Monalisa Touch®

Have you experienced changes in your vaginal health since menopause? Did you know that as many as 50% of postmenopausal women suffer from changes in their vaginal health.

It’s OK to talk about it – because now you can do something about it!

MonaLisa Touch®: A Novel Laser Therapy for Vaginal Health

Patients are calling it “Life-Changing”

MonaLisa Touch delivers gentle laser energy to the vaginal wall tissue that stimulates a healing response by generating new collagen, elastin and vascularization. A typical course of treatment is three procedures over 18 weeks.

  • In-office procedure
  • Requires no anesthesia
  • No downtime
  • Minimal side effects
  • Each treatment is <5 minutes
  • 8 Published Studies
  • 6 Ongoing Studies
  • Thousands of women have been treated worldwide since 2012

In both European and US clinical trials, women reported symptom relief after the very first treatment and even greater improvement after treatments 2 and 3.

Ask us today if the MonaLisa Touch is right for you.

 

MonaLisa Touch Overview

Hospital Surgeries

  • Hysteroscopy
  • Hysterectomy
  • Laparoscopy
  • Laparoscopic Tubal Ligation
  • Myosure www.myosure.com
  • Robotic Surgical Approaches
  • Minimally invasive techniques for surgical approaches

Hysteroscopy – is a procedure that allows a gynecologist to look inside your uterus. The hysteroscope is a long tube, about the size of a straw, which has a built-in viewing device. Hysteroscopy is useful for diagnosing and treating some problems that cause infertility, miscarriages, and abnormal menstrual bleeding. Sometimes other procedures, such as laparoscopy, are done at the same time as hysteroscopy.

Hysterectomy– A hysterectomy (his-tur-EK-tuh-mee) is a surgery to remove a woman’s uterus or womb. The uterus is where a baby grows when a woman is pregnant. The whole uterus or just part of it may be removed. After a hysterectomy, you no longer have menstrual period there are different ways that your doctor can perform a hysterectomy. It will depend on your health history and the reason for your surgery.

  • Abdominal hysterectomy. This is done through a 5- to 7-inch incision, or cut, in the lower part of your belly. The cut may go either up and down, or across your belly, just above your pubic hair.
  • Vaginal hysterectomy. This is done through a cut in the vagina. The doctor will take your uterus out through this incision and close it with stitches.
  • Laparoscopic (lap-uh-ro-SKOP-ik) hysterectomy. A laparoscope is an instrument with a thin, lighted tube and small camera that allows your doctor to see your pelvic organs. Your doctor will make three to four small cuts in your belly and insert the laparoscope and other instruments. He or she will cut your uterus into smaller pieces and remove them through the incisions.
  • Laparoscopically assisted vaginal hysterectomy (LAVH). Your doctor will remove your uterus through the vagina. The laparoscope is used to guide the procedure.
  • Robotic-assisted surgery. Your doctor uses a special machine (robot) to do the surgery through small cuts in your belly, much like a laparoscopic hysterectomy (see above). It is most often done when a patient has cancer or is very overweight and vaginal surgery is not safe.

Laparoscopy – is a surgery that uses a thin, lighted tube put through a cut (incision) in the belly to look at the abdominal organs or the female pelvic organs. Laparoscopy is used to find problems such as cysts, adhesions, fibroids, and infection. Tissue samples can be taken for biopsy through the tube (laparoscope).

Laparoscopy is done to:

  • Check for and possibly take out abnormal growths (such as tumors) in the belly or pelvis.
  • Check for and treat conditions such as endometriosis, ectopic pregnancy, or pelvic inflammatory disease (PID).
  • Find conditions that can make it hard for a woman to become pregnant. These conditions include cysts, adhesions, fibroids, and infection. Laparoscopy may be done after initial infertility tests do not show the cause for the infertility.
  • Do a biopsy
  • Do a tubal ligation
  • Find the cause of sudden or ongoing pelvic pain.

Laparoscopic Tubal ligation -A tubal ligation is considered a permanent method of birth control. The fallopian tubes are cut or blocked, which prevents pregnancy by blocking the egg’s path to the sperm and uterus. Laparoscopy makes it possible to see and do the surgery through small incisions in the abdomen.

For a laparoscopic tubal ligation, the surgeon makes two small incisions-one in or just below the belly button (navel) and one at the upper edge of the pubic hair. The abdominal cavity, where the reproductive organs are, is inflated with air or a harmless gas so that the surgeon can see and avoid injuring abdominal organs or the inside of the abdomen.

The surgeon inserts a thin, lighted viewing tube (laparoscope) through the incision. The laparoscope has a lens that magnifies what the surgeon is viewing. The instrument that the surgeon uses to cut (ligate) the tubes may be inserted alongside the laparoscope or through the incision just above the pubic hair. The surgeon looks through the laparoscope while moving this instrument to get the tubes cut in the correct location

Myosure – procedure is a new and innovative treatment that enables incision-less, fast removal of submucosal fibroids and polyps as well as providing effective relief of abnormal uterine bleeding (AUB). MyoSure is an ideal treatment option for women of all ages seeking to preserve uterine form and function. The MyoSure® tissue removal system was designed, from the ground up, specifically for the removal of intrauterine pathology. It features a small cutter blade encased in an outer tube. The cutter blade is powered by an electro-mechanical drive system which enables simultaneous rotation and reciprocation of the cutter to remove both fibroids and polyps quickly and effectively. Because the cutter does not utilize RF energy, the pathological specimens, captured in a vacuum canister tissue trap, remain intact.

The unique cutter is also connected to a vacuum source which continuously aspirates resected tissue through a side-facing cutting window in the outer tube. The tissue removal device’s side-facing cutting window dimensions limit the depth of tissue resection to minimize perforation risk. When the device is not cutting, the cutting window automatically closes to prevent a loss of uterine distension, thereby reducing the potential for uterine perforation and making rapid resection procedures possible. To learn more about this procedure go to www.myosure.com .

Robotic Surgical Approaches – When medication and non-invasive procedures are unable to relieve symptoms, surgery remains the accepted and most effective treatment for a range of gynecologic conditions. These include, but are not limited to, cervical and uterine cancer, uterine fibroids, endometriosis, uterine prolapse and menorrhagia or excessive bleeding.

Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has for many years been the standard approach to many gynecologic procedures. Yet with open surgery can come significant pain, trauma, a long recovery process and threat to surrounding organs and nerves. For women facing gynecologic surgery, the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery can understandably cause significant anxiety.

Fortunately, less invasive options are available. Some gynecologic procedures enable surgeons to access the target anatomy using a vaginal approach, which may not require an external incision. But for complex hysterectomies and other gynecologic procedures, robot-assisted surgery with the da Vinci® Surgical System may be the most effective, least invasive treatment option. Through tiny, 1-2 cm incisions, surgeons using the da Vinci System* can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and excellent clinical outcomes.

Cancellations of scheduled surgical procedures with less than a 72 hour notice will be assessed a $200 administrative fee. This fee is not billable to insurance or reimbursable and must be paid before we can schedule any further office appointments, office procedures or surgeries. If you are requesting a refund of your surgery deposit and less than a 72 hour notice was given, you will receive your refund less the $200 surgery cancellation fee. This cancellation fee only applies to Southwest Ob Gyn Physicians. Other medical specialist involved in your care may have a separate cancellation fee.

Gynecology

  • Evaluation of Abnormal Uterine Bleeding
  • Annual Well Women Exams, Pap smears & HPV testing
  • Adolescent Gynecology
  • Contraception 
  • Diagnosis and Management of Urinary Incontinence
  • Diagnosis and Treatment of Pelvic Floor Disorder
  • Fibroids
  • Genetic Testing ( familial cancers and diseases)
  • Management of Menopausal Issues and Hormone Replacement
  • Permanent Sterilization
  • Preconception Counseling

Obstetrics

On your initial obstetrical (OB) visit you will receive a packet of information and a comprehensive prenatal guide entitled “Pregnancy”. We urge you to read the packet and guide in its entirety as it will answer many of the questions and concern you may have throughout your pregnancy and postpartum period.

On your initial OB visit, you will also meet with an OB Coordinator who will assist you with many of the financial details of your prenatal care, such as providing you with an explanation of your insurance benefits and establishing a financial agreement and payment plan for any amount not covered by your insurance.

1st Trimester ~ Less than 14 weeks, 0 days

2nd Trimester ~ 14 weeks, 0 days through 27 weeks and 6 days

3rd Trimester ~ 28 weeks through delivery

Postpartum Care

Postpartum Care

Taking home a new baby is one of the happiest times in a woman’s life. But it also presents both physical and emotional challenges.

  • Get as much rest as possible. You may find that all you can do is eat, sleep and care for your baby. And that is perfectly okay. You will have spotting or bleeding, like a menstrual period off and on for up to six weeks.
  • You might also have swelling in your legs and feet, feel constipated, have menstrual-like cramping. Even if you are not breastfeeding, you can have milk leaking from your nipples, and your breasts might feel full, tender or uncomfortable.
  • Follow your doctor’s instructions on how much activity, like climbing stairs or walking, you can do for the next few weeks.
  • Doctors usually recommend that you abstain from sexual intercourse for four to six weeks after birth.

In addition to physical changes, you may feel sad or have the “baby blues.” If you are extremely sad or are unable to care for yourself or your baby, you might have a serious condition called postpartum depression.

Postpartum Depression

Approximately 10 percent of mothers develop post partum depression (PPD).

If after a week or two of the “baby blues,” you are still feeling extreme anxiety, a sense of hopelessness, despair and/or negative feelings, to the degree that it interferes with your daily life, you may be suffering from postpartum depression. Other symptoms of postpartum depression include:

  • Disinterest in your baby or yourself
  • Inability to sleep (insomnia) or the wish to sleep all the time even when baby is awake
  • Loss of appetite or excessive need to eat all the day
  • Thoughts of harming yourself or your baby
  • Feeling of guilt or hopelessness
  • Panic Attacks
  • Extreme concerns or lack of interest in baby

Should you have any of these signs of postpartum depression, take steps immediately to get the help you need. Speak with your doctor and let him or her know what you are feeling. They have the experience and understanding to support you through this period. If necessary, he or she can refer you to the resources where you can find additional help.

3rd Trimester

3rd Trimester ~ 28 Weeks Through Delivery

Group B Strep Culture – Group B strep (GBS) is a kind of bacteria that many people harbor in their intestinal tracts. The bacteria may also inhabit (or “colonize”) your vagina as well, and be passed on to your baby during labor and birth.

Repeat HIV test – is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS). This test is recommended by The State of Texas.

2nd Trimester

2nd Trimester ~ 14 Weeks, 0 Days Through 27 Weeks And 6 Days

Blood Test to check for Gestational Diabetes – Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy.

CBC – The complete blood count or CBC test is used as a broad screening test to check for such disorders as anemia.

Level 2 Ultrasound – Comprehensive Ultrasound performed at 19-21 weeks. This is a detailed examination of the fetal anatomy and an opportunity to find out the sex of the baby.

1st Trimester

1st Trimester ~ Less Than 14 Weeks, 0 Days

Tests for Chromosomal Abnormality

CVS (Chorionic Villus Sampling) this is an invasive test that can be done around 10-12 weeks. During a CVS, a small sampling of the cells is taken from the placenta. SAFE MEDICATIONS DURING PREGNANCY

Nuchal Translucency/Ultra Screen – This is a minimally invasive test performed between 9-13 weeks from the last menstrual period. A transvaginal ultrasound is used to measure the neck fold (or nuchal translucency) of the baby. A blood test is also performed that test is also performed that tests foe Beta HCG and PAPP-A proteins. These combined tests can detect 90% of babies for Downs Syndrome and 97% of babies with Trisomy 18.

Cystic Fibrosis – (also known as CF or mucoviscidosis) is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine. It is characterized by abnormal transport of chloride and sodium across epithelium, leading to thick, viscous secretions.[1

Counsyl – is a preconception carrier screen for more than 100 single gene disorders. The test is simultaneously less expensive yet far more comprehensive than currently available assays for cystic fibrosis and Ashkenazi Jewish diseases

Quad Screen – This is a maternal test offered from 16 – 20 weeks. The quad screen is a prenatal test that measures levels of four substances in a pregnant woman’s blood:

  • Alpha-fetoprotein (AFP), a protein made by the baby’s liver
  • Human chorionic gonadotropin (HCG), a hormone made by the placenta
  • Estriol, a hormone made by the placenta and the baby’s liver
  • Inhibin A, another hormone made by the placenta

Results of the quad screen indicate your risk of carrying a baby who has certain developmental or chromosomal conditions, such as spina bifida or Down syndrome not whether your baby actually has these conditions.

Amniocentesis – (also referred to as amniotic fluid test or AFT) is a medical procedure[1] used in prenatal diagnosis of chromosomal abnormalities and fetal infections,[2] in which a small amount of amniotic fluid, which contains fetal tissues, is sampled from the amnion or amniotic sac surrounding a developing fetus, and the fetal DNA is examined for genetic abnormalities.

Safe Medications During Pregnancy

You may use this as a guideline for medications safe to use during your pregnancy. Please call the office or contact us if your symptoms persist or if you have a fever over 100.4 degrees.

Cold Symptoms
For allergy or cold symptoms, you may take Sudafed or Sinus Tylenol, Robitussin (Plain or DM) for cough, and Sucrets or Chloraseptic Lozenges for sore throat associated with allergies or a cold.

Indigestion
Mylanta (either chewable or liquid), Maalox, Mylicon, Gaviscon or Tums are all safe to take for indigestion. If you have persistent problems with indigestion, there are some things you can do: eat small, frequent meals, avoid carbonated beverages and spicy foods, do not drink through a straw, and do not lie down after eating. If these changes don’t help or if you have nausea and vomiting or severe abdominal pain, contact your physician. SAFE MEDICATIONS DURING PREGNANCY

Headaches or Discomfort
Tylenol – Regular or Extra Strength. Ibuprofen may be used in the first and second trimesters ONLY. DO NOT USE ASPIRIN. Call the office if pain persists or if headaches are accompanied by blurred vision, pain in the upper right abdomen, sudden weight gain, or swelling of the face and/or hands.

Minor Bladder Irritations
Eliminate all carbonated beverages, coffee, and tea from your diet. Increase your water intake to 8-10 glasses per day and drink 3-4 glasses of cranberry juice per day. If not better within 24 hours, please call the office.

If urinary symptoms include hesitancy when you start to void, a strong sense of urgency to void, increased frequency and burning on urination, fever, chills, low abdominal pain or cramping, back or flank pain, blood in the urine, or foul-smelling urine, please call the office immediately.

Swelling
Do not add salt to your food (get rid of the salt shaker!) and limit or omit high-sodium foods such chips, salted nuts, pretzels, soy sauce, bouillon and canned soups, bacon or ham and other processed meats. Many canned and processed foods contain a lot of sodium. Check nutrition labels and limit your sodium intake to 2 gms per day. Elevate your feet whenever possible. Please call the office if swelling continues, if you notice significant swelling in your face or hands, or if swelling is accompanied by a headache or epigastric pain.

Backache
Avoid wearing shoes with heals and standing for long periods of time. Sit in chairs that provide good back support. A warm bath, heating pad, or cold compresses can help ease back pain. You may take Tylenol as needed for pain. Call the office if backache continues.

In the late second and third trimesters, back pain can be a sign of preterm labor or urinary tract infection. If you have back pain that is intermittent and rhythmic, doesn’t respond to any of the above treatments, or is accompanied by severe pain and/or fever, call the office immediately.

Nausea
Try eating dry crackers before getting out of bed in the morning. Eat every two or three hours throughout the day. Avoid smells that trigger nausea, highly seasoned or fatty foods, alcohol, caffeine, and cigarette smoke. Sometimes peppermints or ginger tea can help reduce nausea. Do not take prenatal vitamins on an empty stomach or if feeling nauseated. If not controlled with diet, try Emetrol (if not diabetic) or Nestrex. If vomiting continues, call the office.

Leg Cramps
Avoid standing or sitting with your legs crossed for long periods and stay well-hydrated. Eat a balanced and calcium-rich diet. Get regular exercise and stretch your calf and thigh muscles by stretching them three times a day and before you go to bed (see below). Lie down on your left side to improve circulation to your legs. Try taking a warm bath before

If you do get a cramp, immediately stretch your calf muscles by straightening your leg – press down on your heel first and gently flex your toes back toward your shins. It might hurt at first, but it will ease the spasm and the pain will gradually go away. Walking around for a few minutes after the cramp subsides may be helpful, too.

Call the office immediately if your muscle pain is continuous and is accompanied by redness, warmth, tenderness, or swelling. These can be signs of deep vein thrombosis.

Stool Softener
Surfak, Docusate, Dialose, Metamucil, Fibercon are all safe to take during pregnancy.

Constipation
Try to avoid constipation by staying well-hydrated (drink plenty of fluids), eating fresh fruits and vegetables, and exercising. Milk of Magnesia or Senekot are safe to take for constipation.

Diarrhea

If you have diarrhea, you should stick to a bland or clear liquid diet until the diarrhea subsides. It is safe to take Kaopectate or Imodium to treat diarrhea after 12 weeks of pregnancy. If diarrhea lasts more than 48 hours or is accompanied by weakness and fatigue, nausea and vomiting, right upper abdominal or epigastric pain, headache, blurred vision, bleeding from the gums or from minor trauma, jaundice or yellowing of the skin, or pain in the shoulder or neck, call the office immediately.

Hemorrhoids

To prevent hemorrhoids (or piles), eat a healthy diet that includes fresh fruits and vegetables, drink plenty of liquids, exercise regularly, use a stool softener (if needed), and avoid standing or sitting in the same position for prolonged periods. If you develop

You will get most of the vitamins and minerals you need from a healthy diet. However, it is difficult to get enough calcium, iron, and folic acid (a B-vitamin that helps to prevent defects of the brain and spinal cord known as neural tube defects) from the food you eat. Therefore, we recommend that you take a prenatal vitamin every day.