Our gynecologists treat these conditions and more…
Abnormal Pap smear management
Abnormal vaginal bleeding
Chronic pelvic pain
Gynecologic related cancers
Milford Regional’s highly skilled gynecologists offer women comprehensive gynecologic care and perform an array of surgical procedures to diagnose and treat women with gynecologic issues. Depending upon the diagnosis, treatment may involve medication or procedures performed in the physician’s office, while others may require day surgery or inpatient surgery at the Medical Center. In all cases, our gynecologists take great care in the evaluation, diagnosis and best course of treatment for each patient based upon their own unique circumstances.
Some of the more common gynecologic conditions which may involve surgery include:
|Abnormal Pap Smears||Abnormal Vaginal Bleeding|
|Incontinence||Fibroids, Endometriosis, Cancer|
When a woman receives an abnormal Pap smear report, quite often a colposcopy is performed. A colposcopy is a diagnostic procedure conducted with a lighted magnifying tool used to examine the vagina and cervix. A biopsy will be done (removal of a small amount of tissue) to be examined under a microscope. If abnormal cervical cell changes are confirmed and are minor, it may go away on its own or respond to medication. If the cell changes are moderate to severe, your doctor will determine what follow-up you need depending on your age and the diagnostic results. In some cases, more extensive surgery may be indicated, but a common procedure to eliminate abnormal tissue from the cervix is called a loop electrosurgical excision procedure (LEEP). This procedure is an effective and simple way to remove abnormal cells. After the procedure, your doctor will usually suggest that you have a Pap test every six months until you have three normal results, to be sure all of the abnormal cells are gone.
Incontinence is a condition that many women experience, particularly as they age. Stress incontinence involves the leakage of urine when you cough, sneeze or laugh. Urge incontinence refers to the feeling of a full bladder and an urgency to urinate. Often the muscles surrounding the bladder become weak from childbirth, being overweight or from an injury. There are many non-surgical treatments that your doctor may recommend for incontinence including exercising the pelvic floor. If these treatments are unsuccessful, surgery may be indicated. Our urogynecologist and urologists are available to provide the most comprehensive, expert care for our patients with this condition.
Presented by Dr. Samuel Zylstra
Take Back Control! – Incontinence
Taking Back Control
Judith Cook can now enjoy shopping at her leisure,
something she couldn’t do just a few months ago
before her surgery. Read Judith’s story.
There are many possible causes of abnormal vaginal bleeding. If a woman is of child-bearing age, pregnancy is considered and bleeding would indicate a problem. If pregnancy is ruled out, and the bleeding is mild, medication may be prescribed.
Some women with abnormal bleeding may benefit from a treatment called endometrial ablation. This procedure destroys a thin layer of the lining of the uterus and stops or reduces menstrual flow. There are several types of ablation and you and your doctor will determine which treatment is right for you. If endometrial ablation does not control heavy bleeding, further treatment or surgery may be required.
In some cases, the doctor may decide to do a D&C (dilation and curettage) to help diagnose or treat fibroids, endometriosis or chronic pelvic pain. It may also be used to diagnose uterine cancer. Fibroids are non-cancerous, muscular tumors that grow in the wall of the uterus. Endometriosis occurs when the tissue that lines the uterus grows outside the uterus.
If medicine or other less invasive procedures (see above) are not successful in treating fibroids, chronic pelvic pain, endometriosis, or there are cancer cells present, a hysterectomy (removal of the uterus) is often recommended.
Depending upon the gynecologic condition, a hysterectomy may be:
Partial: Removing just the uterus and leaving the cervix in place
Total: Taking out both the uterus and cervix
Radical: Removing the whole uterus, lymph nodes, and the upper part of the vagina. A radical hysterectomy is done most often when there is cancer present.
A hysterectomy may be done through the abdomen, the vagina, through a minimally invasive laparoscopic procedure or a new robotic-assisted surgery that uses breakthrough surgical technology. The da Vinci Surgical System is a sophisticated robotic platform designed to expand the surgeon’s capabilities and provides a minimally invasive approach for complex surgical procedures. The patient’s medical history and condition will determine which surgery is appropriate. For more details on robotic-assisted surgery, click here.
Presented by Dr. Leonard DiGiovanni
Fibroids? Get the Facts
When there is the possibility of cancer and/or other complicating factors, Milford Regional is fortunate to have gynecologic oncologist Neil Horowitz, MD, on our active medical staff. Working collaboratively with our gynecologists, this Brigham and Women’s specialist brings expert cancer surgery and consultation close to home.
Neil Horowitz, MD, joined Dana-Farber Cancer Institute (DFCI) and Brigham and Women’s Hospital in 2007, where he is a surgeon and clinical investigator in the gynecologic oncology program. Prior to joining DFCI, he was an attending physician at Massachusetts General Hospital. His research focuses on complex gynecologic surgery and molecular imaging in gynecologic cancers.
A Life Saving Move
Little did Gigi Krain know that her move to Bellingham
would save her life. Discover how this fateful decision brought her
to two of our physicians (Drs. Brenda Coutinho and Neil Horowitz)
and became a real life saver! Read Gigi’s story.