PELVIC FLOOR REHABILIATION
Pelvic Floor Rehabilitation, or PFR, uses a process called biofeedback to assist patients in identifying the muscles of the pelvic floor. PFR is useful in treating many conditions that affect women, such as urinary incontinence, pelvic relaxation, pelvic pain, and painful intercourse. Most commonly it is used for urinary incontinence in women who have weak pelvic floor muscles. Exercises are introduced and practiced in weekly sessions with our Nurse Practitioner, Kelli Porter. The course of treatment varies dependent on the needs of the individual. Your improvement will be tracked week to week.
GYNECARE THERMACHOICE ENDOMETRIAL ABLATION
One effective treatment for heavy periods is a global endometrial ablation procedure called Gynecare Thermachoice Uterine Balloon Therapy System. Gynecare Thermachoice is an effective, non-hormonal, permanent treatment for heavy periods. It involves a minimally invasive, 8-minute in-office procedure that can be performed by Dr. Jukes.
ESSURE TUBAL OCCLUSION
Essure is a hormone-free, permanent birth control procedure that works with your body to create a natural barrier against pregnancy. Without surgery, burning, or the risks of getting your tubes tied, this gentle procedure can be performed by Dr. Jukes in our office in less than an hour. Trusted by women and doctors for over five years, Essure is covered by most insurance providers. Dr. Jukes has received extensive continuing education and training with the Essure procedure and is an Essure accredited physician. If the Essure procedure is performed in our office, depending on your specific insurance plan, payment may be as low as a simple co-pay. It is simply the least invasive and also most effective form of permanent male or female contraception other than a hysterectomy!
Dr. Jukes may recommend our in-office Urodynamics testing if you experience frequent urinary incontinence, the loss of bladder control, a common and often embarrassing problem. The severity of urinary incontinence ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time. If urinary incontinence affects your day-to-day activities, don’t hesitate to contact our office. Urodynamics testing allows us to measure the pressure and volume of your bladder as it fills and the flow rate as it empties. Test results help Dr. Jukes to provide treatment options. In most cases, simple lifestyle changes or medical treatments such as Pelvic Floor Therapy can ease your discomfort or stop urinary incontinence.
The Leep procedure is usually recommended when your annual Pap smear indicates the presence of abnormal cervical cells, or cervical dysplasia. This may be an early warning that cancer may occur. The loop electrosurgical excision procedure, or LEEP procedure, is one of several procedures that Dr. Jukes has available to help diagnose and treat abnormal cervical cells. Abnormal cells can be removed which allow new healthy cells to grow. It has a 90-95% cure rate for cervical dysplasia. The LEEP procedure takes about 5-10 minutes and is performed in our office under local anesthesia.
The Colposcopy is a procedure that Dr. Jukes and her Nurse Practitioner, Jen Vasquez perform in the office. While performing an additional pap smear, they will look at your cervix with a special microscope after applying vinegar solution over the cervix. The vinegar solution causes any significant abnormalities to appear white.
If any significant lesions are visualized, a biopsy of the area may be taken for evaluation in the lab. DO NOT worry about this biopsy. Most women do not even feel it being done. Your cervix does not have nerve endings like your skin. We will then use medicine that will stop any bleeding at the biopsy site. This can cause some cramping like menstrual cramps. If you want to take some Ibuprofen prior to your procedure, this can help with the cramping.
The results from the colposcopy will take about 1-2 weeks to receive. Unless the results require that we do further procedures, we will usually see you back for a pap smear in 3-6 months.
MIRENA INTRAUTERINE DEVICE
Mirena is an intrauterine device used to either prevent pregnancy or treat heavy bleeding. The device has a small amount of progesterone within its T-shaped structure. This progesterone does not circulate throughout your body but only affects the lining of the uterus to thin it down and eliminate periods. It can be left in place for up to 5 years, is very safe and you can become pregnant within 1 month of its removal. Visit Mirena for more information.
The Mirena device prevents pregnancy by preventing implantation of a fertilized egg. You must be agreeable to this before we will place the device for you. Mirena can be easily inserted in-office by Dr. Jukes. It is usually inserted while on your menses and insertion can be uncomfortable, so we recommend taking 600mg of Motrin prior to the insertion.
The ParaGard intrauterine contraceptive device is a simple T-shaped piece of soft, ultra-flexible plastic, wrapped in copper and designed to fit comfortably in the uterus. ParaGard is hormone-free, and can be left in place for up to 10 years. This device can be easily inserted in-office by Dr. Jukes, usually while on your menses. Because insertion can be uncomfortable, we recommend taking 600mg of Motrin prior to insertion.
Nexplanon is one of the most effective birth control methods available. Nexplanon is a long-acting, prescription contraceptive that is a flexible rod, about the size of a small matchstick. It is placed under the skin of your arm in our office. It is estrogen free, containing only progestin, and is effective for 3 years eliminating the need for daily, weekly or monthly birth control dosing. Nexplanon is reversible, and can be removed at any time, easily in our office.