The Canandaigua Medical Group
Obstetrics and Gynecology Services

Office Procedures Performed by the Physician, Nurse Practitioner and Physician Assistants of the Obstetrics and Gynecology Department Include:

Physical Examinations: Involves a thorough history and physical examination of the patient to determine the presence or absence of physical problems. Includes wellness counseling.

Gynecological Examination: Involves a thorough examination of the breast and female genitourinary system. Usually involves a pap smear of the cervix.

Prenatal Care: Care of women during pregnancy. It consists of periodic examinations for the determination of blood pressure, weight, changes in the size of the uterus, and the condition of the fetus. A variety of laboratory tests provide important data for treatment or education. Patient teaching is an important aspect of prenatal care.

Post Partum Care: Care of women following birth. Involves a thorough examination of the breast, female genitourinary system and birth control counseling.

Pre-Operation Evaluation: Care before a surgical procedure. Involves a thorough history and physical examination of the patient to determine the presence or absence of physical problems. The provider will discuss the procedure with the patient and allow the patient to express any concerns they may have.

Post-Operation Care: Care following a surgical procedure. May involve one or more visits to the provider who monitors the healing status of the wound and the patient's overall recovery.

Monitoring Laboratory Tests.

• Papanicolaou (Pap) Smear: used to detect cancer cells from the cervix and vagina.

Diagnosis and Management of acute and chronic diseases.

Blood Pressure Evaluation.

Fertility, Infertility and Contraception counseling and management.

Review of various ancillary procedures.

• Dexa Scan - A simple procedure used to measure bone density. Bone density is important in identifying people at risk of bone injury and osteoporosis.
• CAT Scan (Computerized axial tomography) - use of a computer to produce from x-ray data, a cross sectional view of the anatomical part being investigated.
• MRI Scan (Magnetic resonance imaging) - a type of diagnostic radiography using electromagnetic energy. This technique is valuable in providing soft tissue images of the central nervous and musculo-skeletal system.
• Ultrasound procedure - uses ultrasound to produce an image or photograph of an organ, or tissue for diagnostic and therapeutic purposes.
• Mammography - x-ray examination of the breast.

Diagnosis and management of sexually transmitted diseases (STD's) and gynecological infections.

Health promotion counseling.

Norplant Insertion and Removal - Norplant is a contraceptive method that involves placing six match-size, flexible capsules under the skin of a woman's upper arm. These capsules release a low dose of a form of progesterone continuously for up to five years. Progesterone prevents the release of eggs from the ovaries. A physician inserts the six capsules through a small incision.

Breast Cyst Aspiration -A breast cyst is a benign fluid filled sac. A patient may or may not feel a cyst, but they do appear on a mammogram or ultrasound. Cyst aspiration is a quick and simple procedure to remove cyst fluid. The physician inserts a needle into the cyst and drains the fluid. The patient can usually return to her normal activities following the procedure. A sample of the fluid may be sent to the laboratory for evaluation and identification.

Colposcopy - A colposcope magnifies the external genitalia area, vagina and cervix. This close-up view allows a physician to easily examine and identify abnormal areas. A colposcope resembles a microscope. Physicians recommend colposcopy for women who have had abnormal pap smear results.

Cryosurgery - A physician may use cryosurgery to remove abnormal cervical tissue. The procedure uses probes and extremely cold temperature to locate, freeze and destroy the abnormal tissue. Cryosurgery is relatively painless and produces little scarring.

Pessary Fitting - A pessary is a device that is inserted into the vagina by a provider to function as a supportive structure for the uterus and/or bladder.

Diaphragm Fitting - A diaphragm is a dome-shaped latex cup that covers the cervix during intercourse. A provider fits the patient with the proper sized diaphragm for her cervix. The patient is taught how to properly insert the diaphragm. It is inserted into the vagina before intercourse. A diaphragm prevents sperm from gaining access to the upper reproductive tract. It also serves a spermicide holder.

Paragard/Progestasert IUD Insertion - The copper intrauterine device (IUD), Paragard and the hormonal IUD, Progestasert, prevent fertilization of the egg. Paragard can remain effective for ten years. Progestasert lasts for only one year. Both IUD's are inserted into the uterus. Removing or replacing the IUD is a simple process.

Post Coital Test (PCT) - A Post Coital test determines the quantity and mobility of sperm in a specimen of semen. The sample is taken from the patients cervical canal following sexual intercourse. Physicians recommend having a Huhner's test around the time of ovulation.

Endometrial Biopsy - An endometrial biopsy is used to monitor precancerous abnormalities, ovulatory abnormalities, and women whose mothers took diethylstilbestrol (DES) during pregnancy. This procedure usually is conducted to obtain a sample of tissue for pathologic examination. After a routine pelvic examination is done to determine the position of the uterus, the cervix is exposed and cleaned. An instrument is placed on the cervix to stabilize it and another instrument is introduced into the uterine cavity in order to withdraw a sample of the endometrial lining. The samples are sent to a lab for examination and identification. This procedure can cause cramping but can, at times, enable a woman to avoid surgery.

Services Performed by the Obstetrics and Gynecology Nursing Staff:

• Interviews and collecting data.
• Nursing advice and teaching.
• Weight, height and blood pressure check.
• Dressing changes, bladder catheterizations, etc.
• Administration of various medications and immunizations.
• Comfort Patients.