Philosophy
Specialized gynecologic care is an important part of your health maintenance. Your annual clinical visit involves not only a pap smear, but also a general health review. We encourage you to ask questions about your health, health issues and your care. Asheville Women's Medical Center is a comprehensive women's healthcare center with high-quality mammographic screening as part of your periodic review (see screening guidelines to find out if you qualify). Our Women's Diagnostic Laboratory is conveniently available to provide routine screening blood/urine tests or to perform specific diagnostic studies as you require.

If you require a problem-oriented clinical appointment, our doctors are specifically trained and experienced to help you. Not all gynecological problems require surgery. However, if this type of care is required, you may expect a full explanation of the indications, risks and benefits. Take advantage of our complete video library to further build your information base and resolve any questions you might have.

We encourage you to take an active part in your healthcare. The doctors and staff of Asheville Women's Medical Center will provide solid information and clinical guidance to assist you in choosing the best care.

The human body functions best with balanced diet, proper rest and exercise. Yearly physical examinations are advised for all women. This clinical opportunity is not just a technical information-gathering exercise, but more importantly a chance to discuss with a trained health professional any health-related questions that you have.

Routine Health Maintenance Screening
Below are guidelines for routine health screenings:

Surgery
There are certain health situations and conditions that require surgery for healing. Our doctors are trained and experienced in surgery of the reproductive system, breast and bladder. As gynecologists, our attention is exclusively focused on the unique health problems of women.

Common types of surgery

Office-based care:
Cervical Colposcopy and Biopsy
A diagnostic procedure done in the office for the diagosis and management of the abnormal pap smear.

Endometrial Biopsy
A diagnostic procedure to sample the lining of the endometrium (lining of the uterus) This technique is often used to evaluate abnormal uterine bleeding.

Fine Needle Aspiration (FNA)
Breasts cysts are often drained by this process. FNA can also be used to sample a solid lump that is felt during an examination. A generous local anesthesia is often used.

Core Needle Biopsy
This office-based method takes a larger sample of a breast lump. The FNA gathers cells to view microscopically. The core biopsy samples a little piece of the tissue directly. Local anesthetics are always used to make the procedure pain-free.

Skin Biopsy
This is a method used to sample abnormal skin changes anywhere on your body. A small specimen is taken to be evaluated under the microscope.

Urodynamic Testing
This special test measures and evaluates bladder function. Patients who suffer from urinary incontinence often have this test performed to design the best therapy for their problem. The test is as uncomfortable as a full bladder, which is a common symptom.

Hospital-based surgery:
D and C
Dilatation and curettage is a method to surgically scrape out the lining of the uterus. This technique is often used for bleeding disorders, such as excessive menstruation with associated anemia.

Hysteroscopy
A method often used in concert with a D and C to visualize the inside of the uterus. We are often able to see intrauterine defects such as a polyp or fibroid and then better direct treatment.

Hysterectomy
This surgery removes the uterus. The reasons for surgery may vary from persistent bleeding, prolapse (falling out), cancer of lining or adjacent ovaries, large benign growths like fibroids and pain conditions caused by infection, inflammation and endometriosis. This operation is done by several different methods including vaginal hysterectomy, laparoscopic-assisted vaginal hysterectomy, and abdominal hysterectomy. Each procedure is done with or without ovary, removal based on each patient's unique situation.

Urogynecology
As women mature, the supporting structures of the pelvis change due to childbirth and age. A condition of pelvic relaxation or prolapse of the vagina and uterus can occur. Mixed symptoms of increasing pressure and associated loss of urine can disrupt a woman's day. Medical and surgical treatments are available to correct or reduce these symptoms.

Medical Treatments and Studies

• Pharmaceutical (drug) therapy
• Urodynamic bladder testing to define and quantify the source and magnitude of the problem

Surgical Therapy
Anterior and posterior vaginal repair. This procedure is designed to correct vaginal prolapse or pelvic relaxation.

Bladder Support Surgery
A variety of operations are available to support and restore the bladder to a functioning position. To reduce and eliminate activity-produced urinary loss, these operations are often combined with other procedures such as a hysterectomy to produce more durable and desirable results.

The pubo-vaginal sling (with TVT) can be done as an outpatient procedure in many situations. Visit www.controlsuddenurineloss.com for more information.