Operations Performed by an OB/GYN; Female Surgery

Obstetrics and Gynecology

In addition to seeing patients and delivering babies, OB-GYNs (obstetrician/gynecologist) also perform “female surgery.” Some surgeries are done in the office (cryosurgery), some are done as part of delivering a baby (cesarean or episiotomy), and the others are diagnostic (breast biopsy) or for repairs (stress incontinence).

In this article you will find helpful information about the surgeries, procedures, and operations performed by obstetricians and gynecologists and what exactly this type of doctor is.

Is there a difference between OB and GYN?

An OB-GYN is a physician who specializes in two fields: obstetrics and gynecology.

The obstetrics part refers to care of the woman and fetus during pregnancy; while the gynecology part refers to care of the non-pregnant woman throughout the lifespan.

Female surgeries, operations, and other procedures

While it is common to think that OB-GYNs only treat pregnant women, this is not true. OB-GYNs are specialized doctors of the female reproductive system. Of course this includes pregnancy, but it also includes any other issues with the female reproductive system (vagina, breasts, uterus, pelvic floor, ovaries, fallopian tubes, etcetera…)

The following is a list of some procedures, operations, surgeries or repairs done by OB-GYNs in alphabetical order.

Amniocentesis

  • Amniocentesis is a procedure done by an obstetrician-gynecologist to obtain a sample of amniotic fluid for varying diagnostic tests or treatments. Amniotic fluid is the fluid that surrounds the fetus in the uterus during pregnancy. The procedure is invasive as it involves a long needle entering the uterus through the outer abdomen–it is however not a procedure that requires anesthesia or long recovery. It may require fetal heart monitoring of the baby for a period of time before and after the procedure.

Bartholin’s Gland, Abscess Drainage

  • In the female body, two glands known as Bartholin’s Glands, are located–one on each side–of the vaginal opening. The Bartholin’s gland secretes fluid for lubrication in the vagina. Sometimes these glands become blocked, injured or infected and can cause the development of a cyst or Bartholin’s Abscess. If caught early, these cysts or abscesses can be treated non-surgically with warm compresses, sitz baths, or other remedies. More advanced cases require that the abscess be drained surgically. This can be done in a doctor’s office using local anesthesia (numbing the area) or in a hospital under general anesthesia (put to sleep). The surgeon, or OB-GYN, will make a small incision over the cyst to allow for the built up fluids in the abscess to drain.

Breast Abscess Drainage

  • Breast abscesses may develop in women who are breastfeeding, non-lactating women, or post menopausal women. Most commonly an abscess develops related to lactation as a result of infection and/or clogged lactation duct (known as mastitis). When these abscesses form, if detected early can be treated at home with warm compresses, antibiotics, or other treatment methods. A more advanced abscess will need to be drained by a surgeon or OB-GYN. This will mostly likely be done in a hospital under anesthesia; the abscess will be incised with a scalpel and the fluid will be drained.
  • In cases where the woman is not breastfeeding and an abscess forms, it may be biopsied and/or involve other testing as this is more unlikely and can be cause for suspicion.

Cervical Biopsy

  • A biopsy may be done if an abnormality was found in a routine pelvic exam, cervical exam or Pap smear. Cervical biopsies can be done both under local anesthesia or under general anesthesia, and there are several different techniques. The technique used will determine if the patient will receive local or general anesthesia and if it can be done in the office or in a hospital. The technique is chosen based on what the reason is for the biopsy and the patient’s medical history.

Cervix, Cryosurgery

  • Cryosurgery is the use of extreme cold to remove abnormal (cancerous, or pre-cancerous) tissues, normally on external parts of the body, such as the skin. Cryosurgery can be used to remove abnormal tissue and/or pre-cancerous cells that may be present on the cervix. After these cells are frozen off, the tissue is able to regenerate itself and grow new healthy tissue.

Cervix, Electrocauterization

  • Similar to cryosurgery, electrocauterization also seeks to remove abnormal tissue and/or pre-cancerous cells that may be present on the cervix. Instead of extreme cold however, electrocauterization uses electro-wave currents to remove the tissue.

Cesarean Section

  • A cesarean section is a surgery performed by an OB-GYN to surgically deliver a baby from the uterus. Cesarean sections (C-Section) may be performed under spinal anesthesia (awake and numb from the navel down) or general anesthesia (asleep).
  • A cesarean section may be indicated if there is maternal or fetal distress during labor; failure to progress in labor; certain fetal anomalies or congenital diseases; multiples pregnancy (like twins or triplets); severe pre-eclampsia; umbilical cord prolapse; history of a previous cesarean section; among other reasons.
  • An incision is made by the surgeon across the lower part of the abdomen, through many layers of abdominal tissue, fat and muscle, into the uterus. Once the uterus is cut, the infant is carefully removed by the surgeon. Then, all of the layers are sewn back together by the surgeon.
  • This is a major surgery that requires a hospital recovery of 2-3 days and a longer recovery of about 8 weeks.

Culdocentesis

  • Culdocentesis is a diagnostic procedure where fluid behind the uterus (in a space referred to medically as the posterior pelvic cul-de-sac, or Pouch of Douglas), is removed with a needle and examined. This diagnostic is helpful to determine ovarian cyst rupture, ruptured ectopic pregnancy, or pelvic inflammatory disease (pelvic infection).
  • In many cases today, ultrasound technology has replaced the need for a culdocentesis as it is less invasive and more comfortable for the patient.

D&C (Dilitation and Curettage)

  • A D&C procedure (dilitation and curettage) can be done either in the doctor’s office or in the hospital. It is a procedure where the cervix is manually dilated (opened up) and the uterine lining is scrapped or cleaned. The procedure is done to remove tissues after a miscarriage in the first trimester, or to treat excessive bleeding.
  • Different types of anesthesia may be administered for pain treatment: general anesthesia (put to sleep), spinal or epidural block (numb from waist down), or local (numbing just around the cervix).

Endometrial Biopsy

  • An endometrial biopsy is the sampling of tissue, for diagnostic purposes, on the lining of the uterus (endometrium). The tissue is obtained by tools inserted through the vagina, into the cervix, until reaching the inner part of the uterus–once the tool is in the uterus it removes a small portion of endometrial tissue and examines it for a diagnosis.

Episiotomy

  • An episiotomy is the cutting of female perineal tissue, typically done near the end of labor as the infant’s head is about to emerge, if it seems that the skin opening is too small. After the infant is delivered the cut is sewn together with stitches.

Fibroid Tumor Removal

  • The removal of uterine fibroids is also known as a myomectomy. In this operation the fibroid tumors are removed surgically by an OB-GYN, and the uterus is left intact. It is possible to become pregnant after a myomectomy. This type of surgical procedure will be done in a hospital.

Hysterectomy with Oophorectomy

  • Hysterectomy is the complete removal of the uterus and an oophorectomy is the removal of the ovaries by surgery. This type of surgical procedure will also be done in a hospital.

Laparoscopy and Laparotomy

  • Laparotomy and laparoscopy refer to the technique of inserting cameras and tools through small incisions on the abdomen to view, treat, perform surgery and diagnose. Laparotomy refers to the cutting of these small incisions; while laparoscopy refers to the viewing of the abdominal organs. This would be considered a major operation and would be done in the hospital under general anesthesia (while asleep).

Ovarian Cyst

  • Cysts, or fluid filled sacs, can develop on one or both of the two ovaries in the female reproductive system. Some women develop cysts with no symptoms, while others can have symptoms like pain, nausea, vomiting, irregular menstruation, etcetera. Often times these cysts go away on their own, but in more severe cases these cysts can be removed laparoscopically (surgically).

Pap Smear

  • A pap smear is a routine screening test for women that screens for cervical cancer. It can also be used to test for the human papillomavirus, or HPV.
  • A speculum in inserted into the vagina so that the cervix can be viewed. A small tool is used to scrap around the opening of the cervix thereby collecting a sample of cells present. The sample is sent to a lab where the cells are examined for abnormalities.

Women aged 21 years to 65 years should have a routine Pap smear screening done every 3 years, or if combined to screen for both HPV and Pap smear, every 5 years. After 65 years of age you can speak with your doctor about stopping these routine tests.

Pelvic Floor Surgery

  • The procedural repair for pelvic organ prolapse (when the bladder, uterus, or bowel drops), is called pelvic floor surgery and is performed by OB-GYNs.

Rectovaginal Fistula Repair

  • Fistula is defined as an abnormal connection between to organs. In this case a rectovaginal fistula means an abnormal connection between the vagina and rectum. This may be caused by injury during childbirth, Crohn’s disease, injury from radiation or other medical surgeries or procedures. Sometimes a rectovaginal fistula can repair itself, but most times a surgery is needed to fix it.

Stress Incontinence Surgery

  • As many women age, they begin to suffer from stress incontinence. Stress incontinence is when one leaks urine as a result of coughing, laughing, sneezing, lifting something, jumping, etcetera. OB-GYNs can perform surgery to help strengthen the bladder neck and urethra to minimize this urinary leaking.

Tubal Ligation

  • A tubal ligation or sterilization (salpingectomy) is when one or both of the Fallopian tubes are removed.