The physicians in the General Gynecology and Obstetrics Services Division provide the latest state of the art medical services to patients with a variety of Gynecology conditions including, pelvic organ prolapse, urinary incontinence, pre-invasive cancer of the cervix, pelvic and vaginal infections, pelvic pain, contraception, menopausal management, and any other disorder which is not unique to our cancer or infertility specialists. These physicians also provide all routine obstetric services including ante-partum care, prenatal testing and management of labor and delivery for routine and complex obstetrical patients. The KU Women's Health Specialty Centers can provide these patients with a seamless access to our high risk obstetrics specialists for management of unique and unusual disorders of pregnancy, genetic testing and the post-partum period.
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Areas of Expertise
Surgery for all general gynecologic disorders is available including pelvic organ prolapse, urinary incontinence, endometriosis, pelvic pain and a multitude of other common and uncommon genital disorders. We can also offer minimally invasive surgery for those problems which are best managed by this approach including total laparoscopic hysterectomy and the very latest in robotic assisted hysterectomy. Our physicians understand every women's desire to have minimally invasive surgery whenever possible in order to return to work and their family activities as quickly as possible and will use these technologies whenever, it is prudent and justified to do so.
Young girls and women, usually in the age range of 8-18 years old, may have special gynecology conditions and diseases. Many times these situations are initially addressed by the patient's pediatrician. However, our specialists are able to assist the pediatrician with our specialized knowledge of the female genitalia and the disorders peculiar to the female genitalia and this age group. Young females and their parents are rightfully concerned about a number of issues including, growth and development, utilization of vaccines for prevention of sexually transmitted diseases, prevention of undesired pregnancy, sexuality, and menstrual disorders among a multitude of other conditions. Our physicians are uniquely qualified to evaluate and treat young females with these problems. We also offer expertise in the application of the new vaccine to prevent cervical cancer and evaluation of preinvasive cancer of the cervix which may affect these young females and can advise them about this issue.
Vulvovaginal disorders affect almost all women at sometime during their lifetime. While so called "yeast infections" are perhaps the most common, other vaginal infections are also problematic. Yeast infections classically cause the patient to have intense itching, redness and a white discharge. However, one needs to remember that not everything that "itches" or causes irritation in the female genital area is a yeast infection. We often see patients that have been previously inappropriately treated multiple times for yeast infections without an examination and or cultures to establish the diagnosis and proper treatment. Several other diseases may cause similar findings and symptoms and need to be evaluated to determine the appropriate treatment. Any of the physicians in the general gynecology division can address these conditions and problems.
Chronic pelvic pain is a very common problem among all age groups from late teenagers who may have pain from endometriosis and painful menses to the very complex patient who has utilized multiple medications or undergone several operations to attempt correction of her pain. Pain in the pelvis is difficult to diagnose accurately for many reasons. First, are the many possible causes of the pain including endometriosis, infection, uterine fibroids, and ovarian causes such as cysts. Second are the other non-genital organs in the pelvis which may cause pain and be mistaken for a "female cause" such as bowel or bladder dysfunction. Bladder pain from diseases such as infections, stones and interstitial cystitis are much more common than recognized in the past. Third, the human brain recognizes pain coming from the pelvic organs in a way that the site of the pain may be different than where the body recognizes the pain. While this sounds strange, it is the way the body works. Our specialists can help the patient with proper testing, medications and when appropriate, surgical therapy.
Proper therapy of menopausal symptoms has been extremely confusing since the Women's Health Initiative reports which began to appear in 2002. Prior to that time the data and the attitude of most gynecologists suggested that essentially all women would benefit from so called "hormone replacement" therapy. Now it is recommended that "hormone therapy" be utilized only for those women who have significant hot flashes or other menopausal symptoms. In addition, it is now recommended that hormone therapy be utilized for shorter periods of time and be re evaluated at yearly intervals by the patient and her gynecologist. Multiple medications, oral, transdermal, vaginal, compounded or FDA examined, are available for patients who have symptoms requiring therapy. As academic and teaching faculty members at the KU School of Medicine, our physicians must stay current with the latest developments in this every changing debate and discovery in the area of hormone therapy. Patients can benefit from the knowledge and insight our physicians pass along to medical students every day.
Sexual dysfunction is perhaps one of the most perplexing and difficult of all gynecologic disorders to satisfactorily evaluate and treat. This is because of the many reasons that the patient may have an unsatisfactory sexual experience. The potential problems range from vaginitis causing discomfort only during intercourse, to scarring and distortion of the lower genital tract from previous childbirth, to social and psychological issues between the patient and her sexual partner. Our physicians are able to determine the causes for these issues and properly advise the patient of treatment options, which can offer relief of her symptoms.
Prevention of pregnancy until the time selected by the patient and her partner is perhaps one of the most important functions of the gynecologist. There are many methods to choose from today. These range from the well known birth control pills to transdermal methods, IUDs, intravaginal hormonal contraception, and the new implantable device. Our experts can answer your questions about any of these methods and can make proper recommendations for the best choice for the individual patient and her partner.
Cancer and its precursors cause a great deal of anxiety for all of our patients. Fortunately, the pap smear provides an excellent screening device for this disease and has saved countless lives since its widespread use began in the 1950's. Colposcopy is a procedure used to evaluate a pap smear which has been determined to be abnormal. The physician looks through a microscope at the cervix which has been treated with a vinegar solution to determine the proper place to biopsy tissue. This tissue is then sent to the pathologist for diagnosis. After the pathology report is available, our doctors will recommend a treatment for the abnormality. There are several treatments available including laser, freezing of the cervix and removal of limited amounts of the cervix with a wire loop or LEEP procedure. In a great many cases, all that is necessary is close observation and repeating the pap smear at appropriate intervals. All of our physicians are very well qualified to care for your pap smear needs and the follow up necessary for your wellbeing.
Loss of urinary control may occur as a result of aging or more commonly following the birth of one or more children. In addition, the trauma caused by normal vaginal childbirth may cause the pelvic organs to gradually prolapse or descend further into the vaginal canal toward the opening of the vagina. The proper medical terms for these disorders are urinary incontinence and pelvic organ prolapse. Symptoms may vary from none at all to marked pressure and visualization of the female organs on the outside of the body at the vaginal opening. Urinary incontinence may occur only with a so-called stress phenomenon such as lifting or straining or coughing. In addition it may occur at unpredictable times when the bladder is full. The patient may feel the urge to urinate and be unable to reach the restroom in time prior to losing some urine. This is termed urge incontinence. The proper approach to urinary incontinence requires the physician to perform testing when indicated and carefully examine the patient to determine the type and amount of organ prolapse which is present. Our physicians are very experienced and qualified in the testing required to determine the type of incontinence and what surgical procedure or medications will benefit the patient. Often minimally invasive or one day surgery procedures may be used to correct these problems, thus limiting the amount of time the patient must take off work and from her family.