Definitions of Procedures by Becton Women's Clinic

	We have compiled this list of definitions to enable our patients to make informed choices that are right for them. If you have questions, or need to discuss options, please make an appointment with Dr. Becton or Paige Reynolds, BSN.
COLPOSCOPY	A colposcopy is done after a patient has an abnormal Pap smear. It helps to confirm the diagnosis of the Pap smear and the results of the colposcopy often decide what type of treatment is needed. This procedure is done in the office and lasts about 5 minutes. During a colposcopy, Dr. Becton will insert a speculum and apply acetic acid, also known as vinegar, to the patient's cervix. If there are abnormal cells, the acetic acid will make them turn white. Dr. Becton will inspect the cervix will looking through a special microscope called a colposcope. If abnormal cells are seen, Dr. Becton may do a small biopsy. The biopsy will be sent to the hospital pathology lab. Dr. Becton will review the results and decide what treatment is necessary. If the patient is pregnant, a biopsy is generally not performed and treatment is postponed until after delivery.

CRYOTHERAPY	This procedure is done after the results of a colposcopy and is a good option for treating abnormal cervical cells. Cryotherapy is done in the office and lasts about 3 minutes. During this procedure, Dr. Becton will insert a speculum so that he can see the patient's cervix. The cryo probe is placed on the surface of the cervix, covering the abnormal cells. Cold nitrogen gas flows through the wand of the probe and an 'ice ball' forms on the cervix, killing the abnormal cells. Cryotherapy is relatively painless. Most patients only complain of mild cramping. Patients may experience a watery of blood tinged discharge for a few days to a few weeks as the bad cells continue to die. The patient will need to have a repeat pap smear done in about 3 months to confirm that all of the abnormal cells are gone.

LEEP	LEEP is short for Loop Electrosurgical Excision Procedure. This procedure is another treatment option for abnormal cervical cells. It is also done in the office. A speculum is inserted and the cervix is numbed with a local anesthesia. A loop made of thin wire is electrically charged. The loop is passed across the area of the cervix that is affected by the abnormal cells. This removes a thin layer of the surface tissue. The tissue will be sent to the hospital pathology lab. A yellow medicine is applied to the cervix to shop any bleeding. Patients may have some vaginal bleeding or discharge for a few days following the procedure. Patients may also have some cramping. This is normally managed with ibuprofen. The patient will need to have a repeat pap smear in about 3 months to confirm that all of the abnormal cells are gone.

ESSURE	Essure is permanent and simple birth control. Essure is NOT reversible. Before a patient can proceed with ESSURE, she MUST be sure that she does want any more children in the future. There is no cutting or incisions and the procedure is done in the office. Local anesthesia and oral pain medications are used. Dr. Becton inserts small flexible coils through the patient's vagina and into her fallopian tubes. Most women are able to return to normal activities within the day. During the three months following the procedure, the patient's body and the small coils work together to create a natural barrier that prevents the egg from being released into her uterus. During this time, patients must continue to use another form of birth control. Three months after the ESSURE, Dr. Becton will order a test to confirm that the tubes are fully blocked. Once it is confirmed, the patient may stop other birth control methods.

MIRENA IUD	Mirena is an intrauterine device that is inserted through the patient's cervix and into the uterus. The insertion is done in the office and only takes a few minutes. There is minor discomfort when the Mirena is put in. Most patients describe it being similar to menstrual cramps. It is common for patients to experience cramping or irregular bleeding during the firth month following the procedure. After the first month, most patients will have lighter and shorter periods. This device has progesterone that prevents the patient from ovulating. It is 99.8% effective and works immediately. It can be used for 5 years or removed sooner if a patient decides she wants another pregnancy. There is no daily routine which makes it an appealing form of birth control.

NOVA SURE ENDOMETRIAL ABLATION	Nova Sure is a alternative to a hysterectomy and treats heavy and irregular vaginal bleeding. Depending on the patient, this can be done in the office or at the hospital as an outpatient surgery. Tests, such as an ultrasound and blood work, may need to be done before Dr. Becton can decide if a patient is a good candidate for this procedure. There is no cutting or incisions and can normally be done under local anesthesia. During the Nova Sure Ablation, the patient's cervix is slightly dilated and the Nova Sure device is inserted into the uterus. The device expands, conforming to the patient's uterus. Precisely measured radio frequency energy is delivered through the device for an average of 90 seconds. This destroys the lining of the uterus. The device is retracted into the wand and is removed from the patient's uterus. Following the procedure, most patients have some cramping and pain that lasts a few hours after the Nova Sure Ablation. Patients will experience a watery and/or bloody discharge. This may start immediately to a couple of weeks after ablation. Following the procedure, patients are restricted for 7 days from intercourse, douching, and using scented powders and sprays. There are no other activity restrictions.

TOT: Improving Urinary Incontience	TOT stands for Transobturator Tension Free Tape. This is an outpatient surgery that improves urinary stress incontinence which is urine loss with coughing, sneezing, laughing, and other activities. Dr. Becton may order bladder testing called Urodynamics, to confirm that a patient is a good candidate. During the TOT, a mesh sling is stretched underneath the bladder to give support helping relieve urinary stress incontinence. This surgery is done entirely through the vagina. Since this surgery is outpatient, the patient will be released from the hospital the same day. Most woman are able to return to their normal activities within a few days.

LAPAROSCOPIC SUPRACERVICAL HYSTERECTOMY	Laparoscopic supracervical hysterectomy is also called a LSH. This style of hysterectomy is less invasive than the traditional abdominal hysterectomy. It is done through three small abdominal incisions and the cervix is left in place. This allows faster recovery time and the remaining cervix will also help to support the vaginal cuff and prevent prolapse.