Gynecology
Routine Well Woman’s Care
Your routine annual exam might include a variety of opportunities to take advantage of early detection and screening for different women’s health issues. Depending on your age different tests such as pap smears, HPV screening, mammogram, bone density scans, and blood tests might be recommended. Another goal at you annual visit is to take advantage of general health maintenance advice that might be specific to your needs.
Contraception Counseling
One of the most common issues to address during a visit to your gynecologist is contraception counseling. We will be able to provide the most up to date information on all the different forms of reversible and permanent contraception available. Options we can consider range from hormonal methods such as birth control pills, patches and rings to more long term methods such as intrauterine devices. During your visit we will be able to outline and discuss both the contraceptive effectiveness and non-contraceptive benefits of these different methods. For women who have completed their child bearing years we can also discuss permanent options such as tubal ligation and tubal occlusion with Essure, a less invasive procedure. We will be able to find the right method to suit your goals and needs.
Screening and Treatment for Sexually Transmitted Infections
Sexually transmitted diseases, or STDs, can be transmitted through sexual intercourse or exposure to bodily fluids. Barrier methods of contraception are the standard in preventing sexually transmitted infections, but unfortunately they are not foolproof. Patients may or may not be symptomatic from an STD. If left untreated some STDs can cause more long term problems and infertility. We can provide all the latest information about the different lab tests including vaginal cultures and blood work that can be done in the office. We will also be able to provide the most up to date treatment recommendations as they are needed. During your visit be sure to ask about STD screening and treatment.
Evaluation of Uterine Fibroids
Fibroids or Myomas are benign tumors that develop over time in the wall of the uterus. Fibroids can exist in up to 60% of the population; however, a majority of women with fibroids will be symptom-free. Women who have symptoms experience problems such as heavy bleeding, bloating, painful menstrual periods, difficulty with intercourse, pelvic pain, and in rare cases recurrent pregnancy loss. If you have symptomatic fibroids we will be able to outline the best management strategy for you. In some cases, medical management might be preferable to help relieve the symptoms. Alternatively, a surgical approach might be suggested. We are able to provide all the latest minimally invasive techniques for removing your fibroids including laparoscopic myomectomy, robotic myomectomy with the daVinci robot, and hysteroscopic resection with Myosure. In some cases, a more definitive option such as hysterectomy might be recommended as well. If you think you are having symptoms from uterine fibroids please call for a consultation today.
Pelvic Pain Evaluation
Pelvic pain especially ongoing or chronic pain can adversely affect your day to day life. There are a wide range of causes for pelvic pain including but not limited to, gynecologic problems such as endometriosis, fibroids, scar tissue from prior surgeries or pelvic infections, and even physical abuse. Patients with pelvic pain can be evaluated with routine office tests, and more advanced imaging studies including ultrasound and CT scan. Treatment for these conditions can include both medical and surgical approaches. We will work closely with you, and tailor the best treatment plan to achieve optimal symptom control.
Menopause
Menopausal symptoms include hot flashes, menstrual irregularity, vaginal dryness, night sweats, difficulty with intercourse, and decreased sexual desire. These symptoms are attributed to the natural decrease in your body’s own hormones; specifically estrogen. While these symptoms are usually expected at some point in life and can be considered normal, they might be adversely affecting your overall quality of life.
Treatment options include lifestyle changes, over the counter supplements and remedies, and prescription medications such as hormone replacement. While prescription hormone replacement therapy comes in a variety of different formulations, it may not be your first choice. We will be able to review and summarize the pros and cons of all the above mentioned options taking into account your health issues, to arrive at the best management recommendations to fit your personal needs. If you think you are experiencing menopausal symptoms call us to arrange a consultation.
Abnormal Pap Smear Evaluation
The routine Pap smear is a cornerstone of our cervical cancer screening and prevention program. If your Pap smear is abnormal we will spend time to explain all the next steps in evaluating that abnormality.
These tests might include HPV screening and Colposcopy to further investigate and confirm the Pap result. We will also outline different management or treatment strategies. These could range from simply repeating the Pap test at more frequent intervals, to treatment with a Loop Electrical Excision Procedure or LEEP. We can also discuss and recommend the HPV vaccine that helps prevent abnormal pap smears.
MonaLisa Touch
MonaLisa Touch is an FDA approved treatment for “genitourinary syndrome of menopause.” This refers to the thinning of vaginal tissue which develops in some women after menopause and can cause burning, dryness, pain with sexual activity and varied urinary symptoms, including more frequent infections. The procedure consists of three treatments six weeks apart that are performed in our office. Each treatment takes approximately five minutes with minimal discomfort, and has no downtime- in other words, you walk out and go back to work, home, exercise, or whatever else you may have planned for the day. A once yearly maintenance treatment is then required that could be performed at the same time as your annual exam.
Pediatric, Adolescent, and Teens
The American College of Obstetricians and Gynecologists (ACOG) recommends that teens start seeing an ob-gyn between the ages of 13 and 15 or if you and/or your daughter have questions about her period, puberty, or reproductive or sexual health — be it normal or seemingly abnormal. We recommend that you first discuss any concerns with your child’s pediatrician before seeing us, so that her healthcare team is aligned.
Preconception and 1st Trimester Obstetrics
Preconception Counseling
You might consider a preconception visit to plan for a healthy pregnancy. During this visit we can perform a comprehensive review of your medical history, family history, and when appropriate obstetrical history. This will help us identify risk factors, and optimize treatment of any pre-existing medical conditions. If you are thinking of becoming pregnant we might need to adjust medications you are taking. We might also recommend routine tests and vitamin supplements to start prior to conception. Your preconception visit could be your first step towards a healthier outcome for you and your baby.
1st Trimester
We are currently providing critical medical care for the first trimester of pregnancy. Our physicians pride themselves on a meticulous focus for your individualized needs and is based on compassionate care. In the first trimester, we will begin your care with a standardized panel of lab work and tests. We will utilize ultrasound exam to confirm the pregnancy viability and due date. There are also more specialized screening tests that we might offer and discuss including genetic testing in the first trimester. The first few visits are a great time to answer all your questions and talk about the expected course of prenatal care.
Pregnancy FAQs
Whether this is your first pregnancy or your fifth, there are always questions for moms-to-be. Fortunately, our Rockville, MD, OBGYNs and the team at Potomac Ob Gyn, LLC are always here to answer any questions you might have about your pregnancy. So take a deep breath. We’re here to provide moms with peace of mind.
What are the early signs and symptoms of pregnancy?
This is one question we hear a lot and also a topic that’s searched quite frequently online. While every woman will experience different symptoms, some of the most classic early signs of pregnancy include,
- Nausea
- Breast tenderness
- Exhaustion
- Mood swings
- Frequent urination
- Sudden food aversions
- Missed period
What should I expect from my first prenatal visit?
When you come in for your prenatal appointment expect to spend some time with your doctor. We will collect a urine sample and also take blood. This will help us confirm the pregnancy and also determine your baby’s due date. We will also perform a thorough physical evaluation to check your vital signs and the rest of your health.
This blood test will also be used to check for any health problems including STDs. A pap smear may also be performed to check your vaginal and cervical health. These visits are also a time for us to get to know you better and to answer any questions you may have along the way. We know you will have questions; make sure to write them down and bring them with you.
Can I take medications while pregnant?
While some medications are perfectly safe to use, even throughout the first trimester, there are certain supplements and medications such as ibuprofen that could be harmful to your unborn child. Make sure to write down the list of medications and supplements you are taking and let our OBGYNs know at your first appointment. We can determine which medications are safe to continue using and which ones may need to be replaced with a safer alternative.
Should I take prenatal vitamins?
It’s a good idea for all pregnant women, including women who are trying to become pregnant, to take a daily prenatal vitamin, which contains folic acid and other nutrients that can keep both you and your unborn baby healthy.
What foods should I avoid while pregnant?
Pregnant women must avoid these foods and beverages,
- Raw fish
- Undercooked or processed meats
- High-mercury fish such as swordfish or tuna
- Raw meats
- Caffeine
- Unwashed produce
- Raw sprouts
- Unpasteurized cheese, milk, and juice
- Alcohol
Is exercise safe?
Yes, exercise is not only safe but recommended for pregnant women to help them maintain good health throughout their pregnancy. Exercise will not increase a woman’s risk for a miscarriage. Even just 30 minutes a day of moderate aerobic activity such as a brisk walk can promote good health for you and your baby. If you’re not sure about which athletic activities are safe for you during pregnancy, simply ask our OBGYNs.
Basic Infertility Evaluation
Infertility is defined as the inability to conceive after one year of trying. An infertility evaluation is one of the more specialized workups that can be initiated at our offices. In some cases it might be appropriate to initiate a workup after only six months of trying to conceive. At your appointment we can begin to explore some of the more common causes of infertility which can be either male or female related. These can be categorized generally into problems with the sperm, ovulation, Fallopian tubes or the uterus. Your doctor will be able to outline a series of tests that might include blood work, sonograms, and even a semen analysis. Sometimes a referral to a reproductive endocrinologist or fertility specialist might be recommended as well. If you are worried about infertility be sure to call for an appointment to further discuss these concerns.
Surgery
Endometrial Ablation
Endometrial Ablation is a treatment for women with heavy menstrual bleeding. It is generally viewed as an alternative to hysterectomy in certain patients who have not responded to medical therapy. There are certain clinical criteria that need to be met for you to safely undergo endometrial ablation. The physicians at Potomac Ob Gyn will be able to tell you if you are a good candidate for this minimally invasive procedure.
The surgery involves using different types of energy to cauterize the lining of the uterus. If successful this will either greatly decrease or eliminate menstrual bleeding. It is performed as an outpatient procedure with minimal recovery time. Due to the lasting effect on the lining of the uterus ablation is not recommended for women who might want to be pregnant in the future.
Laparoscopy
Laparoscopic surgery involves inserting a camera and instruments through tiny incisions into the abdomen in order to visualize abdominal and pelvic organs. An increasing amount of gynecologic surgery can be done through this minimally invasive technique. The physicians at Potomac Ob Gyn are all able to perform laparoscopic surgery to treat most gynecologic problems. We will guide you through pre-operative counseling and evaluation, the day of surgery, and your post-operative recovery. Most laparoscopic surgery is “same day surgery” which means you will not have to spend the night in the hospital. Be sure to inquire about these procedures during your visit so we can explain all the different risks and benefits of laparoscopy.
Myomectomy
Myomectomy is a procedure that involves surgically removing fibroids and then repairing the uterus in order to maintain the ability to successfully carry a child. Most women with fibroids have no symptoms at all. Sometimes fibroids will cause pain, bleeding and complications that necessitate medical treatment. When medical management is not effective your doctor might recommend a surgical approach.
Myomectomy can be performed through an open incision on the abdominal wall (called laparotomy), or through tiny incisions on the abdominal wall (laparoscopy). Alternatively, this surgery may be done through a transcervical approach with a special camera called a hysteroscope. A hysteroscopic myomectomy requires no incisions on your abdominal wall. At Potomac Ob Gyn, LLC, we are able to utilize advanced technology such as the daVinci surgical system to perform robotically assisted laparoscopic myomectomies, and the Myosure hysteroscopic system to resect and remove fibroid tissue. While the open incision approach will require a short hospital stay post operatively, some of the more minimally invasive approaches are done as outpatient procedures. Depending on the size and position of the fibroid tumors these advanced approaches may be appropriate for you. If you need a myomectomy we will be able to review all the risks and benefits of these different procedures with you.
Hysterectomy
Partial or total hysterectomy involves removal of the uterus. Our providers are able to utilize the daVinci surgical system to perform robotically assisted laparoscopic hysterectomies.
Hysteroscopy
Hysteroscopy involves passing a camera through the cervix in order to visualize the inner lining of the uterus. There are many indications for hysteroscopic exploration of the uterus, including abnormal bleeding, fibroids, and the presence of endometrial polyps. This procedure can be both diagnostic and therapeutic at the same time. Your physicians at Potomac Ob Gyn, LLC are also able to use more advanced hysteroscopic techniques to perform myomectomies, Essure tubal occlusions and resections of endometrial lesions. One of the advantages of a hysteroscopic approach to surgery is that it can be done as an outpatient and has a fast recovery time.
daVinci Surgical System Robotic Surgery
Robotic Surgery with the daVinci Surgical System is essentially advanced laparoscopy. The daVinci robot is a computerized instrument that the surgeon controls to perform gynecologic surgery through tiny incisions. The advantages of the robotic system include a three dimension high definition view that can be zoomed to high magnification, better dexterity, and simultaneous control over 4 separate instruments including the camera.
Gynecologic procedures being performed with the daVinci system include hysterectomy, partial hysterectomy, myomectomy, and surgery for removal of endometriosis. Some of the advantages of this approach over the more traditional open incision methods are less post-operative pain, and a faster recovery. For patients in Montgomery County, be sure to ask us if daVinci Robotic surgery is indicated for you.