The Woman’s Clinic offers many office procedures to assist in providing the care you deserve. Procedures are scheduled in a timely manner in a comfortable office environment. We offer competitive self-pay prices for those without insurance or for those with high insurance deductibles. For your convenience we have listed some of the most common office procedures offered at the Woman’s Clinic. You may click the title for a brief description.

Pap Test

The pap test is a screening for cervical cancer. To obtain a pap smear a speculum is inserted into the vagina to visualize the cervix. The pap smear is then obtained by using a small brush and spatula. You may experience mild cramping.

Colposcopy

A colposcopy is performed when your pap smear is abnormal to confirm the test and determine the degree of severity. The colposcope magnifies the cervix to highlight the abnormal areas. Biopsies are obtained and treatment, if any, is based on the biopsy results. We will collect a urine sample for a pregnancy test even if permanent birth control is in place. You can take Ibuprofen 200mg, (2-4 tabs) 30 minutes prior to your appointment time.

Leep

Loop Electrosurgical Excision Procedure is performed to treat high grade abnormal cervical cells. The cervix is injected with a local anesthetic prior to the procedure. A thin, wire loop uses an electrical current to remove a cone-shaped portion of the cervix. Mild cramping may occur – a yellow/brown paste is applied to the cervix which normally causes a dark brown, watery drainage. We will collect a urine sample for a pregnancy test even if permanent birth control is in place. You can take Ibuprofen 200mg, (2-4 tabs) 30 minutes prior to your appointment time.

Endometrial Ablation

Endometrial Ablation is a procedure that stops or reduces heavy bleeding by removing most of the uterine lining. Endometrial ablation has become increasingly more popular for woman experiencing irregular and heavy menstruation. An ablation is hormone free and allows the uterus to remain intact. We utilize GYNECARE THERMACHOICE Uterine Balloon Therapy System. This system is an 8-minute outpatient procedure, requiring no incision and may performed in office under local anesthesia. A small soft, flexible catheter is inserted through the vagina and cervix, into the uterine cavity. A balloon attached to the tip of the catheter is then filled with fluid to fit the shape and size of the uterus. The fluid is then heated for 8-minutes, treating the uterine lining.

Hysteroscopy

Hysteroscopy is used to diagnose and treat problems of the uterus. A thin, light scope is passed through the vagina and cervix into the uterus and transmit the images onto a screen. Hysteroscopy can be done in the office or at the hospital.

Endometrial Biopsy

An endometrial biopsy (EMB) is a test performed to rule out uterine cancer and other abnormal uterine growths. A small catheter is inserted into the uterine cavity – gentle suction removes a small sample of the lining. The sample is sent to a pathologist for review. Mild to moderate cramping is to be expected.

Transvaginal Pelvic Ultrasound

Most ultrasounds in our office are performed transvaginally. Transvaginal ultrasound is a test used to look at a woman’s reproductive organs, including the uterus, ovaries, and cervix. The patient will be given a probe covered with a condom to insert into the vagina. Results are typically reviewed with a provider after the ultrasound is performed.

SIS

Saline Infusion Sonogram or Sonohysterogram is a test that examines the uterine cavity for defects and is normally performed between cycle days 5-12 (cycle day 1 is the first day of normal flow). First, pending a negative pregnancy test, a speculum is placed into the vagina, a small tube (or catheter) is then placed through the cervix into the uterine cavity. The speculum is removed and the vaginal probe is inserted into the vagina. Saline is then injected into the uterine cavity to allow visualization of any intracavitary defects. The saline infusion takes approximately 4-5 minutes – after the procedure the uterus and ovaries will be evaluated with the transvaginal probe. It is typical to experience lower pelvic/abdominal cramping. We will collect a urine sample for a pregnancy test even if permanent birth control is in place. Ibuprofen 200 mg (2-4 tabs) may be taken 30 minutes prior to the procedure. The pain/cramping normally subsides by the time you leave the office. You will normally receive the results of the test that day.

FemVue Sono HSG

The FemVue Sono Hysterosalpingogram (HSG) is an procedure performed in the office with ultrasound to evaluate tubal patency. First, a catheter is placed into the uterus, saline is delivered into the uterine cavity to evaluate for any intrauterine structural abnormalities (SIS). The saline/bubble mixture is then delivered into the uterus and flows into the fallopian tubes. Under ultrasound the saline and air bubbles are highly visible, allowing tubal patency to be determined. Ibuprofen 200 mg (2-4 tabs) may be taken 30 minutes prior to the procedure. The pain/cramping normally subsides by the time you leave the office. You will normally receive the results of the test that day.

Follicle Studies

Follicle Studies are normally performed around cycle day 12 to assess your response to fertility medications. A transvaginal pelvic ultrasound will be performed. The results of the follicle study will indicate endometrial thickness and assess follicular development. Frequently a second scan is needed based on response.

Sperm Washing and Artificial Insemination

Intrauterine Insemination or IUI – the husband will be asked to produce a semen sample the day of the insemination – this can be collected in the office or outside of the office if kept warm (at body temperature) and delivered within 60 minutes of collection. The sample will be assessed microscopically prior to the washing for concentration and motility. The sample will then be washed and prepared. Washing of the sample removes prostaglandins and bacteria and it also concentrates the sperm by removing seminal plasma. After the sample is washed and the patient confirms it is her name on the sample the insemination will be performed. A speculum will be inserted into the vagina, a small tube or catheter will be inserted through the cervix into the uterine cavity. The sample will be housed in a syringe attached to the catheter and will be slowly delivered. The patient will remain recumbent for 20 minutes post procedure. Mild to moderate pelvic cramping and scant spotting may occur. Normal activity may be resumed following the insemination. A pregnancy test is recommended 14 days after the procedure.

Bone Densitometry Test or DXA

DXA or dual-energy x-ray absorptiometry is a device used to screen for osteoporosis. It measures bone density at various sites using low dose x-ray to predict your risk of fractures. During the test, you will lay on a soft table and a scanner will pass over your lower spine, hips, and wrist. There is no need to undress for the test. For more information visit the osteoporosis link.

Urodynamics

Urodynamics testing is used to assess the lower urinary tract and is performed prior to planning surgery for urinary leakage or if the cause of leakage is not clear. It assesses how much urine your bladder can hold, what makes you leak (cough, valsalva, jumping, ect.), and assesses for problems emptying the bladder. You will be asked to come to your appointment with a full bladder. First you will be asked to empty your bladder at the bedside commode to measure your urine, next a small catheter will be used to measure your post-void residual (how much urine is left in your bladder after voiding). The pressure sensitive catheter used for urodynamic testing will then be placed in your bladder and one in your vagina, – your bladder will be filled with saline, and you will be asked to cough and bear down at various time during the test. The test is performed in the office and will take approximately 45 minutes to one hour. Please call the Woman’s Clinic if you have further questions regarding the test.

Mirena IUD

Mirena IUD or intrauterine device is indicated for birth control and heavy menstrual cycles. It is a T-shaped device that releases progesterone continuously over five years. IUD’s are one of the most effective methods of birth control, during the 1st year of perfect use only 1 in 100 women using the Mirena will become pregnant. Many women will have lighter, less painful periods and some women will stop having periods. This is a common side effect and is not harmful. Normal cycles and fertility will return when the Mirena is removed. We will obtain a urine sample for a pregnancy test if within childbearing age despite permanent birth control. You may take Ibuprofen 200mg (2-4 tabs) 30 minutes prior to procedure.

Skyla IUD

Skyla is a hormone containing iud similar to the Mirena IUD that continually releases progesterone over 3 years. It is over 99% effective and is completely reversible after removal. The Skyla thickens cervical mucus to prevent sperm from ascending into the upper genital tract. The Skyla is smaller compared to the Mirena and is easier to place in women who have never had a vaginal delivery. The Skyla releases less hormone than the Mirena so therefore is only effective for 3 years and women may not notice the benefit of lighter or abscent menstrual cycles. We will obtain a urine sample for a pregnancy test if within childbearing age despite permanent birth control. You may take Ibuprofen 200mg (2-4 tabs) 30 minutes prior to procedure.

Nexplanon

Nexplanon (Implanon) is a single-rod, progestin-only subdermal implant indicated for long-acting birth control. Nexplanon is a soft and pliable implant that is placed in a safe location in the inner, upper arm. Nexplanon is more than 99% effective. The Nexplanon is effective for up to 3 years. The Nexplanon’s small size makes it hard to visualize under the skin, however it is still palpable on examination. For more information clicke here or call the Woman’s Clinic to schedule an appointment.

Essure

Essure is a permanent birth control method. Essure is a surgery and hormone free procedure performed at the Woman’s Clinic. A soft, flexible coil is passed through the vagina and cervix and placed into each fallopian tube where it conforms to their shape. Over the next three months, the body works with coils to provide a natural barrier to prevent pregnancy. After three months, a confirmation test will be done to confirm the coils are in place and the fallopian tubes are fully blocked.