If you have symptoms you feel require or have been told you require a hysterectomy, you may have other options.

Advances in gynecologic medicine have resulted in minimally invasive outpatient or medical treatments for some of the most common reasons for hysterectomy- heavy, abnormal and/or irregular bleeding, and fibroids.

To ensure you have all the options available, make sure your gynecologist's evaluation for bleeding has included a sonohysterography or diagnostic hysteroscopy. Polyps and submucous fibroids which are a frequent cause of bleeding that fails medical management are diagnosed this way.

Minimally invasive procedures that can be used by your gynecologist to treat these conditions are:

For heavy BLEEDING:

Endometrial Ablation
--an outpatient or office procedure whereby the endometrium (the part of the uterus that bleeds) is destroyed by cautery, heat or freezing.

Liletta IUD
--an intrauterine device(IUD) which is inserted as a simple office procedure and causes a thinning of the endometrium resulting in markedly decreased bleeding.

Hysteroscopic Polypectomy, D&C
--an outpatient procedure whereby an endometrial polyp is removed by using a small camera and a loop inserted through the cervix.


Hysteroscopic Myomectomy, D&C
--an outpatient procedure whereby a fibroid is removed by using a small camera and a resection device inserted through the cervix.

Uterine Artery Ablation(UAE)
--a procedure performed by an interventional radiologist during which coils are used to block the blood supply to the fibroids resulting in significant shrinkage of their size.

Discuss these and other options with any of the gynecologists at Genis Women's Care, PC who are trained in these procedures.

Do I Need A Hysterectomy At All?
Mara Endometrial Ablation
Suffolk OB/GYN Group
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Endometrial polyp by hysteroscopy
Endometrial Polyp By Hysteroscopy(below)
Endometrial polyp by saline infusion
Sonohysterography, saline infusion ultrasound (SIS)
Normal endometrium by saline infusion
Saline Infusion Sonography (SIS) 

Ultrasound is a medical test that helps gynecologists diagnose and treat certain gynecologic conditions. Gradations of gray and black images appear, and, by shape and contrast, pelvic organs are identifiable by your gynecologist.

The transducer can be applied to the lower abdomen to view the uterus and ovaries through the abdominal wall. Or, a smaller probe can be inserted vaginally.  Transvaginal ultrasound generally results in better, more detailed images.

Sonohysterography, also known as saline infusion sonography, is a modification of the transvaginal ultrasound. Saline is infused inside the uterus while the ultrasound is being performed. The fluid acts as a stark contrast to the gray since any fluid is seen as black.

SIS is commonly used to evaluate abnormal menstrual and postmenopausal bleeding. As you can see from the images, both pictures on the left appear similar.  The pictures to their right were obtained during saline infusion.  The top shows a normal smooth endometrial cavity. The bottom picture shows an endometrial polyp which would not have been detected with traditional ultrasound. Click here to see how it may appear with hysteroscopy which uses a camera.

Options for further treatment and evaluation are different for the two scenarios.  Your gynecolgist should review all your options with you.
SIS can be performed at any of our office locations- Suffolk, Harborview and Smithfield.  Our OB/GYN offices are convenient to Churchland of Portsmouth, Chesapeake Square, Isle of Wight, Newport News and Hampton.
Obstetricians and Gynecologists