Women can stay on top of their reproductive health by seeing their gynecologist regularly for a pelvic exam. It’s recommended to get a pelvic exam:

• At your well-woman gynecologic exam
• If you think you might have a sexually transmitted infection (STI)
• If you are experiencing abnormal uterine bleeding or vaginal discharge
• If you have pelvic pain

Through this exam, a thorough discussion with you, and, if needed, diagnostic services, your gynecologist can identify illnesses or problems affecting your reproductive system. This can include endometriosis, urinary incontinence and gynecologic cancers. 

Of the potential conditions that your gynecologist may find, are there any that may require surgery?

Abnormal Uterine Bleeding

Abnormal uterine bleeding is unusual bleeding that starts in your uterus and flows out your vagina. This includes bleeding when you are not on your menstrual cycle, bleeding more heavily than normal during your menstrual cycle, and bleeding after menopause.

Medication can help manage this condition, though surgery is sometimes necessary. Surgical options include:

• Resectoscope hysteroscopy to remove polyps, scar tissue or fibroids that may cause abnormal bleeding
• Hysterectomy to remove the uterus and permanently stop your menstrual cycle. This is an option when other forms of treatment have failed. Depending on your situation, your surgeon may also remove your cervix, your ovaries and/or your fallopian tubes.

Asherman’s Syndrome

Asherman's Syndrome occurs when scar tissue or adhesions form in the uterus, usually after uterine surgery, a miscarriage or an abortion. Surgery is usually the best treatment, specifically:

• Resectoscope hysteroscopy to remove the scar tissue or adhesions

Cervical Cancer

Cervical cancer forms on the cervix, an organ that keeps your uterus closed while you are pregnant until it’s time to deliver your baby. Treatment options include radiation, chemotherapy and surgery. If surgery is the best route, it will likely be:

• Resectoscope hysterectomy to remove the cervix and uterus and prevent the cancer from reoccurring. If the cancer is in an advanced stage, your surgeon may also remove part of your vagina and lymph nodes.

Endometriosis

Endometriosis is a condition where the tissue that lines your uterus begins growing in other parts of your pelvic area, such as your pelvic side walls, ovaries, bowels, bladder and uterus. 

Hormonal medications are often the first line of treatment for endometriosis. If that proves ineffective, our experts at The Institute for Gynecologic Care at Mercy may recommend surgery, namely:

• Endometriosis excision surgery to remove endometrial growths and scar tissue, while preserving the uterus whenever possible

Ovarian Cancer

Ovarian cancer forms on the ovaries, the reproductive organ that produces eggs. Patients with ovarian cancer are often treated with chemotherapy and surgery, such as:

• Hysterectomy to remove the uterus, fallopian tubes and one or both ovaries

Ovarian Cysts

An ovarian cyst is a growth that forms on or within the ovary. Many ovarian cysts are harmless, cause no symptoms, and go away on their own. Others grow large and push the ovary out of its proper position, causing pain.

For small, painless cysts, your OB-GYN provider may want to simply keep an eye on it for a period of time. However, large, painful cysts may require surgery, specifically:

• Ovarian cystectomy to remove the cyst

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when the pelvic muscles and the ligaments that support the uterus and vagina become weak or loose. This causes the bladder, uterus or other pelvic organs to slip into the vagina from their usual position in the lower belly. 

Some cases of pelvic organ prolapse are mild and require monitoring rather than immediate treatment. For more severe cases, your doctor may recommend surgery involving: 

• Endoscopy and pelvic reconstruction to put your pelvic organs back in their proper positions

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is when your ovaries produce too many male hormones, which may result in cysts on the ovaries or fertility problems because of changes in ovulation.

There is no cure for PCOS, but you can manage your symptoms with medications and other therapies. Surgery is usually not a treatment option.

Urinary Incontinence

Urinary incontinence is the loss of bladder control, resulting in the uncontrolled leaking of urine. This is a common condition among older adults, especially women.

To start, your urogynecologist will likely suggest noninvasive therapies and lifestyle changes, such as weight loss, Kegal exercises and medication. If those do not provide relief, there are surgical options. 

Uterine Cancer

Uterine cancer forms either in the uterus lining (endometrial cancer) or in the uterus’ muscle wall (uterine sarcoma). Treatment usually entails chemotherapy, radiation and surgery, namely: 

• Hysterectomy to remove the uterus and thus eliminate the cancer. If the cancer is advanced, your surgeon may also need to remove your ovaries and your fallopian tubes. 

Uterine Fibroids

Uterine fibroids are noncancerous growths that form on the wall of the uterus, usually during one’s reproductive years. Many cases do not cause any symptoms, while others cause heavier and longer periods, pelvic pain and frequent urination. 

If you are experiencing symptoms of uterine fibroids, your gynecologist may prescribe medication or suggest surgery, such as:

• Myomectomy to remove fibroids and reduce or eliminate symptoms
• Acessa ProVu® System to shrink your fibroids while sparing healthy uterine tissue