Sturdy Memorial OB/GYN's:
Cutting Edge Treatment for Common Ailments
According to the Centers for Disease Control (CDC), approximately 600,000 hysterectomies are performed annually in the U.S., and about 20 million American women have had a hysterectomy. During a hysterectomy, a woman's entire uterus is surgically removed, sometimes along with the ovaries and fallopian tubes. Although hysterectomy is often necessary, less radical treatment options are available for certain gynecological conditions. Sturdy Memorial Hospital offers pelvic organ prolapse repair and outpatient endometrial ablation, which provide relief from two common conditions without removing the uterus.
Pelvic Organ Prolapse Surgery
Pelvic organ prolapse is a condition characterized by pressure and/or herniation of the bowel, bladder or uterus through the vagina and is often accompanied by urine loss or leakage during coughing or sneezing. These symptoms are caused by the weakening or breakage of the connective tissues that hold the pelvic organs in place. Pelvic organ prolapse is most commonly caused by childbirth, but those with naturally weak connective tissues are also at risk. When the condition causes discomfort, embarrassment, or impairs normal activity, women should seek gynecological treatment.
A physical examination is needed to diagnose prolapse, and certain bladder function tests are necessary to identify underlying conditions that might contribute to urine loss. Traditionally, hysterectomy or surgery to create artificial suspension of the uterus were performed to alleviate the symptoms of pelvic organ prolapse, but these procedures had high failure rates. In some cases, a removable device called a pessary is used to hold the organs in place, but many patients find this intrusive and inconvenient. Today, site specific repair is possible using the original connective structures, reinforced by mesh sutures for strength if necessary, to fix the defect and return the body to its natural state.
Dr. Ralph Philosophe, an OB/GYN on staff at Sturdy Memorial Hospital, is among a handful of surgeons in the region to use laparoscopic microsurgery to pinpoint and repair the area of damage. With this technique, he uses a small lighted camera to direct the procedure with little surgical incision and minimal disruption to the areas around the surgical site. During the surgery, healthy connective tissue is reattached to restore the organs' natural placement. In cases where the connective tissue is considerably weakened, a mesh suture may be used to strengthen the bond. Typically, the surgery can be conducted through the vagina, but if the defect occurs higher a 1/4-inch incision may be made in the belly-button to facilitate abdominal approach. Because this procedure repairs the defect by returning the pelvic organs to their normal state, it has an extremely high rate of long-term success.
"Each procedure is unique," explains Dr. Philosophe. "In order to truly restore the natural position of the pelvic organs, the location and severity of each patient's damage, along with their particular anatomy, must be taken into account. This is not a 'one size fits all' procedure, but one that provides the best repair needed to fix the exact problem."
The procedure takes approximately 1.5 hours, requires general or spinal anesthesia, and necessitates a 1-2 day inpatient hospital stay. Patients are typically "up and about" the day after surgery, and recovery takes 3-4 weeks. Complications and side effects are extremely rare, and include bleeding, infection and injury to the bowel, bladder or ureter. Symptomatic women of any age, who are healthy enough for surgery, are urged to explore pelvic organ prolapse surgery as a treatment option.
Endometrial Ablation
Many women experience excessive menstrual bleeding and irregular periods. Hormone therapy and hysterectomy are common treatments for this problem. However, for pre-menopausal women with no future childbearing plans, endometrial ablation is a viable treatment option for heavy, prolonged menstruation or irregular bleeding.
Endometrial ablation destroys the uterine lining, or endometrium, which helps end or reduce menstrual flow. Dr. Elizabeth Terry, a new OB/GYN on staff at Sturdy Memorial, uses the NovasureŽ method to perform thermal endometrial ablation. This outpatient procedure is performed under general anesthesia and takes approximately 30-45 minutes to complete. During thermal endometrial ablation, a thin sheath containing an electrode is placed through the cervix. The electrode expands to fill the uterine cavity, and uses steady heat to desiccate, or dry out, the endometrium. Before the device is activated, it checks the air pressure inside the uterine cavity to rule out the presence of uterine leaks and prevent the heat from spreading to other parts of the body. The actual ablation takes only about 2 minutes, after which the physician uses a lighted hysteroscope to examine the uterine cavity and make sure nothing remains.
Patients are able to return home the day of surgery, and should feel "normal" within a couple of days. Minimal pain and cramping are possible, and can usually be controlled with over-the-counter pain relievers. Endometrial ablation carries a slight risk of uterine perforation, but complications are rare. Most patients are able to return to work a day or two after the procedure.
"Endometrial ablation is an excellent option for many women who have finished childbearing and want relief from excessive bleeding, but are averse to having a hysterectomy" says Dr. Terry. "Often patients see the procedure as a more comfortable and less invasive option."
Patients with abnormally shaped or sized uteruses are not candidates for ablation. Ablation stops menstruation in approximately 50% of patients, and another 40% experience a reduction in menstrual flow. It does not always cause sterilization, and birth control methods must still be employed to prevent pregnancy after ablation. Pain related to endometriosis or other underlying causes will not be alleviated by ablation. For these reasons, patients may ultimately opt for hysterectomy or other treatment. However, for many women with prolonged or heavy periods, endometrial ablation is a desirable alternative that provides a positive long-term result.
Other Advanced Surgical Offerings
In addition to pelvic organ prolapse repair and outpatient endometrial ablation, many other innovative gynecological procedures are performed at Sturdy Memorial Hospital. These include laparoscopic microsurgical procedures to correct problems with bladder control, fibroids, tubes and ovaries, as well as laparoscopic hysterectomy, which are less painful alternatives to traditional open surgery with shortened recovery times and minimal scarring. Another highly sophisticated procedure performed by Dr. Philosophe is tubal ligation reversal, which gives women who've had their tubes tied the opportunity to have more children if they desire. To learn more about Sturdy Memorial Hospital's OB/GYN Department and affiliated physicians, please visit the Obstetrics/Gynecology section of our site, and call 508-236-8500 to find an OB/GYN in your area.
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