Gynecology
Below are some of the gynecology services that we specialize in:
Adolescent Gynecology
We enjoy seeing young women ages 14 and older. Teens, although in general not requiring an involved physical exam or cancer screening, are well served becoming acquainted with the many resources a gynecologist can offer. These health and lifestyle decisions might include, for example, a reminder to wear a bike helmet, to protect herself from STDs with condoms, how to evaluate herself and determine when to be seen for a vaginal infection or irregular period pattern. We want our teens to go out into the world with a complete knowledge of the gynecologist’s role in her life. To that end, we offer many printed and downloadable resources for our teens.
Gardasil vaccination is encouraged and will be given to interested women age 19 and over.
Click here for information about sexuality, especially for teens
Click here for information about healthy relationships
Alternatives To Hysterectomy
Endometrial Ablation
Every year 650,000 American women have hysterectomies. This operation involves surgical removal of the uterus. Many of the women who have this operation do so because of heavy or prolonged periods.
Endometrial ablation may be an effective alternative to hysterectomy for patients suffering from heavy or prolonged bleeding during their period. It is often chosen when other treatments have failed or are otherwise undesirable. This procedure involves the removal of the lining of the uterus, which is the source of the bleeding.
To determine if you are a candidate for this procedure, your physicians will perform a physical examination and possibly other tests such as an ultrasound and endometrial biopsy. An endometrial biopsy is obtained by sampling the uterine lining. These may help to determine the cause of your heavy menses.
If you are a candidate, then you are placed on medication to decrease the thickness of the uterine lining. The remaining lining is removed at the time of surgery.
Endometrial ablation is performed during a procedure called operative hysteroscopy. A narrow telescope is inserted through the vagina and the cervix into the uterus. A tiny camera attached to the telescope allows the uterine cavity to be shown on a TV monitor during surgery. Your uterus is filled with a liquid to make the procedure easier. The lining of the uterus is then removed, using a heat generating instrument inserted through the tube. Your physician may decide to perform a laparoscopy at the same time to rule out other conditions that could require further therapy. In this procedure, the physician inserts a telescope through the umbilicus (belly button) to see inside the body. Other tubes can be placed through the skin to introduce probes or instruments; in this way a number of surgical procedures can be performed without a large surgical incision.
The goal of endometrial ablation is to reduce menstrual flow or completely eliminate it. This is achieved by reducing the amount of uterine lining that sheds each month. To date, studies have shown that 80% of patients have no flow or light to normal flow. The remaining 20% of patients will continue to experience a heavy flow and require alternative therapies.
Our practice has experienced gynecologists who are dedicated to providing a safe, effective alternative to hysterectomy. We hope this has helped you to better understand endometrial ablation and how it can work for you. If you have any questions that have not been answered, please ask your physician. Your questions are important and we welcome the opportunity to discuss your concerns.
Contraception/Family Planning
We welcome a discussion with you about your fertility. From a discussion on how to enhance your fertility to get pregnant to how to choose among the many birth control options now available, we are ready to help you make the decisions that fits your goals.
Click here for up-to-date information on birth control choices
Click here for birth control information especially for teens
Gardasil Vaccination
Offered to women 19 years and older, this vaccination to prevent cervical cancer is nearly 100% effective against the 11 HPV (human papilloma virus) subtypes it targets. These are the two most common viral subtypes that cause genital warts and the 9 most common viral subtypes that cause high grade precancerous changes on the cervix as seen on PAP smear. Ages 12 – 14, when a girl is HPV-naive and has a very strong immune system, is the ideal time to get this vaccine. However, insurance will cover the three-shot series through age 26.
Click here for the most up-to-date information about Gardasil
Gyn Ultrasound/Sonohysterogram
We offer gynecologic and first trimester ultrasound performed by Certified Ultrasonographers. Since 1991, our physicians have used their extensive knowledge of gynecology to help provide the most accurate use of this diagnostic tool. We were the first office in the Rochester area to perform saline sonohysterography, which allows a more accurate interpretation of ultrasound when assessing the uterine cavity. We also offer first trimester ultrasound screening. This ultrasound is done to establish a due date, for bleeding or other concerns and as part of screening for Down Syndrome.
Hpv/Pap Smears/Colposcopy
Cervical cancer, which we now know is almost always caused by the high risk strains of the HPV virus, has been screened with the PAP smear since about 1950. Although traditionally the PAP has been done yearly in all women, it is now tailored to the age and PAP history of a woman. If indicated by the PAP results, you may be advised to have a colposcopy, a magnified look at the cervix by a pair of binoculars on a stand in the colposcope.
Click here for the most up-to-date PAP Guidelines
Infertility
Our doctors have a special interest and expertise in infertility evaluation and treatment. After a thorough history, examination and testing, they will outline the best options for treating your infertility problems. Since 1990, we have enrolled patients in our Ovulation Monitoring Program, which allows us to use ultrasound and medication to help patients overcome a variety of infertility issues. We also can perform laparoscopy when necessary in conditions such as endometriosis, fibroids, and pelvic scarring. We work closely with the reproductive endocrinologists in Rochester.
Menopause Transition
The “change of life” can be looked at as a new beginning. Realistically, however, we know some of the changes are not so great. This time of life typically includes changes at work and at home. Kids grow up; jobs and marriages get better or worse. On top of that, there are the physical changes due to the loss of estrogen and just plain getting older. Although there are typical symptoms such as hot flashes, there is a broad range of ways women experience the menopause transition. For some it is an easy time but for many it is not. Our care is individualized to how you are feeling, we are holistic in the sense that we take into account the context the menopause transition is occurring in. Natural approaches without medication, bio identical hormones and non estrogen medications are available. This is also a time of life when screening and prevention of heart disease, osteoporosis, cancer and weight gain are addressed.
Pelvic Support Problems
Pelvic Organ Prolapse
This is a medical condition that occurs when there are defects in pelvic floor support. It results in sagging of vaginal tissue and dropping of the bladder, uterus and rectum especially when straining or standing. As the problem worsens, women can feel tissue protruding through the vaginal opening. There may also be discomfort and bladder or bowel control problems. Vaginal laxity can also result in less satisfying sex for both the patient and her partner. Minor degrees of prolapse can often be helped by doing Kegel exercises. Severe prolapse can be managed by wearing a vaginal device called a pessary. For severe prolapse most patients prefer to have a surgical repair known as pelvic reconstructive surgery.
Preventative Gynecology
Your annual exam is a time to address your general health, especially as it relates to cancer prevention, bone density, fertility and life transitions.
Through a complete review and discussion of a woman’s year since her last annual exam including habits, medications, recent changes in relationships, new medical or surgical history and a physical exam,we help women achieve the lowest possible risk of gynecologic problems.
Problems with Menstruation
At the core of gynecology services, menstrual problems have many solutions today. We offer the full range of evaluation and treatments for menstrual problems.
Your evaluation at the office might include bloodwork, an endometrial biopsy, an ultrasound or a sonohysterogram. The treatments may range from lifestyle modifications to hormonal therapy to hormonal therapy to placement of an IUD or an in-office balloon ablation or even surgery.
For more information about the treatment of abnormal uterine bleeding, scroll up to “Alternatives To Hysterectomy”
STDs
Preservation of a woman’s health and fertility through diagnosis and treatment of sexually transmitted diseases is an important part of our care at ParkWest.
You may be seen immediately if the need is urgent for screening. Please call 585-473-2846 for an appointment.
Urinary Continence
Bladder Control Problems
Urinary incontinence is a very common problem which will affect 30% of women during their lifetime. While there are several potential causes, it is usually due to either a loss of vaginal support or to an overactive bladder resulting in bladder spasm. The physicians at ParkWest have the training and experience to treat this embarrassing condition.
Your doctor will probably refer you to our state of the art Urodynamics Lab for a thorough diagnostic evaluation before recommending treatment. We offer a full range of treatment options including physical therapy, biofeedback, bladder retraining, lifestyle changes, acupuncture, medication, pessaries or minimally invasive surgery.
Drs. Karen Duguid and Uma Penmetsa are the Directors of our Urodynamics Lab.
For more information on urinary incontinence services at ParkWest Women’s Health, click here
Other Available Services
- Contraception/IUDs
- Fertility
- Sexual HealthProblems