Trigger Point Injections for Pelvic Pain
Agent Onset of action (min) Duration of effect (min) Maximum total dose (mg) Lidocaine 2–5 30–120 300 Bupivacaine 5–10 120–240 175 Ropivacaine 3–15 120–360 200 Fig. 14.1 Iowa trumpet needle…
Loop Electro-Excision Procedure (LEEP)
Author N Comparators Recurrence rate (%) Mathevet et al. [10] 86 Cold knife cone 3.6 LEEP 6.9 Laser 6.9 Mitchell et al. [11] 390 LEEP 13 Cryotherapy 19 Laser 13…
Vulvar Biopsy and Excision/Ablation
Subjective persistent irritation or other local symptoms with no gross lesions Persistent lesion despite standard therapy (i.e., unresolved candidiasis) Lesions with any of the following features: asymmetrical, irregular border, color…
Urodynamic Testing
Indications for urodynamic testing Complicated history Stress incontinence before surgical correction Urge incontinence not responsive to therapy Recurrent urinary loss after previous surgery for stress incontinence Frequency, urgency, and pain…
Getting Started in Office-Based Gynecologic Procedures: Office Set-up, Procedural Implications and Ensuring Patient Safety
Fig. 2.1 Example of procedure room set-up for office-based surgery An individual or group of individuals specifically dedicated to office procedures should manage the set-up and maintenance of the room…
Pre-procedure Patient Evaluation and Management
Fig. 1.1 Ambulatory surgery visits and discharges of hospital inpatients with procedures: United States, 1996 and 2006 (revised) Fig. 1.2 Rates of ambulatory surgery visits by facility type: United States,…
Office-Based Global Endometrial Ablation
Global ablation device ThermaChoice (n = 137) Her Option (n = 193) HTA (n = 187) NovaSure (n = 175) MEA (n = 215) Protocol differences and exclusion criteria Maximum sound length (cm) 10 10 10.5 10 14 Inclusion of…
Informed Consent
Ethical components Medical decision-making capacity Disclosure Understanding Voluntary choice Authorization Medical Decision-Making Capacity Capacity is a threshold criterium for informed consent [1]. The informed consent process cannot take place unless…
Hysteroscopic Sterilization
Fig. 5.1 Distribution of methods of sterilization in the Netherlands in 2010 (By courtesy of Michel Vleugels, MD, PhD, personal communication) Even before the introduction of the hysteroscope in the…
Barbed Suture Use in Minimally Invasive Gynecology: A Practical Guide
Fig. 14.1 The Barbed sutur Fig. 14.2 Barbed sutur with 2 needles Fig. 14.3 Barbed sutur with loop Various combinations of suture size, length, needle type, and monofilament material (including…
