• Painful Sex
• Pelvic pain
• Low back pain
• Irregular bleeding
• Mid-cycle bleeding
• Heavy bleeding
• IUD placement check
• Delayed periods
• Ovarian Cysts
• Uterine Fibroids
• Rule out Pregnancy
• Obesity/ Abdominal bloating – Unable to evaluate uterus on exam.
• Urinary Incontinence
• Pelvic Inflammatory disease (PID)
• Congenital abnormalities of genital tract (Uterus/ Ovaries)

Explanation of “Transabdominal” vs “Pelvic trans-abdominal” vs “Pelvic Transvaginal” Ultrasound studies.

Full Pelvic Ultrasound is a two part study as listed below. Both parts are important to complete a full evaluation of the pelvic organs.

1. Pelvic abdominal ultrasound.

The CPT code for this is 76856.

This is a part of a the full pelvic ultrasound which includes visualization of the lower abdomen from the lower part of the abdomen and includes evaluation of uterus/ bladder and any other additional masses (if present) from the lower abdominal angle.

2. Pelvic transvaginal ultrasound.

The CPT code for this is 76830

This is the second component of the full pelvic ultrasound. In this study, a vaginal probe is used to evaluate the uterus/ ovaries/ adnexal masses etc from the vagina.

Both the above studies are needed to a full pelvic evaluation and each are indicated by a separate CPT code hence billed separately since they are separate studies with different probes.

WE HAVE TO PERFORM BOTH OF THE ABOVE STUDIES TO COMPLETELY EVALUATE THE PELVIS.

Situations in which we may not do a Transvaginal sonogram:

• If you have never had vaginal intercourse (virgin).
• If you are actively bleeding from the vagina.
• If you are pregnant and you have placenta previa.

3D ultrasound (CPT- 76377) is done in addition if there are any masses, fibroids, IUD or any uterine pathology.

A Color Doppler (CPT-93975) is done in addition if there is pelvic pain/ ovarian cyst/ mass/ tumor etc.

Complete abdominal ultrasound is indicated by CPT codes from 76801-76812

This includes a full exam of your upper and mid abdomen and organs such as gall bladder/ liver/ stomach etc.

WE DO NOT PERFORM THIS STUDY AT OUR FACILITY SINCE WE ARE A GYN (WOMEN’S HEALTH) FACILITY.

Hope this helps clarify your concerns. We are happy to give you a CD with all the images and also a finalized report. Please note that the finalized report can take upto 10 days.

Sincerely

Walk IN GYN Team.

The post Ultrasound- When to do a pelvic ultrasound? appeared first on Walk In GYN Care.

That said… get set to change your life as we bust some myths and list some facts right here for you!

Drink 10-15 glasses of plain water daily (no lemon, no cranberry).

THINGS TO AVOID

• DO NOT HOLD URINE.
• No cranberry supplements.
• Avoid all acidic condiments/ foods like vinegar, vinegar based salad dressings, marinara sauces/mayo etc.
• Avoid orange juice/ lemonade
• Avoid Green tea – can have 1 cup followed by water in morning when near a bathroom.
• Avoid Vitamin C supplements on a routine basis.
• Restrict coffee and tea intake all along the day. Take only 1 or 2 cups at one time only, if possible.
• No coffee/tea on empty stomach
• Avoid SPICY foods- biggest culprit.
• Avoid dairy – If lactose sensitivity.
• Avoid Gluten – If Gluten sensitivity.
• No panty liners.
• No sprays, washes or rephresh etc in vaginal area.
• Other FOODS TO AVOID- Broccoli, Chia seeds, Kale, Turmeric in excess, Black Beans, Garbanzo beans, Artificial sweeteners, alcohol (specially hard liquor), alcoholic cocktails, strawberries, blueberries.
• No SODAS
• Avoid green chillies, red pepper, jalapenos.

THINGS TO DO

• WATER-WATER-WATER
• PROBIOTICS – 50 billion units daily – See attached reflux protocol.
• Natural probiotics- Miso, sauerkraut.
• GOOD FOODS- Avocadoes, Bananas
• Other alkaline foods – Sweet potatoes, Apricots, Sprouts, Spinach, Green beens, Eggs, Coconut, Cauliflower, Quinoa, Ginger

KEEP A BLADDER/GUT JOURNAL (depends on your symptoms).

• Daily voiding numbers and times
• Night time voiding frequency/ Leaking episodes.
• Abdominal pain episodes/ nausea/ constipation episodes.
• Painful sex episodes.

As always!

Be safe, be strong and be prepared.

Your friends at Walk IN GYN Care

The post Healthy Gut and Bladder- Tips and tricks! appeared first on Walk In GYN Care.

Some of the common causes of pelvic pain include endometriosis, dysmenorrhea, pregnancy, UTIs, pelvic inflammatory disease, degenerating fibroids and twisted or ruptured ovarian cysts.

If you are experiencing pelvic pain, there are a number of steps your gynecologist may take to figure out the cause.  First, your provider will need a detailed history of how long you have been experiencing the pain, what it feels like, how often and when it occurs. Associated factors such as relationship to menstrual cycle, painful intercourse or urination can guide your gynecologist towards the possible cause.

A complete women’s health exam including a pelvic exam can help elucidate possible pathology. If your doctor finds cervical motion tenderness (pain on palpation of the cervix) or pain while examining the uterus, or surrounding organs, this may indicate pelvic infection or inflammation (PID). PID is treated by a full course of antibiotics, which may or may not include partner treatment depending on test results.

A thorough evaluation includes a sonogram (pelvic ultrasound) to evaluate the uterus for fibroids and/ or ovaries for ovarian cysts etc. Depending on your history, you may also need to do a pregnancy test and be checked for sexually transmitted diseases. If you are experiencing any urinary frequency, pressure or pain with urination, you may be asked to give a urine sample where your urine can be checked for an infection.

Treatment is usually is directed to specific diseases that cause chronic pelvic pain. When there is no clear etiology found for the pain, then treatment is directed to alleviating the symptoms. Treatment options for endometriosis may include oral contraceptive pills, injectable contraceptives, surgery or Lupron.

If your gynecological exam is normal, then non-gynecological reasons need to be ruled out. Remember, the pelvis (lower part of the abdominal cavity) has numerous other organs that can lead to pain. The most common non-gynecologic causes are related to irritable bowel (upset gut) and inflammation of the bowel. Women with these conditions may be suffering from bloating, constipation, blood in stool and heartburn. Most of us tend to ignore our symptoms until they start to affect our quality of life.

Another non-gynecological cause is interstitial cystitis (angry bladder). Women with this condition suffer from long term distressing pain, painful sex and constant lower abdominal discomfort.

The first line treatment for both of the above conditions is lifestyle modification, avoiding spicy foods, drinking at least 10-15 glasses of water a day and eating a health balanced diet.

After a thorough women’s health check up, if the cause of the pain is still an enigma, a visit to a gastro-enterologist and an urologist may be in the pipeline.

If any of the above symptoms have been affecting your daily lives, please feel free to walk in for a complete check up…

Be safe, be ready and be prepared!

Dr. Adeeti Gupta

The post Pelvic Pain-Common Causes & Treatment appeared first on Walk In GYN Care.