of vein therapy involves a light beam that is pulsed onto the veins in order to seal them off, causing them to dissolve. Successful light-based treatment requires adequate heating of the veins. Several treatments are usually needed for optimal results.
Ambulatory Phlebectomy
This procedure involves making tiny punctures or incisions through which the varicose veins are removed. The incisions are so small no stitches are required.
Transilluminated Powered Phlebectomy (TIPP)
The TIPP treatment is a minimally invasive procedure for removing varicose veins that is performed using the TriVex® System. Transillumination is a unique feature – much like a flashlight placed under the skin – that allows a surgeon to see, accurately target and remove varicose veins, then visually confirm the extraction.
Vein Ligation
During this type of vein surgery, incisions are made over the problem vein and the vein is tied off. This is done in order to cut off the flow of blood to the varicose vein, which in turn causes it to become less visible.
Vein Stripping
Vein stripping involves tying off of the upper end of a problem vein and then removing the vein.
There are many other varicose vein treatments out there which include laser surgeries, catheter-assisted procedures and endoscopic vein surgeries. Please consult your physician or other medical care provider regarding what type of treatment is best for you.
Please also remember that current treatments for varicose veins and spider veins are highly successful. However, it’s possible that varicose veins can recur.

Prevention

There’s no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce your risk of developing varicose veins or getting additional ones. Traditional, common-sense approaches include:

  • Exercise. Get your legs moving. Walking is a great way to encourage blood circulation in your legs. Your doctor can recommend an appropriate activity level for you.
  • Watch your weight, and your diet. Shedding excess pounds takes unnecessary pressure off your veins. What you eat makes a difference, too. Follow a low-salt, high-fiber diet to prevent the swelling that may result from water retention and constipation.
  • Watch what you wear. Avoid high heels. Low-heeled shoes work calf muscles more, which is better for your veins. Don’t wear tight clothes around your waist, legs or groin. Tight panty-leg girdles, for instance, can restrict circulation.
  • Elevate your legs. To improve venous circulation, take several short breaks daily to elevate your legs above the level of your heart. For example, lie down with your legs resting on three or four pillows.
  • Avoid long periods of sitting or standing. Make a point of changing your position frequently to encourage blood flow. Try to move around at least every 30 minutes.
  • Don’t sit with your legs crossed. This position can aggravate circulation problems.

Alternative Medicine

Some alternative medicine experts have noted that horse chestnut seed extract may be an effective treatment for chronic venous insufficiency; this is a condition associated with varicose veins in which the leg veins have problems returning blood to the heart. The herb may help improve swelling and discomfort caused by varicose veins. Make sure you talk with your doctor before trying horse chestnut seed extract or any other herb or dietary supplement.

Always Be a Cautious Consumer
Before undergoing any procedure, ask your doctor about any health risks and possible side effects. Unless you fit into the coverage criteria (if you have signs or symptoms such as swelling and bleeding), most insurance companies will not reimburse for a cosmetic procedure. However, for more information, click here to read up on the health insurance coverage information. Even though the treatments are not too costly, they can still add up. It may be wise to inquire about treatment costs, as well.

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