A simple, 10 to 15 minute procedure that is performed at your OBGYN office. You are positioned on the examination table like you are for a Pap smear. After the OBGYN doctor preps you for the procedure, he/she will then use a colposcope – which is a large, microscope that is positioned in front of the vagina to view your cervix. A bright light on the end of the colposcope lets your gynecologist see the cervix clearly. While doing the colposcopy, the OBGYN doctor will focus on the areas of the cervix where changes in an abnormal cervix are seen as white areas. The whiter the area is, the worse the cervical dysplasia is. Abnormal vascular (blood vessel) changes are also apparent through the colposcope. Typically, the worse the vascular changes are, the worse the dysplasia.

If your Obstetrician/Gynecologist can see an abnormal area with the colposcope, a tissue biopsy is then taken from the abnormal area and sent to the lab for more testing. Note that your doctor may do more than just one Biopsy. How many biopsies depend on how many abnormal areas he/she finds. Once the biopsies are done, the doctor will then do an ECC also known as an Endocervical Curettage – which takes samples from the canal of the cervix. Test results are usually back within two weeks at which time your doctor will have you come back to the office to go over the results and determine what will be the next best step to take. After the procedure, the doctor recommends no sex, tampons, or douching for 2 weeks or until you come back in for the results. This is so your cervix heals from the biopsies.

An examination of the cervix and the lining of the uterus (endometrium).

A woman may need diagnostic hysteroscopy if she is experiencing:

•    Heavy, prolonged, or irregular menstruation
•    Bleeding after menopause
•    Bleeding due to hormone therapy
•    Difficulty getting pregnant

An Obstetrician/Gynecologist may also request a diagnostic hysteroscopy if:

•    An ultrasound reveals the lining of a woman’s uterus is thicker than normal
•    A tissue sample is needed to check for abnormal cells that may be cancerous
•    Endometrial biopsies and polypectomies are needed

During an endometrial biopsy, a tissue sample is taken from the lining of the uterus. The sample is later examined for any abnormal cells or signs of cancer. This procedure may be done with or without anesthesia.

Polypectomy is a procedure used to remove polyps that may be the cause of abnormal bleeding. The ultimate goal of the procedure is to stop abnormal bleeding and to inspect the tissue removed to rule out the presence of cancer.

A form of permanent birth control in which the fallopian tubes are blocked using a natural barrier.

Essure does not require cutting into the body or the use of radiofrequency energy to burn the fallopian tubes. Instead, the physician inserts soft, flexible inserts through the body’s natural pathways (vagina, cervix, and uterus) and into the fallopian tubes. The very tip of the device remains outside the fallopian tube, which provides the woman and the doctor with immediate visual confirmation of placement.

During the three months following the procedure, the body and the inserts work together to form a natural barrier that prevents sperm from reaching the egg. During this period, a woman must continue using another form of birth control (other than an IUD).

After three months, the OBGYN doctor performs a confirmation test in which a dye and special type of X-ray are used to ensure that the inserts are in place and that the fallopian tubes are completely blocked.

Unlike birth control pills, patches, rings, and some forms of IUDs, Essure does not contain hormones to interfere with the natural menstrual cycle. A woman’s periods should more or less continue in their natural state.

An IUD is a method of birth control that is placed inside the uterus to prevent pregnancy. Before the procedure, the OBGYN doctor may give you a pregnancy test and test you for sexually transmitted infections or other infections to make sure it is safe for you to get an IUD. If you have any kind of pelvic infection, you may need treatment before getting an IUD.

Before and during the procedure, the doctor explains the procedures, risks and benefits of the IUD. You may be also given a pain reliever, such as ibuprofen.

The OBGYN doctor:
•    Has you lie on the exam table on your back with your feet in stirrups as you would for a pelvic exam or Pap test
•    Will check the position of your uterus
•    Swabs your cervix with antiseptic
•    Inserts a probe through your cervix to determine how far the IUD should go into your uterus
•    Loads the IUD into the insertion tube, which flattens the arms of the IUD that form the top of the “T”
•    Inserts the IUD through your cervix into your uterus
•    Pulls the insertion tube all the way out
•    Trims the IUD string to about 1 inch from the cervix
•    Removes the forceps and speculum

You may have some cramping during the procedure.

The Obstetrician/Gynecologist will discuss how to check for IUD placement each month after each period.

A cosmetic reduction of abnormally enlarged labia. This procedure is performed for a variety of reasons, including correction of damage done to the labia during childbirth, or for aesthetic reasons. Conscious sedation is combined with local anesthesia. Redundant, scarred or torn labial tissue is surgically removed and incisions are closed with small absorbable sutures.

Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-cancerous conditions (cervical dysplasia) on the cervix. LEEP is used after abnormal Pap results have been confirmed by colposcopy and cervical biopsy. Tissue removed during the procedure will be sent for histological examination.

Local anesthesia on the cervix is used in this procedure. LEEP uses a thin wire loop electrode, which is attached to an electrosurgical generator. The generator transmits a painless electrical current that quickly cuts away the affected cervical tissue in the immediate area of the loop wire. This causes the abnormal cells to rapidly heat and burst, and separates the tissue as the loop wire moves through the cervix.

This technique allows the OBGYN doctor to send the excised tissue to the lab for further evaluation, which ensures that the lesion was completely removed, as well as allowing for a more accurate assessment of the abnormal area.

Excisional biopsy of the lesion is done under local anesthesia. The tissue is then sent for a histological evaluation.

Electrocautery removes genital warts on the vulva or around the anus by burning them with a low-voltage electrified probe. A local anesthetic is usually used for pain control, however, if the warts are extensive, a general anesthetic may be advised.

A number of different procedures are offered for the diagnosis and treatment of vulval conditions such as vulvodynia, vaginismis and lichen sclerosis.

A partial hymenectomy may be recommended in certain cases of chronic vulval pain (vulvodynia) or vulval vestibulitis, redness and inflammation near the opening of the vagina. Conscious sedation is combined with local anesthesia and then the over sensitive areas of hymenal skin are identified and surgically excised. Small absorbable sutures are placed as needed.