Office Procedures

We offer a variety of special office procedures.

Vulvar Labiaplasty

A woman’s labia minora (inner lips of the vulva) come in many different shapes and sizes and may change with childbirth and age. Women seek Labiaplasty consultation for two reasons: functional or aesthetic, or a combination of both. Enlargement, unevenness, and/or irregularity of the labia minora can sometimes cause discomfort, chronic rubbing, a pulling sensation, inability to wear certain clothes and discomfort with intimate contact and exercise. For some women it is mainly an aesthetic concern which may also affect their self-esteem and self- consciousness.
The Labiaplasty procedure is a minor surgical procedure which reduces and contours the labia to an even and more desirable appearance. It is done in office with local anesthesia and premedication. Generally it will take approximately 4-6 weeks for the area to heal completely.

Colposcopy: Cervical and Vulvar

The Colposcopy is a more detailed exam using a special microscope with a green filter, and a mild acid solution placed on the cervix or vulvar area. This exam is intended to focus on and highlight any areas of abnormality.

The Cervical Colposcopy is done in the case of an abnormal Pap test most often caused by the Human Papilloma Virus (HPV) and is one of the most common procedures done in Gynecology. Generally one or more biopsies are taken at the time of Colposcopy and this will determine if treatment is needed.

The Vulvar Colposcopy is done when lesions are present on the external vulvar area which may be benign skin conditions, precancerous, HPV related, or possibly cancerous. Again biopsies are generally taken to determine the course of treatment.

LEEP (Loop Electro-Excisional Procedure)

The LEEP is an effective office based procedure for the treatment of pre-cancerous abnormalities of the cervix found after an abnormal Pap test and Colposcopy and biopsy confirmation. A small piece of the cervix is removed, using an electrocautery instrument, and sent to pathology for evaluation. The procedure is done in the office with local anesthesia and usually takes less than 15 minutes.

Pelvic Ultrasounds

A pelvic ultrasound provides visualization of the structures and organs in the lower abdomen and pelvis specifically the uterus and ovaries. Ultrasound imaging is safe, painless, and does not use ionizing radiation. It is noninvasive and a highly effective tool in Gynecology for the diagnosis of many conditions.

Early Termination of Pregnancy (Medical Abortion Pill, RU486)

The Abortion Pill (RU486) is a safe, legal, and effective way to end a pregnancy in the earliest stages without surgery. A pregnancy counseling consultation is required to review all the options prior to proceeding with a medical abortion. Patients will then be counseled step by step on the medical abortion process including the administration of two medications, first mifepristone in office then misoprostal approximately 48 hours later at home.

A followup visit is required after one week and includes contraceptive counseling. The medical abortion pill is most effective (94%-98%) for women who are are 8 weeks pregnant or less but can be given up to 10-11 weeks.

Office Diagnostic Hysterscopy with Endorsee

This in office procedure is a diagnostic procedure where a small camera is gently placed thru the cervix and inside the uterine cavity when women are having irregular or heavy bleeding and/ or are suspected of having abnormal growths such as polyps, myomas, hyperplasia, and rarely cancer of the endometrial lining. Generally biopsies are taking and small polyps can be removed at the same time. This can eliminate the need for a hospital procedure and general anesthesia.

The procedure can also be used to remove intrauterine devices (IUD’s) when the threads are lost and not visible and/or the device may be malpositioned.

It is performed in office using local anesthesia and premedication and generally takes less than 20 minutes. Patients recover in office for about 15 minutes after.

Endometrial Biopsy

The endometrial biopsy is a minor office procedure which involves taking a sample of the uterine or endometrial lining and is then sent to the laboratory for further analysis. This procedure is most commonly done in women who are having postmenopausal bleeding, excessive or heavy bleeding and irregular bleeding after a certain age. It is performed in the office using local anesthesia.

Excision or Biopsy of Vulvar Lesions

These excision procedures are done to remove any lesions of the vulvar area including, genital condylomas (warts), skin tags, cysts, pre-cancerous lesions including vulvar intraepithelial lesions (VIN), or benign compound nevi. In some cases, for example of suspected VIN, a vulvar biopsy is performed prior to complete excision. The procedures are performed in office using local anesthesia and sometimes require suturing.

Gardasil 9 HPV Vaccine

The Gardasil 9 is a vaccine, a truly amazing vaccine, indicated for the prevention of vulvar, vaginal, cervical, anal, oropharyngeal and other head and neck cancers caused by human papillomavirus (HPV) Types 16,18,31,33,45,52,and 58, and the prevention of genital warts (condyloma) caused by HPV types 6 and 11.

It is indicated in girls and boys, women and men ages 9 through 45 years and is generally covered by most insurances. It is a series of three shots over six months and is administered in office. Most common side effects include redness, swelling, and mild pain at the injection site which usually resolves with a few days.