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Biopsy - A minor surgical procedure to remove a small piece of tissue that is sent to the lab to be examined under the microscope.  You may have a pinching or cramping feeling when it is done. 

Endometrial biopsy - Using a small catheter (straw), a small amount of the lining of the uterus is gently scraped to determine the reason of bleeding.  The sample is sent to the pathologist to read under the microscope.

Colposcopy - This examination involves viewing the cervix, vulva, or the vagina under the magnification of a colposcope similar to a microscope.  By using a vinegar solution, your doctor can see where the abnormal  cell are located on your cervix.  This is easily and quickly done in the office.  If an area of abnormal cells is seen, then your doctor may decide a cervical biopsy is needed. 

Loop electrosurgical excision procedure (LEEP) - A thin wire loop that carries an electric current is used to remove abnormal areas of the cervix.  In addition, this electric energy also is used to close off the blood vessels on the surface of the cervix.  This procedure can easily be done in the office.  

Laparoscopy - A surgical procedure in which a slender, light-transmitting,  telescope-like instrument, the laparoscope, is inserted through a cut in the navel  to view the pelvic organs or perform surgery. 

Hysteroscopy - A thin telescope-like device with a camera is inserted through the vagina and into the cervix to view the inside of the uterus. 

Dilation and curettage (D&C) - The opening of the cervix is enlarged.  The tissue is gently scraped or suctioned from the lining of the uterus.  The tissue sample is then examined under the microscope looking for any abnormal cells like hyperplasia (pre-cancerous) or cancer cells.

Tubal Ligations - Tubal Ligations can either be performed laparoscopically or transcervically.

Using laparoscopy, a small incision is made in or near the navel for the laparoscopic camera to view the pelvic organs.  Another tiny incision is made just above the pubic hairline to perform the ligation.  The fallopian tubes are closed by tying, banding, clipping, cutting them, or sealing them with electric current. 

During the transcervical tubal ligation or Essure procedure, soft, flexible coils called "micro-inserts" are passed through the body’s natural pathways (vagina, cervix, and uterus). They are then placed into each fallopian tube. The micro-inserts are made with materials that have been used in medical devices for many years. They do not contain or release hormones. During the first 3 months following the procedure, your body and the micro-inserts work together to form a tissue barrier (like scar tissue) so that sperm cannot reach the egg. This prevents you from getting pregnant. You will need to use another form of birth control during this time. After 3 months, your doctor will perform a special type of x-ray test called an HSG. This test will assure you that your tubes are completely blocked and you can rely on the Essure micro-inserts for birth control.  (www.essure.com)

Hysteroscopy/ Dilation and curettage/ Polyp removal - If growths such as polyps or uterine fibroids are causing the abnormal bleeding, you may have this procedure combination at first to evaluate the uterine cavity followed by removal of the polyp or fibroid.

Endometrial ablation - This procedure is used to treat abnormal bleeding.   Treatment may use electricity, laser, heat or freezing to destroy the lining of the uterus.  It is intended to stop or reduce bleeding permanently.  An endometrial biopsy is needed prior to treatment.  A woman should be done with having children when she elects to have this procedure done.  (www.Novasure.com) or (www.uterus1.com)

Hysterectomy - Removal of the uterus is another procedure that may be used to treat abnormal bleeding.  This may be done when other forms of treatments have failed or are not an option.  Although hysterectomy is a major surgery, it, however is definitive treatment for abnormal bleeding.  After the process, a woman will no longer have periods nor be able to have children.  Before you decide on treatment, think and discuss all your options with your doctor.

Vaginal Prolapse Procedures - Pelvic support problems may be corrected by surgery.  The surgery can be done through the vagina or abdomen. 

Incontinence Procedures (Trans-obturator Sling) - A sling procedure corrects stress incontinence by supporting your urethra to keep it in its correct position.  The surgically implanted sling corrects stress incontinence by supporting and repositioning the bladder neck and urethra in their correct position, which can help the urethral sphincter function properly.