Smart Procedures for Smart Women – The convenience of in-office urogynecological procedures as high tech as hospital based surgery

By Joseph Gauta, MD, FACOG

Over the past several years there have major advancements in the procedures available in the medical field of Urogynecology.

Not too long ago, the only option women had was to have major surgery in a hospital setting, which can be intimidating, inconvenient and costly.

Now, there are treatment options available right in the convenience of your physician’s office.  The procedures are many, so to name a few of the most prevalent methods that women are seeking, we’ve listed the top four accessible treatments for common urogynecological issues.

eCoin-OAB (overactive bladder)
Most women that have gone through childbirth or suffer from cysts, fibroids, or perhaps have undergone pelvic surgery know the difficulty that comes with trying to hold your bladder.

Overactive bladder can take a toll on your daily activities, like trying to contribute to the workforce productively, household chores, sexual activity, and the list goes on and on.  With traditional surgical options, the overactive bladder disorder may or may not last long-term, but there are innovative advancements you should be aware of that could change your life.

One of the latest developments is through a tiny implantable device called, eCoin.  It’s a small round implant the size of a nickel, and it’s inserted superficially into the ankle.  The device is made up of electrical impulse connections that stimulate the tibial nerve.

How does eCoin help with OAB?
The stimulation of the tibial nerve fibers causes a reaction in the spinal cord, which then regulates the pelvic or pudendal nerves to inhibit bladder activity.

It is well known that intermittent stimulation of certain nerves produces changes in the nervous system and with eCoin, you will feel the results immediately.  The best part is that the procedure can be done right in the office and completed in just a few minutes.  It’s incredibly easy to place the device and just as easy to remove or adjust it as needed.

eCoin is approved in certain countries for investigational use only.
The Florida Bladder Institute is participating in an intercontinental study based on eCoin’s role in overactive bladder and other disorders.  The studies will help to determine the best settings for patient’s precise complications and outcomes.  The studies will be used internationally to help other physicians and patients determine optimal treatment algorithms.

Essure
If you’re completely sure that you are done having children, the option that most people think of first is tubal ligation, which requires surgery to tie the fallopian tubes permanently.

With Essure (an in-office procedure) the physician will insert a thin catheter that works in the opposite way of a vascular stent.  The Essure catheter contains a tiny spring like stent that occludes the fallopian tubes.  The total procedure usually takes just a few minutes to perform, and over a short period of time, the tubes completely block and occlude.

Novasure
Do you suffer from heavy periods?  Novasure is an in-office procedure that ablates the uterus within 90 seconds flat.  The physician will insert a small wand that contains expandable netting.  Once inserted, the mesh is extended to cover the uterine lining.  A moderate amount of radiofrequency energy is delivered via the netting for 90 seconds.  After the uterine lining is ablated, the wand and netting are removed.  In total, this procedure takes 5 minutes to perform.  Your heavy bleeding will be a thing of the past, and you’ll most likely wonder why you waited so long to have your issues treated.

Myosure Hysteroscopy
The advanced hysteroscope device called Myosure allows for many different procedures to be performed in the comfort of the office setting.  Myosure can be used for resection or removal of myomas, polyps, fibroids, biopsies, and other obscure excisions that may be necessary for your urogynecological health.

Joseph Gauta MD
Dr. Gauta is certified by the American Board of Obstetrics and Gynecology in the subspecialty of Female Pelvic Medicine and Reconstructive Surgery (Urogynecology). He is the founder of The Florida Bladder Institute, the region’s premier Urogynecology practice specializing in treating women with urinary incontinence, bladder and bowel dysfunction, pelvic floor disorders, organ prolapse, pelvic floor reconstruction, and a variety of other complex women’s health issues.

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