Boulder Gynecology Office Evaluation & Procedures
Gynecological evaluations and procedures performed in the comfort of our Boulder office.
We realize procedures to evaluate gynecologic conditions are among the most dreaded procedures for women. In an attempt to improve your comfort and convenience, we perform many gynecological procedures and evaluations ourselves in our Boulder office. We feel the familiarity of the office and staff can help put you at ease.
Urodynamic evaluation for urinary incontinence
Urodynamics are a combination of tests to evaluate bladder and urethral function. Urodynamics is useful in the evaluation of urinary incontinence. The tests assess how the bladder fills, pressure in the bladder as it fills, the rate of urine flow with emptying, bladder capacity, and sphincter function. A thorough urodynamic evaluation takes about 45 minutes. While some women report feeling embarrassment in the process, it is not painful. We will do our best to make you as comfortable as possible.
Transvaginal ultrasound is a way to look at a woman’s reproductive organs, namely the uterus and ovaries. In pregnancy, the uterus fills the abdomen. Ultrasound is done using an abdominal probe. In the non-pregnant state, the uterus is deep in the pelvis and so it can best be imaged using an ultrasound probe against the cervix. A thin rod with a transducer or probe at the end is inserted into the vagina to look up at the pelvic organs. Women generally tolerate this procedure very well, and no special preparation is necessary.
Saline infused sonography
Saline infused sonography or sonohysterography is a way to better image the interior of the uterus. By instilling a small amount of sterile saline through the cervix at the time of transvaginal ultrasound, we can better visualize abnormalities in the lining such as polyps or fibroids. The procedure takes about 20 minutes. Patients can experience cramping so we recommend taking 600 to 800 mg of ibuprofen 30 minutes prior to the appointment.
Endometrial biopsy is a means to obtain cells from inside the uterus for evaluation by a pathologist and avoid performing a D&C (dilation and curettage). During endometrial biopsy, we insert a slender straw- like device through the cervix to obtain a sampling of cells from the uterine lining. Endometrial biopsies are generally done to evaluate abnormal menstrual bleeding. The procedure takes only a few minutes. Some cramping does occur so we advise taking 600 to 800 mg of ibuprofen 30 minutes prior to the appointment time.
Colposcopy and LEEP
Colposcopy and LEEP are done to evaluate and treat (respectively) abnormal cells of the cervix. The procedures are done with a speculum in the vagina. The colposcope will magnify and shed light on the cervical cells so that tiny biopsies can be taken where abnormalities are seen. LEEP (loop electrosurgical excision procedure) is done with a small wire loop to shave off precancerous cervical cells. A local anesthetic is injected into the cervix before the LEEP is done. Most women do very well with both procedures and report that their pre-procedure anxiety was worse that the procedure itself.
Pessaries are used to conservatively (non-surgically) manage pelvic prolapse. They are silicone or rubber devices placed inside the vagina to help support the uterus, or the vaginal walls of the bladder or rectum. They require appropriate fitting in order to provide adequate support and be worn comfortably. We provide fitting and education on pessary use during an office visit.