Procedures

Accidental urine leakage is no laughing matter. And yet it happens every single day to countless women simply by laughing. Or coughing. Or through the simple action of picking up a child.

Stress Urinary Incontinence: End the Embarrassment/Resume Living Life to the Fullest

Many women are surprised to learn that urinary incontinence affects more than 13 million American women. The problem is so common, occurring in women as young as age 25; yet no one wants to talk about it. In fact, many women change their entire lives to avoid activities in which they might have an accident. Fortunately, you don’t have to be that person.

TVT, a minimally invasive procedure covered by most insurance plans, is a revolutionary new treatment.  TVT is performed on an outpatient basis, recovery time is 2 to 3 days, and its success rate is greater than 90%.

TVT stops urine leakage the way your body was designed to – by supporting your urethra.  TVT can be performed under general or local anesthesia. The outpatient procedure is minimally invasive, requiring 2 tiny incisions near the groin. Most women experience very little or no discomfort after the procedure, and are able to return to normal activity the next day. TVT has been available for over 20 years and is revolutionary with incredible improvement with your quality of life.

Women who suffer from pelvic-organ prolapse tend to under-report their symptoms due to embarrassment. About one in every three women over the age of 45 experiences some degree of prolapse. The most common symptoms? Urinary incontinence, back pain, feelings of pelvic fullness or pressure, pain during intercourse, and problems with bowel movements and “something coming out”.

The pelvic organs include the uterus, rectum and bladder. Prolapse occurs when the muscles and ligaments of the pelvic floor, which support these organs, weaken, causing one or more of the organs to drop out of place.

This common condition usually results from multiple vaginal births, menopause and estrogen loss.

When considering the best treatment options for prolapse, our doctors take into account which organs are affected, the severity of symptoms, and whether other medical conditions are present. Many patients are able to reduce pain and pressure with non-surgical treatment or through insertion of a pessary (a doughnut-shaped silicon device) into the vagina. If non-surgical techniques fail to alleviate the pain or pressure, prolapse repair may be the next step.

The procedure takes about 45 minutes to perform under general anesthesia. Patients usually stay overnight in the hospital and are told to “take it easy” for six to eight weeks, avoiding strenuous activity or heavy lifting.

Talk to us about your symptoms and learn if this procedure is right for you.

End Painful, Heavy Periods with Uterine Ablation

How do we define a “heavy period”? Actually, there’s no set definition; it’s up to you. If your period is interfering with your everyday activities, or you worry about bleeding through your clothes, you may be a candidate for a simple outpatient procedure that will permanently reduce your menstrual flow.

About 1 in every 5 women experiences excessive menstruation.

Painful, heavy periods can force women to alter their lives: declining social activities, sleeping excessively, experiencing depression and anxiety about a condition which is controlling their lives. Drs. Brown, Pearson and Guepet have performed uterine ablation on dozens of patients and witnessed the difference it makes in their lives.

Ablation is a simple, permanent solution to excessive bleeding that requires no incision, is done on an outpatient basis, and offers a quick recovery. Talk to us about your menstrual concerns. You don’t need to suffer in silence.

 The New Hysterectomies

Countless women suffer each month from menstrual problems. The may experience excessive and unpredictable bleeding due to fibroid tumors. Some experience significant pelvic pressure and bladder issues. Yet despite the debilitating pain, most of these women avoid a recommended hysterectomy for as long as possible. They fear the prominent abdominal scar, as well as the painful, extended recovery associated with traditional abdominal hysterectomy.

Fortunately, there are now safe, effective alternatives to the traditional abdominal hysterectomy. Laparoscopic Supracervical Hysterectomy (LSH), Laparoscopic Total Hysterectomy (TLH) and Single Incision Laparoscopic Surgery (SILS) can be less painful, produce less scarring and require a shorter recovery time than the traditional hysterectomy.  Robotic Hysterectomy can be used for more complicated cases that in the past had to undergo open abdominal procedures. At Brown, Pearson, & Guepet Gynecology we have extensive experience in all of these hysterectomy options and have been national preceptors in teaching other physicians how to perform them. We pride ourselves in rarely ever requiring large abdominal incision for any hysterectomy.

How do these minimally invasive hysterectomies work? Each involves general or regional anesthesia and uses laparoscopy to remove the uterus. A small laparoscope (thin lighted telescope) and small surgical instruments are inserted through several tiny incisions (less than 1 cm) in the navel and abdomen. (In SILS, there is only one small incision.) Using these instruments, the surgeon is able to carefully remove the uterus through one of the small incisions. These procedures are usually outpatient, requiring less than a 24 hour stay. Most patients are able to resume normal activities within 7 days, begin driving as soon as they are no longer taking narcotic pain medication and scars are barely visible. Ask your doctor if you’re a candidate for TLH, SILS, or Robotic Hysterectomy.

For complex hysterectomies with anticipated scarring from previous surgery, adhesions or endometriosis, robot-assisted surgery with the da Vinci Surgical System is often the most effective, least invasive treatment option. Through tiny, 1-2 cm incisions, the doctor can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and excellent clinical outcomes. Robot-assisted hysterectomy also allows them better visualization of anatomy, which is especially critical when working around delicate and confined structures like the bladder. Our physicians are trained, certified and experienced in utilizing robotic-assisted surgical systems to perform hysterectomy.

Potential benefits include:

• Significantly less pain
• Less blood loss
• Fewer complications
• Less scarring
• A shorter hospital stay
• A faster return to normal daily activities

Overcoming Overactive Bladder

Urge urinary incontinence (or overactive bladder) is a problem for more than 33 million Americans. Interrupted sleep, running to the bathroom day and night, and limiting activities based on bathroom availability are some of the symptoms women endure. Sadly, only about half the women who endure overactive bladder seek medical help for it. Treatment options include medication, diet modification and physical therapy. If these are unsuccessful, a minimally invasive procedure called InterStim© brings relief to many patients.

InterStim is performed on an outpatient basis, has no activity limitations upon returning home, and the success rate is greater than 80%. InterStim uses a small stimulation system, implanted under the skin, that provides electrical stimulation of the sacral nerves located under the tailbone. The sacral nerves control bladder function. By gently stimulating the nerves, InterStim restores urinary control. The stimulation can easily be adjusted or deactivated by you at home as needed. The size of a silver dollar, the device is unobtrusive and fully concealed.