Gynecological Services

Gynecology

From your first gynecologic exam to post menopause, Teverbaugh, Croland, and Mueller OBGYN & Associates provides a comprehensive array of general, preventive and specialized gynecologic care. We perform many in-office procedures, such as ESSURE, a minimally invasive permanent form of birth control, Colposcopy and LEEPS to manage abnormal pap smears, and Urodynamics testing to evaluate urinary incontinence. We are dedicated to meeting the healthcare needs of women of all ages and will work with you to develop a comprehensive, personalized health care program based on your individual needs.

Our areas of expertise include:

Abnormal and pre-cancerous pap smears
BRACAnalysis testing
Bladder infections
Bladder prolapse
Breast disorder Management
Colposcopy
Contraceptive advice and management
Endometriosis
ESSURE
Gardasil vaccine
Hormone replacement therapy, including bio-identical HRT
Irregular periods
Laparoscopic supracervical hysterectomy
LEEP procedure
Natural Family Planning

Osteoporosis
Ovarian cysts
Polycystic ovarian syndrome (PCOS)
Preconception counseling
Pelvic pain
PMS & PMDD
Routine gynecological exams
STD testing and treatment
Sterilization
Urinary Incontinence
Uterine cryoblation therapy
Uterine fibroids
Uterine prolapse
Vaginal infections
Vulvar or external conditions
Well women care

 

How to Speak with a Provider or Nurse

Because it is difficult to interrupt our providers while they are seeing patients, our staff of nurses has been well trained to answer most of your questions. If your question is beyond the scope of the nursing staff, it will be turned over to your doctor or nurse practitioner for further recommendation.

You can contact our office by phone Monday through Friday 8:00am - 4:00pm. All calls will be returned within the same business day. All calls are routed through the Center for Health office. 309-692-2025

Gynecologic Procedures

The four most common in office gynecologic procedures are the pap smear, colposcopy, LEEP, and cryotherapy procedures. The pap smear is a screening test and is considered to be the best screening tool for identifying abnormal cells on the cervix, also known as dysplasia. The colposcopy is the next step of testing once a pap smear is abnormal. Based on the colposcopy results, the two most common treatments for dysplasia are the Loop Electrosurgical Procedure (LEEP) and Cryotherapy of the Cervix. Each of these four procedures are described in detail below to help you understand why the procedure is being done, what will happen during the procedure, and what you can expect in the days and weeks after the procedure.

Pap Smear
A Pap Smear is a simple test that is done to detect abnormal cells on the cervix, which can lead to cancer. It is quick and easy, and often takes less than a minute to perform. While laying flat on your back, your doctor or nurse practitioner will insert an instrument called a speculum into the vagina. The speculum is used to hold open the walls of the vagina so your provider will have a clear view of your cervix. Next, a small brush will be used to gently remove the cells from your cervix. The cells are then put into a container filled with liquid and sent to the lab for testing. Some women experience mild cramping and / or spotting after their pap smear. This is very normal and should resolve within 24-48 hours.

 

Colposcopy
A colposcopy is done when a pap smear shows abnormal cells on the cervix. It provides more information about the abnormal cells so your doctor can treat them effectively. Like a pap smear, it is performed in the office while laying on your back. A speculum is inserted into the vagina and a colposcope, a special magnifying device, is placed just outside the opening of your vagina. The colposcope is used to enhance the view of the cervix and vagina by 2-60 times, which enables your doctor to identify problems that cannot be seen by the naked eye. A liquid solution will then be applied to your cervix and vagina with a cotton swab, which will make abnormal cells easier to see. If any abnormal cells are visualized, your doctor will use a special device to remove a small piece of tissue from the abnormal area to send for further testing. This is called a biopsy. Along with the biopsy, your doctor may want to perform an endocervical curettage (ECC), which is done by using a special device to remove cells from the cervical canal. If you have a colposcopy with a biopsy, you may have some cramping for 1-2 days and light vaginal bleeding or dark vaginal discharge for a few days. You many need to wear a pad until the bleeding or discharge stops. The dark vaginal discharge is due to a medication that is used to stop bleeding at the biopsy site and is not worrisome. You can return to work directly after the procedure.

Post-Colposcopy Biopsy Instructions:
1. If you have no allergies to Ibuprofen products, you may use Advil or Motrin as directed for cramps.
2. No intercourse, douching, or use of tampons for 10 days.
3. Return to our office for the results of your test in approximately 1 week. This can be scheduled at the front desk after your procedure.
4. If bleeding that alarms you occurs after your biopsy, contact our office (309) 692-2025 to speak with one of the nurses.

 

Loop Electrosurgical Excision Procedure (LEEP)
When normal cervical cells become abnormal, they may need to be removed in order to prevent cancer. The LEEP procedure is an effective and simple way of removing abnormal cells. It only takes a few minutes and can be done comfortably in our office. For the procedure, you will lie on your back and your doctor will insert a speculum into the vagina, just like a pap smear. Local anesthesia will be given through a needle to prevent pain. You may feel a mild sting, dull ache, or cramping when the anesthesia is being given, but will be free of pain for the rest of the procedure. A thin wire loop that uses an electric current is then used to remove a small portion of your cervix, which will be sent to the lab for further testing. After the procedure, a special paste or electrocautery may be used to stop any bleeding. A brownish-black vaginal discharge for up to two weeks can be very normal. If you desire, you can return to work directly after the procedure.

Post-LEEP Instructions:
1. Refrain from sex for 4 weeks.
2. Avoid lifting heavy weights.
3. Brownish-black vaginal discharge for a few days to two weeks is normal. However, if the discharge becomes malodorous, use vaginal douches with 1/3 vinegar to 2/3 water, twice a day for five consecutive days. If odor persists, return to office.
4. If spotting or bleeding persists longer than six days, call the office (309) 692-2025.
5. Return to our office for your test results in 2 weeks and for a follow up visit in 3-6 months.

 

Cryotherapy of the Cervix
If your pap smear or colposcopy biopsy show abnormal cells on your cervix, your doctor may recommend a treatment called cryotherapy. During cryotherapy, the cervix is frozen and abnormal cells are destroyed. The entire procedure takes less than 15 minutes and can be done comfortably in our office. For the procedure, you will lie on your back and your doctor will insert a speculum into the vagina, just like a pap smear. Your doctor will then clean your cervix with iodine solution. Make sure to tell him or her if you are allergic to iodine or shellfish. Next, an instrument attached to a "cryo" machine is inserted into the vagina and place on the tissue that is going to be frozen. When the machine is turned on, gas is sent into the instrument causing the tip to become cold enough to freeze and destroy the cells. The freezing is applied for 3 minutes, followed by a 5 minute break, and then re-applied for another 3 minutes. You may experience menstrual like cramping during the procedure and for approx. 1 hour after the procedure. As your cervix heals, you will have a heavy clear or yellow watery vaginal discharge for up to 2 weeks. This is due to your body shedding the dead cells from your cervix. During this time, you may want to wear a pad.

Post-Cryotherapy Instructions:
1. Expect to have a watery vaginal discharge for 10-14 days.
2. No intercourse, douching, or use of tampons for 10 days.
3. If you experience cramping, which is normal, you may use Advil or Motrin as directed as long as you are not allergic.

 

Dilation and Curretage (D&C)
Dilation and curettage (D&C) is a procedure used to diagnose or treat many conditions that cause abnormal bleeding from the uterus, to remove tissue that remains in the uterus after a miscarriage, and can also be used to help detect uterine cancer. A D&C can be done in an outpatient surgery center or a hospital, and may also be done in conjunction with other procedures, such as hysteroscopy (click here to learn more about the hysteroscopy procedure).

Before your doctor begins the D&C, you will be placed under general anesthesia, which means you will not be awake during the procedure. You will lie on your back and your legs will be placed in stirrups. Next, your doctor will insert a speculum into your vagina and a clamp will be put on your cervix to help hold it in place. The cervix is then opened, or dilated, and the tissue lining the uterus will be removed using an instrument called a curette or with suction. The tissue will then be sent to the lab for further examination.

Most women are able to go home within a few hours after the procedure and are able to resume normal activities within 1-2 days. After a D&C, a new lining will build up in the uterus, which may cause your next menstrual period to occur earlier or later than expected.

 

Endometrial Biopsy
An endometrial biopsy is a simple procedure in which a small sample of tissue is removed from the inner lining of the uterus, called the endometrium. There are several reasons your doctor or nurse practitioner may recommend an endometrial biopsy, such as abnormal menstrual bleeding, bleeding after menopause, or absence of uterine bleeding. The purpose of this type of biopsy is to identify possible cell changes related to hormone levels, the presence of abnormal tissues such as fibroids or polyps, or to check for uterine infections such as endometritis. An endometrial biopsy may also be used to detect the presence of abnormal cells or cancer.

An endometrial biopsy is most often performed in the doctor’s office, but may also be done in conjunction with other gynecologic procedures in a hospital or surgery center. For most women, the procedure will be done in the comfort of our office. While lying flat on the examination table with your feet and legs supported as with a pelvic exam, your physician will insert a speculum into your vagina in order to obtain a clear view of your cervix. Next, a thin tube, called a catheter, will be inserted through the cervical opening into the uterus. The catheter has another smaller tube inside it, which your physician will withdraw to create suction. Your physician will then gently rotate and move the tip of the catheter in and out to collect small pieces of endometrial tissue. This may cause some cramping. Once an adequate sample has been obtained, the catheter and speculum will be removed and the tissue will be sent to the lab for further testing. After the procedure, your doctor will give you instructions regarding your activity, however, most women are able to return to normal activities immediately following their exam. It is normal to have some mild cramping, spotting, or light vaginal bleeding for a few days after the procedure.

 

Endometrial Ablation
Endometrial ablation is used to treat many causes of heavy bleeding. Ablation is a short procedure that destroys the lining of the uterus and stops the menstrual flow in many women. In some women, menstrual bleeding doesn’t stop completely, but is reduced to normal or lighter levels. Since this procedure treats the lining of the uterus, it does not involve removal of the uterus and does not affect a woman’s hormone levels.

Ablation is done as outpatient surgery, meaning you can go home the same day. There are no incisions involved and recovery takes about 2 hours. After the procedure, some women experience menstrual like cramping for 1-2 days and / or a thin, watery discharge mixed with blood, which can last a few weeks. In most cases, women can expect to go back to work or return to normal activities within 1-2 days following the procedure. It may take several months before the full effects of ablation are reached.

Endometrial ablation works well for many women who suffer from heavy bleeding. If you are interested in having an ablation done, please contact our office to schedule an informational visit with one of our physicians.

 

Essure
The Essure Procedure is the first non-incisional permanent birth control procedure approved by the FDA. This gentle procedure can be performed in the comfort of our office in approximately 10 minutes. During the Essure procedure, soft, flexible coils called “micro-inserts” are passed through the body’s natural pathways (vagina, cervix, and uterus). The coils are then placed into each fallopian tube. The micro-inserts are made with materials that have been used in medical devices for many years, and do not contain or release hormones. During the first 3 months following the procedure, your body and the micro-inserts work together to form a tissue barrier (like scar tissue) so that sperm cannot reach the egg. You will need to use another form of birth control during this time. After 3 months, your doctor will order a special type of x-ray test called an HSG, which can be done at any local hospital. This test will assure that your tubes are completely blocked and you can rely on the Essure micro-inserts for birth control.

For more information regarding the Essure Procedure, please visit www.essure.com or call our office to schedule an informational appointment with one of our doctors.

 

Hysteroscopy
A hysteroscopy is a technique used to look inside the uterus by using a special instrument called a hysteroscope. The hysteroscope is a thin, lighted telescope-like device that is inserted through the cervix and into the uterus, where it will then transmit images onto a screen, allowing the doctor to see inside the uterus. A hysteroscopy can be performed in an outpatient surgery center or a hospital, and may also be done in conjunction with other procedures, such as a dilation and curettage, otherwise known as a D&C. (click here to learn more about the D&C procedure).

A hysteroscopy is most commonly performed to find the source of abnormal uterine bleeding. However, it is also used to remove adhesions, or scar tissue within the uterus that can be caused by infection or a prior uterine surgery or to diagnose the cause of repeated miscarriages.

Before your doctor begins the hysteroscopy, you will be placed under general anesthesia, which means you will not be awake during the procedure. You will lie on your back and your legs will be placed in stirrups. Next, your doctor will insert a speculum into your vagina and a clamp may be put on your cervix to help hold it in place. The hysteroscope is then inserted and gently passed through the cervix into your uterus. Carbon dioxide gas or a fluid, such as saline (salt water), will be put through the hysteroscope in order to expand your uterus. The gas or fluid helps your doctor see the lining of your uterus and the opening of your fallopian tubes more clearly.

Most women are able to go home within a few hours after the procedure and are able to resume normal activities within 1-2 days.

 

Laparoscopy
Laparoscopy is a way of doing surgery without making a large incision, or cut, in the abdomen. A laparoscopy is most commonly used to find the cause of chronic pelvic pain, to treat endometriosis, to remove fibroids, ovarian cysts or an ectopic pregnancy and to perform sterilization or a hysterectomy. A laparoscopy is always performed in an outpatient surgery center or hospital.

Before your doctor begins the laparoscopy, you will be placed under general anesthesia, which means you will not be awake during the procedure. Your doctor will then make a small incision in your navel and insert a thin, lighted tube known as a laparoscope. The laparoscope is a small camera that allows your doctor to see the pelvic organs on a screen. During the procedure, the abdomen is filled with a gas (carbon dioxide or nitrous oxide), which allows the pelvic organs to be seen more clearly. If a problem is found and needs to be fixed, other instruments may be inserted either through the laparoscope or through other small incisions in the abdomen. Another instrument, called a uterine manipulator, may be inserted through the cervix and into the uterus to move the organs into view.

After the procedure, the instruments are removed and the small incisions are closed with stitches, tape or glue. Most women are able to go home within a few hours after the procedure and are able to resume normal activities within 1-2 days. However, it may be necessary to avoid heavy lifting or exercise for longer than a few days depending on the extent of the procedure.

 

Sterilization by Laparoscopy
Sterilization is a very effective way to prevent pregnancy and is often done with a technique called laparoscopy, which uses a thin lighted tube known as a laparoscope to view the uterus, ovaries, and fallopian tubes. Sterilization by laparoscopy is always performed in an outpatient surgery center or hospital.

With tubal sterilization, both fallopian tubes are blocked by tying, sealing, or attaching a ring or clip to them, which prevents an egg from moving down the tube and into the uterus where it would become fertilized. The surgery does not affect either partner's ability to have or enjoy sex. It only prevents pregnancy.

Laparoscopic sterilization is a very effective method of birth control. Fewer than 1 in 100 women who have a sterilization procedure will become pregnant. However, sterilization is a permanent method of birth control. You and your partner must be certain that you do not want any more children, now or in the future. If there is any chance that you may want to have children in the future, a reversible form of birth control may be a better option for you.

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