list of services



    Abnormal Pap Smear:
    In gynecology, the Papanikolaou test or Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a medical screening method, invented by Georgios Papanikolaou, primarily designed to detect premalignant and malignant processes in the ectocervix. It may also detect infections and abnormalities in the endocervix and endometrium. A colposcopic biopsy is a gynecologic procedure that typically is used to evaluate a patient who has had an abnormal pap smear. The colposcope is actually a close-focusing telescope that allows the physician to see in detail abnormal areas on the cervix of the uterus, so that a good representation of the abnormal area can be removed and sent to the pathologist. Adolescent Gynecology:
    Adolescent Gynecologyis a medical subspecialty that focuses on care of patients who are in the adolescent period of development. Patients have generally entered puberty, which typically begins between the ages of 9 to 11 for girls, and 11 to 13 for boys. Adult Gynecology:
    Adult gynecology provides care for women in the reproductive age and those in premenopause and menopause. Amenorrhea:
    Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Physiologic states of amenorrhea are seen during pregnancy and lactation (breastfeeding), the latter also forming the basis of a form of contraception known as the Lactational Amenorrhea Method. Outside of the reproductive years there is absence of menses during childhood and after menopause. Amenorrhea is a symptom with many potential causes. Primary amenorrhea may be caused by developmental problems such as the congenital absence of the uterus, or failure of the ovary to receive or maintain egg cells. Also, delay in pubertal development will lead to primary amenorrhea. Secondary amenorrhea is often caused by hormonal disturbances from the hypothalamus and the pituitary gland or from premature menopause, or intrauterine scar formation. Biopsy - Endometrial:
    A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically (for example, using PCR techniques). Endometrial - Biopsy tests for endometrial cancer which refers to several types of malignancy that arise from the endometrium, or lining of the uterus. Endometrial cancers are the most common gynecologic cancers in the United States. Breast Disease:
    When many women think of breast disease, they think of breast cancer. (Read about "Breast Cancer") But there are many other diseases and conditions of which women need to be aware. Benign breast disease is known by several names including: • lumpiness or generalized breast lumpiness • fibrocystic changes or fibrocystic disease • mammary dysplasia Breast Exam:
    Breast self-examination (BSE) is an easy but unreliable method for finding possible breast cancer. If performed appropriately and regularly BSE may help in early detection of some types of breast cancers, although it should not substitute for screening methods (such as mammography) that have been proven to be effective. The method involves feeling breasts for possible distortions or swelling. Cervical Lesions:
    Cervical intraepithelial neoplasia, or CIN, is the abnormal growth of precancerous cells in the cervix. Most cases of CIN remain stable, or are eliminated by the host's immune system without intervention. However a small percentage of cases progress to become cervical cancer, usually cervical squamous cell carcinoma, or SCC.[1] The major cause of CIN is infection with the sexually transmitted human papillomavirus (HPV), usually the high-risk HPV types 16 or 18. The earliest microscopic change corresponding to CIN is dysplasia of the epithelial or surface lining of the cervix, which is essentially undetectable by the woman. Cellular changes associated with HPV infection, such as koilocytes, are also commonly seen in CIN. It is usually discovered by a screening test, the Papanicolaou or "pap" smears. The purpose of this test is to diagnose the disease early, while it has not yet progressed to invasive carcinoma, and thus is easy to cure. Though epithelial dysplasia may regress spontaneously, persistent lesions must be removed, either with surgery, chemical burning, and heat burning, burning with laser, or freezing (cryotherapy). Cervix Biopsy:
    Cervical conization refers to a biopsy of the cervix in which a cone-shaped sample of tissue is removed from the mucous membrane. Conization may be used either for diagnostic purposes, or for therapeutic purposes to remove pre-cancerous cells. Conization of the cervix is a common treatment for dysplasia and human papillomavirus (HPV) following abnormal results from a pap smear. Circumcision:
    Circumcision is the procedure that cuts some or the entire foreskin (prepuce) from the penis. The frenulum may also be cut away at the same time, in a procedure called a frenectomy. The word "circumcision" comes from Latin circum (meaning "around") and caedere (meaning "to cut"). Contraception:
    Birth control is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant or giving birth. For many people, birth control is an integral component of family planning. Mechanisms which are intended to reduce the likelihood of the fertilization of an ovum by a spermatozoon may more specifically be referred to as contraception. We do offer other forms of birth control in the office known as the Mirena and Implanon. The Mirena is an intrauterine device, which can be inserted into the uterus during an office visit. This can be done with or without the help of ultrasound guidance. The Mirena is made of soft, flexible, plastic. Once placed the Mirena is good for up to five years and then will need to be removed. Mirena blocks the sperm from reaching or fertilizing your egg, it also thins the uterine wall-this may result in benefits like less menstrual bleeding over time. The Implanon is a single-rod implant placed directly under the skin of your upper arm. It offers women up to 3 years of pregnancy protection. This is also a five minute in office procedure where the physician injects the device into your arm through a delivery catheter. Both procedures are minimally invasive and allow the patient to return to work the same day. Contraception:
    Birth control is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant or giving birth. For many people, birth control is an integral component of family planning. Mechanisms which are intended to reduce the likelihood of the fertilization of an ovum by a spermatozoon may more specifically be referred to as contraception. We do offer other forms of birth control in the office known as the Mirena and Implanon. The Mirena is an intrauterine device, which can be inserted into the uterus during an office visit. This can be done with or without the help of ultrasound guidance. The Mirena is made of soft, flexible, plastic. Once placed the Mirena is good for up to five years and then will need to be removed. Mirena blocks the sperm from reaching or fertilizing your egg, it also thins the uterine wall-this may result in benefits like less menstrual bleeding over time. The Implanon is a single-rod implant placed directly under the skin of your upper arm. It offers women up to 3 years of pregnancy protection. This is also a five minute in office procedure where the physician injects the device into your arm through a delivery catheter. Both procedures are minimally invasive and allow the patient to return to work the same day. Cystocele Repair:
    A cystocele occurs when the wall of the bladder bulges through the wall of the vagina. A urethrocele occurs when the urethra sags downward, into the vagina. Both conditions are easy for your health professional to see during a physical exam. They often occur at the same time and are usually caused by damage during vaginal childbirth, in which the baby is delivered through the mother's birth canal (vagina). While many women have some degree of bladder and urethral prolapse, few ever have any symptoms, or the symptoms do not appear for years. When symptoms do appear, they may include difficulty urinating, involuntary release of urine (urinary incontinence), and pain during sexual intercourse. Surgery is not required unless your symptoms interfere with daily activities. Unless another health problem is present that would require an abdominal incision, the bladder and urethra are usually repaired through an incision in the wall of the vagina. This surgery closes the area of prolapse in the bladder or urethra and strengthens the wall of the vagina to prevent prolapse from recurring. Estrogen Replacement:
    Estrogen replacement therapy (ERT) is used to increase estrogen levels in postmenopausal women who have no uterus. This helps prevent perimenopausal symptoms, osteoporosis, and colon cancer. Women in their 20s, 30s, and 40s who experience early menopause after having their ovaries removed (oophorectomy) or because of other medical reasons typically take ERT to reduce their risk of early bone loss and osteoporosis. Historically, women have continued using ERT for years beyond menopause. Some women now discontinue ERT around the age of menopause. Women with a uterus who take estrogen also need the hormone progestin to prevent the estrogen from overgrowing the uterine lining, which can lead to endometrial (uterine) cancer. Estrogen-progestin is called hormone replacement therapy (HRT). General Gynecology:
    Gynaecology or gynecology (see spelling differences) refers to the surgical specialty dealing with health of the female reproductive system (uterus, vagina, and ovaries). Literally, outside medicine, it means "the science of women." General Obstetrics:
    Obstetrics (from the Latin obstare, "to stand by") is the surgical specialty dealing with the care of a woman and her offspring during pregnancy, childbirth and the puerperium (the period shortly after birth). Midwifery is the equivalent non-surgical specialty. Most obstetricians are also gynecologists. Genital Prolapse - Surgery:
    A vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually prolapse farther and farther into the vagina or even through the vaginal opening if their supports weaken enough. The symptoms that result from vaginal prolapse commonly affect sexual functions and bodily functions such as urination and defecation. Pelvic pressure and discomfort are also common symptoms. Genital Warts:
    Warts are caused by viruses and can appear anywhere on the body. Those that show up in the genital area are caused by the human papillomavirus, commonly called HPV, and are easily transmitted by sexual contact. HPV infection is the most common sexually transmitted disease in North America and certain forms of the virus can cause cervical and penile cancer. According to the Center for Disease Control and Prevention at least 50% of sexually active men and women will get a genital HPV infection at some point in their lives. After a person has been infected, it may take one to three months (or longer in some cases) for warts to appear. Some people who have been infected never get warts. If you think you have been infected, see your doctor, even if you cannot see warts. What Do Genital Warts Look Like? Genital warts look like small flesh-colored, pink or red growths in or around the sex organs. The warts may look similar to the small parts of a cauliflower or they may be very tiny and difficult to see. They often appear in clusters of three or four, and may grow and spread rapidly. They usually are not painful, although they may cause mild pain, bleeding and itching. Gynecologic Cytology:
    A Pap test is done to look for changes in the cells of the cervix. During a Pap test, a small sample of cells from the surface of the cervix is collected by your health professional. The sample is then mixed in a liquid fixative (liquid-based cytology) and sent to a lab for examination under a microscope. The cells are examined for abnormalities that may indicate abnormal cell changes, such as dysplasia or cervical cancer. Gynecological Surgery:
    Gynecological surgery refers to surgery on a female's genital parts. This includes hymenoplasty and labiaplasty. Usually it is for reconstructive reasons. It can also be for aesthetic or sexual reasons. There could be tightening of the vaginal wall or making the entrance smaller. Gynecology - History of Breast Cancer:
    Breast cancer may be one of the oldest known forms of cancer tumors in humans. The oldest description of cancer (although the term cancer was not used) was discovered in Egypt and dates back to approximately 1600 BC. The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by cauterization, with a tool called "the fire drill." The writing says about the disease, "There is no treatment."[8] For centuries, physicians described similar cases in their practises, with the same sad conclusion. It wasn't until doctors achieved greater understanding of the circulatory system in the 17th century that they could establish a link between breast cancer and the lymph nodes in the armpit. The French surgeon Jean Louis Petit (1674-1750) and later the Scottish surgeon Benjamin Bell (1749-1806) were the first to remove the lymph nodes, breast tissue, and underlying chest muscle. Their successful work was carried on by William Stewart Halsted who started performing mastectomies in 1882. He became known for his Halsted radical mastectomy, a surgical procedure that remained popular up to the 1970s. Women with a family history of breast cancer account for 5% to 10% of all women with the disease. Having a first-degree relative (mother, sister or daughter) with breast cancer poses the greatest risk to other female members of the family -- doubling the risk compared to that of the general population. Gynecology - Laceration Repair:
    Your doctor will decide the best way to repair your wound. • Some minor cuts can be closed with special adhesive tapes (Steri-Strips) or tissue glue (Dermabond). In addition to use as a surgical adhesive, 2-octyl cyanoacrylate (Dermabond) can be used as a barrier against common bacterial microbes. • Deeper cuts may need repair of deep structures (fascia, the connective tissue envelope around a muscle, may need stitches). • Stitches to the skin surface can help to stop bleeding, protect underlying tissues, and lessen scarring. Herpes Simplex:
    Herpes simplex encephalitis (HSE) is a rare neurological disorder characterized by inflammation of the brain (encephalitis). Common symptoms include headaches, fevers, drowsiness, hyperactivity, and/or general weakness. The disorder may have some symptoms similar to those associated with meningitis, such as a stiff neck, altered reflexes, confusion, and/or speech abnormalities. Skin lesions usually are not found in association with herpes simplex encephalitis. Herpes simplex encephalitis is caused by a virus known as herpes simplex virus (HSV). Hysterectomy:
    A hysterectomy is a surgical procedure whereby the uterus (womb) is removed. Hysterectomy is the most common non-obstetrical procedure of women in the United States. Hysterectomy - Laparoscopic:
    Laparoscopically assisted vaginal hysterectomy (LAVH) is performed through both the vagina and one or more small abdominal incisions. A lighted viewing instrument (laparoscope) and surgical instruments are inserted through one or more small abdominal incisions. The uterus can first be freed from scar tissue through the incision(s) and is then removed through the vagina. Laparoscopic supracervical hysterectomy (LSH) is performed by inserting a laparoscope and surgical instruments through several small abdominal incisions. The uterus is removed in small pieces, and the cervix is left in place (this can be done when cervical cancer is not present). Leaving the cervix may help support other internal organs that might otherwise drop lower into the pelvis, possibly preventing sexual and urinary problems after hysterectomy. Further research is necessary to show whether leaving the cervix intact offers a true long-term advantage over removing the cervix.3 Hysteroscopic Surgery:
    This procedure has fewer surgical risks than a hysterectomy and provides an option to hysterectomy for stopping or reducing menstrual flow or for removing small fibroids or polyps while preserving a young woman's fertility. A new procedure called a Uterine Balloon Ablation was approved by the FDA in December, 1997. Hysteroscopy:
    Hysteroscopy is the inspection of the uterine cavity by endoscopy. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy). Laparoscopy:
    Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery, or pinhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5 - 1.5 cm) as compared to larger incisions needed in traditional surgical procedures. Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic. Leep Procedure:
    The loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to cut out abnormal tissue. LEEP can: • Cut away abnormal cervical tissue that can be seen during colposcopy. • Remove abnormal tissue high in the cervical canal that cannot be seen during colposcopy. In this situation, LEEP may be done instead of a cone biopsy. (For more information, see cone biopsy.) LEEP is also known as large loop excision of the transformation zone (LLETZ). A vinegar (acetic acid) or iodine solution, which makes abnormal cells more visible, may be applied to the cervix before the procedure is done. Menopause:
    Menopause is the time in a woman's life when her period stops. It is a normal change in a woman's body. A woman has reached menopause when she has not had a period for 12 months in a row (and there are no other causes, such as pregnancy or illness, for this change). Menopause is sometimes called, "the change of life." Leading up to menopause, a woman's body slowly makes less and less of the hormones estrogen and progesterone. This change often happens between the ages of 45 and 55 years old. Minority Populations:
    Communities of color, including African-American, Hispanic/Latino, Asian and Pacific Islander, American Indian/Alaska Native Myoma - Uterine:
    Uterine fibroids are lumps that grow on your uterus. You can have fibroids on the inside, on the outside, or in the wall of your uterus. Your doctor may call them fibroid tumors, leiomyomas, or myomas. But fibroids are not cancer. You do not need to do anything about them unless they are causing problems. Fibroids are very common in women in their 30s and 40s. By the time they are 50, about 80 women out of 100 have fibroids. But fibroids usually do not cause problems. Many women never even know they have them. Myomectomy:
    Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and preserves fertility. Myomectomy is the preferred fibroid treatment for women who want to become pregnant. Before myomectomy, shrinking fibroids with gonadotropin-releasing hormone analogue (GnRH-a) therapy may reduce blood loss from the surgery. GnRH-a therapy is also used to improve anemia before surgery by stopping uterine bleeding for several months. Novasure:
    Novasure Endometrial Ablation is the simple, one-step, 90 second treatment that has put a stop to excessive menstrual bleeding for over one million women-without hormones or hysterectomy. This procedure is done in the office, easy to schedule and easy to return to work. For more info go to www.novasure.com. Obstetrical Care:
    An obstetrician (a general obstetrician or one who has specialized training in high-risk pregnancy), a family physician (your family doctor), or a midwife (a certified nurse-midwife, a certified midwife, or a lay midwife). Although 80% of American women continue to turn to obstetricians for care during pregnancy, a growing number are using the services of certified nurse-midwives (CNMs). In fact, according to the U.S. Department of Health and Human Services, the number of CNM-attended births has grown from 19,686 in 1975 to 196,977 in 1994. Pelvic Exam:
    A pelvic exam is a way for doctors to look for signs of illness in organs in a woman's body. The word "pelvic" refers to the pelvis. The exam is used to look at a woman's: • Uterus (the womb) • Cervix (opening from the uterus to the vagina) • Fallopian tubes (tubes that carry eggs to the womb) • Ovaries (glands that produce eggs) • Bladder (the sac that holds urine) • Rectum (the chamber that connects the colon to the anus) Pelvic Floor Disorders:
    The "pelvic floor" is a group of muscles that form a kind of hammock across your pelvic opening. Normally, these muscles and the tissues surrounding them keep the pelvic organs in place. These organs include your bladder, uterus, vagina, small bowel and rectum. Sometimes these muscles and tissue develop problems. Some women develop pelvic floor disorders following childbirth. And as women age, pelvic organ prolapse and other pelvic floor disorders become more prevalent. When pelvic floor disorders develop, one or more of the pelvic organs may stop working properly. Pelvic Pain:
    Although pelvic pain often refers to pain in the region of women's internal reproductive organs, pelvic pain can be present in either sex and can stem from multiple causes. Pelvic pain may be a symptom of infection or may arise from pain in the pelvic bone or in non-reproductive internal organs. In women, however, pelvic pain can very well be an indication that there may be a problem with one of the reproductive organs in the pelvic area (uterus, ovaries, fallopian tubes, cervix, or vagina). Pelvic Prolapse:
    Pelvic organ prolapse, a type of pelvic floor disorder, can affect many women. In fact, about one-third of all women are affected by prolapse or similar conditions over their lifetime. Permanent Sterilization:
    Adiana Permanent Contraception is a safe, simple minimally invasive procedure that permanently prevents pregnancy. Like a Tubal Ligation it blocks the fallopian tubes. Unlike a Tubal Ligation it can be performed in the office saving time and money. It works by stimulating your body’s own tissue to grow in and around tiny, soft inserts that are placed inside your fallopian tubes. It’s safe and requires no incision, or the use of hormones or drugs. For more info go to www.adiana.com. Polycystic Ovarian Syndrome:
    Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman's hormone levels, periods, and ovulation. This can affect fertility and pregnancy. It can also cause male-type body changes. If you have PCOS, your hormone (endocrine) system is out of balance. This can lead to serious health problems, such as diabetes and heart disease. Pregnancy Loss:
    A miscarriage is the loss of a pregnancy during the first 20 weeks. (After 20 weeks, pregnancy loss is known as a stillbirth.) Miscarriage is common. About 1 out of 4 women who become pregnant has a miscarriage at some point in her lifetime.1 Of all diagnosed pregnancies, between 15% and 20% end in a miscarriage in the first trimester or early in the second trimester.1 It is also common for a pregnancy to miscarry so early that a woman does not even know that she is pregnant. Premenstrual Syndrome (PMS):
    Up to 85% of women normally have one or more troubling physical and emotional symptoms between the time they ovulate and the first days of their menstrual period.1 These are called premenstrual symptoms. When premenstrual symptoms interfere with your relationships or responsibilities, they are called premenstrual syndrome (PMS). While some women first have PMS in their teens or 20s, others don't until their 30s. PMS can come and go during your reproductive years; you may find that your symptoms worsen as you approach perimenopause, in your late 30s or 40s. PMS occurs only in women who ovulate during their monthly menstrual cycle. Women who do not ovulate-because of pregnancy, menopause, or taking birth control pills-do not have PMS symptoms. However, many do have similar hormone-related symptoms. Prenatal Care:
    As soon as you suspect you're pregnant, schedule an appointment with your pregnancy health care provider. Even if you've confirmed your suspicion with a home pregnancy test, it's still wise to follow-up with a doctor appointment. This will ensure that you and your baby get off to a good start. Regular appointments with your health care provider throughout your pregnancy are important to ensure the health of you and your baby. In addition to medical care, prenatal care includes education on pregnancy and childbirth, plus counseling and support. Frequent visits with your healthcare provider allow you to follow the progress of your baby's development. Visits also give you the opportunity to ask questions. Also, most healthcare providers welcome your partner at each visit, as well as interested family members. Prescription Refills:
    Prescriptions are refilled only during office hours. That way we can access your chart to make certain that a refill is the best course of treatment. Please have your pharmacist's telephone number available. We use e-Prescribe to electronically send your prescriptions from your electronic health record. Prescriptions cannot be refilled during evenings, weekends, or holidays because the physician on duty will not have immediate access to your records. We follow this routine in order to handle your request for prescription refills as quickly and efficiently as possible. Rectocele Repair:
    A rectocele (rectal prolapse) occurs when the end of the large intestine (rectum) pushes through the back wall of the vagina. An enterocele (small bowel prolapse) occurs when the small bowel pushes through the upper wall of the vagina. Rectoceles and enteroceles develop if the lower pelvic muscles become damaged by pregnancy, labor, childbirth, or a previous pelvic surgery or when the muscles are weakened by aging. A rectocele or an enterocele can be present at birth (congenital), though this is rare. A rectocele or an enterocele may become large or more obvious when you strain or bear down (for example, during a bowel movement). Rectocele and enterocele formation may occur together, especially if you have had surgery to remove the uterus (hysterectomy). Because rectocele and enterocele are defects of the pelvic supporting tissue and not the bowel wall, they are treated most successfully with surgery that repairs the vaginal wall. This closes the area of prolapse into the vagina and strengthens the wall of the vagina to prevent prolapse from recurring. Unless there is another health problem that would require an abdominal incision, rectoceles and enteroceles are usually repaired through the vagina. Sexually Transmitted Diseases:
    Sexually transmitted diseases, commonly called STDs, are diseases that are spread by having sex with someone who has an STD. You can get a sexually transmitted disease from sexual activity that involves the mouth, anus, vagina, or penis. According to the American Social Health Organization, one out of four teens in the United States becomes infected with an STD each year and by the age of 25, half of all sexually active young adults will get an STD. STDs are serious illnesses that require treatment. Some STDs, like AIDS, cannot be cured and are deadly. By learning more about STDs, you can find out ways to protect yourself from the following STDs. Transvaginal Tape (TVT):
    Transvaginal Tape is an outpatient procedure that can treat urinary incontinence. In this procedure the physician will insert a ribbon-like strip of mesh under the urethra to provide support when this area is stressed , such as during a cough or sneeze. This will allow the urethra to remain closed, preventing involuntary urine leakage. Ultrasounds:
    Our office provides an in house sonographer to perform ultrasounds on pregnant patients, and patients who are having pelvic pain, abnormal or heavy bleeding, history of ovarian cyst, and history of uterine fibroids. We offer 3D-4D images of your unborn baby.
    Click to see examples of 3D-4D images
    Click to see examples of 3D-4D images
    Click to see examples of 3D-4D images     Urinary Incontinence:
    Urinary Incontinence is the accidental leakage of urine. There are two major types: urge incontinence or stress incontinence. Urge incontinence means the bladder is unstable and causes you to have strong urges to urinate and often unable to make it to the bathroom. Stress incontinence involves urine leakage when you laugh, cough, or sneeze. We offer an in office procedure to diagnose bladder problems. And there are many medications and minimally invasive procedures that can help treat this problem.