Surgical Procedures in the Office

• Bone Density Testing
• Colposcopy
• Cystometrogram (CMG)
• Endometrial Biopsy
• LEEP Excision of the Cervic
• Sonohysterogram (SONO HSG)

Definitions of Procedures

Bone Density Testing

Osteoporosis (loss of bone mass) is a disease that affects twenty-five million Americans, mostly women.  Half of women over the age of 50 have an osteoporosis related fracture.  At Rock Hill Gyn & Ob, we have the technology in our Rock Hill office to evaluate bone density with the use of our DEXA machine.  Bone density testing is not commonly performed prior to menopause except for unusual medical conditions.

Often this test can be scheduled at the same time as your visit.  You will be asked to lie down on a table while the DEXA machine scans your spine and hips (the procedure is similar to having an X-ray done).  If you are over the age of 65, you should have a bone density scan every two years.  Bone density testing is covered by most insurance plans.

Before your appointment, please download and fill out our Osteoporosis Questionnaire (see below) and bring it with you when you come in for your dexascan.  Note:  Please avoid taking your bone medications and calcium the day of your scan.

Colposcopy

Colposcopy is recommended if the Pap smear results suggest further examination of the cervix is necessary.  These results could show atypical cells, pre-cancerous cells or the HPV virus.

A colposcope is a microscope through which your provider will get a magnified view of the cervix.  A vinegar solution is applied to your cervix and then your provider will use the colposcope to perform the exam.  If abnormal areas are seen, a small sample of cervical cells will be taken and sent to the lab for further evaluation.  These results take approximately ten working days.  You may experience mild cramping and may take four Advil or two Aleve with food one hour prior to the exam.

Avoid intercourse and strenuous exercise for seven days after the exam.  It is okay to take baths and showers.  This exam cannot be done during your period.

Cystometrogram

CMG is a procedure used to evaluate urinary stress incontinence or other bladder problems.  CMG is a simple procedure done in our office.  A tiny catheter is inserted into the bladder.  We will then fill your bladder with a sterile solution to evaluate your bladder function.  The entire procedure takes approximately twenty minutes.  This procedure will help your physician determine the best course of treatment for you.

If you are on medication for your bladder, please discuss this with your physician to determine if you should discontinue your medications for a few days prior to the exam.  No other preparation is necessary.

Endometrial Biopsy

Endometrial biopsy is usually done to investigate abnormal uterine bleeding.  Your physician will take tissue samples from the inside of the uterus using a thin hollow catheter.  The procedure can cause cramping for about five minutes and subsides quickly.  Take four Advil or two Aleve with food one hour prior to your appointment.   Your period may be heavier than usual after the procedure.  There should be no douching or intercourse for five days following the procedure.  Tub baths and showers are fine.

LEEP Excision of the Cervix

Treatment for abnormal Paps that include moderate or severe dysplasia involves removing a portion of the cervix that contains these abnormal cells.  Abnormal cells are removed from the cervix using a thin wire loop through which an electrical current is passed.  The tissue is then sent to the pathologist and results are received within ten working days.

Bleeding is to be expected after the procedure.  The physician will usually place a liquid material on the cervix to help lessen the bleeding.  Expect a thick brown discharge after the procedure.  No tampons, douching or intercourse should be performed for two weeks after the procedure.  No tub baths or swimming for two weeks after the procedure.  Showers are fine.

Heavy bleeding (heavier than a menstrual period - soaking a pad in less than one hour) needs to be reported to your physician.  This happens 5-10 percent of the time.  The most common time for this to happen is the first 24 hours after the procedure or one week after the procedure.  Call our office or the on-call physician if this happens.

Infection is not common, but call the physician for fever greater than 101 degrees or a foul smelling vaginal discharge.

There may be a slight risk of premature delivery in furture pregnancies after a LEEP procedure.  We advise that you delay pregnancy for 6-12 months after the procedure to minimize the risk.

If you are scheduled for a LEEP procedure, please download our Patient Consent for LEEP procedure (see below) and bring it with you to the appointment.

Sonohysterogram (SONO HSG)

This is an ultrasound study done in our office to evaluate abnormal uterine bleeding.  During the procedure your physician will insert a small thin catheter into your cervix.  The uterine cavity is filled with sterile water.  Your physician will then examine your uterus with a vaginal ultrasound.  There will be some cramping during this 5-10 minute procedure.  Take four Advil or two Aleve with food one hour prior to your appointment.  Do not schedule this procedure during your period.