Office Procedures at Madison Gynecology & Wellness

A colposcopy is a specialized examination of the cervix, recommended when a Pap smear shows abnormal results. During this procedure, the cervix is treated with special solutions to highlight any abnormal cells. A biopsy may also be performed to examine these cells more closely. This procedure is conducted right in our office.

• What to Expect: A speculum is inserted, similar to during a Pap smear, to allow the cervix to be viewed directly through the colposcope. You might feel a pinching sensation or cramping if a biopsy is taken.
• Before the Procedure: You may eat normally before the procedure. Over-the-counter pain relievers can be taken about an hour before your appointment. We also offer prescription premedications for pain, inflammation, or anxiety upon request.
• After the Procedure: Cramping, light bleeding, and a yellowish or dark discharge are normal due to a solution applied to stop bleeding. We recommend avoiding inserting anything into the vagina or exercising for 2-3 days. Biopsy results are typically available within 7-10 days.

An intrauterine device (IUD) is a form of birth control that prevents pregnancy by affecting sperm movement and, in some cases, by preventing ovulation. This option is suitable for women who prefer to avoid daily or hormonal systemic methods of contraception and are looking for long-term birth control.

• What to Expect: The procedure begins with a speculum, similar to a Pap smear. The cervix will be cleansed, and the IUD is inserted into the uterus. Some cramping, dizziness, or bleeding may occur, which is common.
• Before the Procedure: You can eat as usual. We advise taking ibuprofen or a similar medication 2-3 hours before the procedure. We also offer prescription premedications for pain, inflammation, or anxiety upon request.
• After the Procedure: Some cramping and bleeding may occur afterward. Ibuprofen can be taken every 6 hours to help with discomfort.

An endometrial biopsy involves taking a small sample of the lining of the uterus to help diagnose the cause of abnormal uterine bleeding. This procedure uses a thin, hollow tube to collect a tissue sample for laboratory analysis.

• What to Expect: After inserting a speculum, the cervix is cleaned, and a thin catheter is used to obtain a tissue sample from the uterus. You may feel significant discomfort for about a minute.
• Before the Procedure: You can eat normally before your appointment. Taking a pain reliever such as Aleve, Advil, or Motrin 30-60 minutes before the procedure is recommended. We also offer prescription premedications for pain, inflammation, or anxiety upon request.
• After the Procedure: Mild cramping and discharge are normal. We suggest avoiding vaginal insertion and exercise for 5 days. Biopsy results are typically available in 7-10 days.

A vulvar biopsy involves taking a small tissue sample from the vulva (the external part of the female genitalia) to investigate symptoms such as itching, redness, swelling, or changes in skin color.

• What to Expect: The biopsy area is cleaned, and a numbing agent is injected. If the biopsy is vaginal, a speculum will be used. One or more small tissue samples will be taken and sent for analysis. If stitches are needed, dissolvable ones will usually be used. You may feel some discomfort during the procedure.
• Before the Procedure: There is no special preparation required, but we recommend gently washing the area before your appointment and wearing comfortable clothing.
• After the Procedure: Keep the area clean and dry. You may shower the next day, but gently pat the area dry with a clean towel.

A hysterectomy is the surgical removal of the uterus. This procedure can be performed using various methods, including laparoscopic or robotic-assisted surgery, to minimize recovery time and reduce pain.

• What to Expect: During the procedure, the uterus is removed through small incisions using a laparoscope or robotic instruments. This approach typically results in less pain, smaller scars, and a quicker recovery than traditional open surgery.
• Before the Procedure: You will be given specific instructions regarding eating, drinking, and medications. You may be asked to stop certain medications before surgery. Arrange for someone to drive you home and help you during the initial recovery period.
• After the Procedure: You may experience some pain, cramping, or light bleeding. Most patients can go home within 24 hours. Recovery typically takes 2.5-4 weeks, during which you should avoid heavy lifting, strenuous activities, and inserting anything into the vagina until cleared by your doctor.

Tubal ligation and salpingectomy are permanent birth control options for those who do not wish to have children in the future. Tubal ligation involves blocking or sealing the fallopian tubes, while salpingectomy is the removal of the fallopian tubes entirely. We prefer salpingectomy as there are studies showing this procedure can reduce ovarian cancer risk in the future.

• What to Expect: These procedures are usually done laparoscopically through 3 small incisions in the abdomen. Tubal ligation may involve cutting, tying, or sealing the tubes, whereas salpingectomy involves removing the tubes.
• Before the Procedure: Follow instructions for fasting before surgery and arrange for transportation home. You may need to stop certain medications before the procedure.
• After the Procedure: Mild cramping and discomfort are normal. You may return to normal activities within a week but should avoid heavy lifting and strenuous activities for a few weeks. Most patients recover fully within a few days to a week.

This procedure involves removing fibroids (non-cancerous uterine growths) or ovarian cysts that cause pain or other symptoms.

• What to Expect: Depending on the size and location of the fibroids or cysts, removal can be done open, laparoscopically, or through robotic-assisted surgery. Small incisions are made in the abdomen, and the growths are removed with minimal impact on surrounding tissues.
• Before the Procedure: You will be advised to fast before surgery and may be asked to stop certain medications. Plan for a ride home and for assistance during the recovery period.
• After the Procedure: Some discomfort and bloating are normal. Most patients can return to light activities within a few days and full activities within a few weeks. Follow your doctor’s instructions regarding activity levels and wound care.

Endometrial ablation is a minimally invasive procedure used to reduce or stop heavy menstrual bleeding by destroying the lining of the uterus.

• What to Expect: The procedure is typically done in an outpatient setting and takes about 15 to 30 minutes. A thin instrument is inserted into the uterus to destroy the lining using heat, cold, or other methods. There are no incisions.
• Before the Procedure: You will be advised to fast before surgery and may be asked to stop certain medications. Plan for a ride home and for assistance during the recovery period.
• After the Procedure: Some cramping and watery or bloody discharge are common for a few days to weeks. Avoid inserting anything into the vagina and refrain from heavy exercise until cleared by your doctor. Most patients can return to normal activities within a day or two.

These surgeries are designed to support and repair pelvic organs that have dropped or are causing symptoms of prolapse or incontinence.

• What to Expect: Depending on the type and severity of the prolapse, different surgical methods may be used, including vaginal, laparoscopic, or robotic-assisted surgery. The goal is to restore normal function and support to the affected organs.
• Before the Procedure: Follow preoperative instructions, which may include fasting and stopping certain medications. Arrange for transportation and assistance during recovery.
• After the Procedure: You may experience some discomfort, spotting, or cramping. Most patients are advised to avoid heavy lifting, strenuous activities, and inserting anything into the vagina for several weeks. Full recovery may take a few weeks to months, depending on the procedure.