Author Archives: Arizona Gynecology Consultants

Healthy diet for Women

What Is a Healthy Diet for Women These Days?

It’s frustrating enough committing to a different lifestyle without having to wade through all the latest health fads and misguided quick-fix diet advice. Is it no-carb, low-carb, or all carbs this week? It may be best to leave these trends behind for good. To live healthfully, you need to understand two main concepts. The first is that healthy living is a long-term lifestyle, not a short-term fad. To achieve long-lasting results, you need to be prepared to be committed. A quick fix is simply that — quick. A lifestyle change is where you achieve lasting results that you can remain confident in. The second concept is understanding YOUR own body. Healthy eating for women is simply not the same as it is for men. Our bodies simply have different needs biologically. These unique needs will help to shape how you achieve your healthy living lifestyle.

Healthy Eating and Diet Tips for Women

The foundations of healthy living are quite simple. Many of us have grown up with the food pyramid, and even though its exact structure could now be up for debate, the main concepts remain. There are certain food groups that must be favored over others for a healthy diet. You often hear that moderation is key. While that may feel cliché, it simply is true. Healthy living does not mean that you need to always refuse yourself a treat. Yes, have that glass of wine sometimes. Yes, go out for taco Tuesday once in a while. While you shouldn’t feel as if you can’t enjoy life, understanding your basic necessities is the key to keeping everything balanced.

Eat More Vegetables

Eat More Vagetables

It likely comes as no surprise that veggies would be at the top of your healthy eating necessities list. And the more colorful varieties of veggies you can introduce to your day-to-day meals, the better! Now more than ever, veggies are ridiculously approachable. It is now increasingly difficult to not find cauliflower wings as an option in many restaurants. From cauliflower pizza crust to wings, fries, and sides, even noodles — veggies are easier to hide than ever, so if you aren’t a huge fan, there are still ways to sneak them in.

You can never go wrong swapping your carb-heavy option like pasta or pizza crust with a much healthier vegetable option, plus there are lots of other ways to get in those veggies. Something as simple as blending some spinach with your morning protein shake can give you a veggie boost you may not normally get into your diet. It is recommended that you get at least 2-2.5 cups of veggies a day. Just try to avoid added salt!

Add Healthy Proteins

Another basic component of healthy eating is protein. This important nutrient gives you energy to get through the day and helps you to feel full. There is nothing worse than feeling like you’re starving yourself, and with the right dietary choices, you’ll never have to feel that way. When it comes to proteins, it may also be some simple switches that can really improve your healthier choices.

For example, to many people, bacon may be a difficult meat choice to let go of. By making a simple switch to turkey, chicken, or vegetarian bacon, you can still enjoy your breakfast meat while improving your sodium as well as calorie intake. Meats such as chicken and turkey are naturally lower in fat and can be used as amazing alternatives across the board for many recipes. Don’t forget about the many amazing plant-based meat alternatives too. It is recommended that you have 5-5.5 ounces of lean protein foods a day.

Healthy Proteins

Get A Healthy Balance of Fats, Carbs, and Dairy

A Healthy Balance of Fats, Carbs, and Dairy

If a diet is telling you that you CAN’T have something, it probably isn’t the healthiest when it comes to life-long results. All the elements of the pyramid matter; you simply have to balance them appropriately.

When possible, whole grains can make a great alternative to your traditional breads and pastas. It is recommended that you have 3 ounces of whole grains a day. Examples of this include whole wheat bread, wheat-based cereal, and whole-wheat pasta (don’t forget about veggie pasta, too!), brown rice, oats, etc. You’ll also want to get in at least three servings of low-fat dairy products such as milk, yogurt, or cheese. Non-dairy foods and drinks that are calcium-fortified are also great elements for any method of healthy living.

And what about fruit? Is it healthy? You may have heard conflicting advice, and the short answer is both yes and no. Fruit is an amazing source of vitamins and natural sugars, but we need to keep in mind that it is still sugar. It is recommended that you have at least 1.5-2 cups of fruit a day. This can include fresh fruit, as well as frozen, canned, or dried, but keep an eye out for any added sugar.

What Specific Nutrients Women Need

As previously mentioned, though there are certain tips for healthy living that travel across the board, healthy eating for women has its differences. As women, there are key nutritional areas that we have to pay more attention to.

These can include iron, folate, and calcium.

  • Iron: Depending on the stage of a woman’s life, the amount of iron needed can vary. For example, during your peak fertility years, the amount of iron your body requires is higher than that of women going through menopause. Excellent sources of iron are red meat, chicken, turkey, fish, spinach, kale, and so much more.
  • Folate (folic acid): This nutrient is especially important during your reproductive years. Excellent sources include oranges, leafy greens, and certain types of beans and peas. Other foods that are fortified with folic acid, like breakfast cereals and some rice and breads, are also good sources.
  • Calcium: The benefits of calcium have been pounded into our brains from an early age. Calcium helps with the health of bones and teeth. The best sources include low-fat milk, yogurt, cheese, plant milk, tofu, and dark leafy greens.

What Foods Should Be Moderated

 While you should never feel like you must fully sacrifice anything, you do need to cut down certain things to succeed.

Overall, there are specific areas where moderation really needs to be taken seriously:

  • Alcohol: Long story short, no matter how you like your alcohol, it’s empty calories. Your body isn’t receiving any benefits from alcohol, and excessive amounts can influence negative food choices too. There is nothing wrong with treating yourself to a drink now and again, but keep in mind how easily it can set you back in your healthy dieting goals.
  • Trans fats: Be sure to pay attention to the nutritional label on the processed foods you put into your grocery cart. If you see trans fats, consider placing them back on the shelf. You may see this more often with desserts, frozen pizzas, and other quick snacks found in your freezer section.

Women of Every Age Need Physical Activity

Physical ActivityAnother important factor when it comes to your healthy lifestyle is your level of physical activity. You want to find a balance between your level of activity and what you put into your body. Often, people assume if they work out a lot, they can eat whatever they would like. This couldn’t be further from the truth. These two elements go hand in hand more than you’d think. Even if you are unable to do extensive physical exercise, making small changes can make a huge impact. This can include parking further from the entryway to a store, taking the stairs versus an elevator, or doing a round of squats during a commercial break on your favorite tv show. Every little step throughout the day adds up.

Bringing It All Together: The Best Diet for Women

So, what is the best diet for women?

Enjoy your veggies and find any way possible to sneak them into your meals. Make it a goal to always have something green on your plate. Consider what proteins will work best for you. Are you fueling your body? Enjoy your fruits, carbs, and healthy fats; just moderate them. If you sprinkled cheese on your salad at lunch, skip it on your broccoli for dinner. Make sure that you are paying attention to your specific needs, especially with your iron and calcium. When possible, squeeze in physical activity. These small steps will make a huge leap in your healthy living success.

Women’s Weight Loss and Other Health Services in Arizona

Women’s Weight Loss Services in ArizonaFor expert women’s health services in Arizona, contact us here at Arizona Gynecology Consultants. We specialize in the unique needs for women’s health and provide expert care. If you need help with weight loss or have another specific need, we are here for you. Our weight loss program is individualized for your needs.

Contact us today for more information about our weight loss services here in Arizona or to schedule an appointment with one of our nutrition and weight loss experts.



Your Annual Women’s Wellness Exam: What Can You Expect?

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What To Expect At A Woman’s Annual Wellness Exam

An annual gynecological exam is a vital part of maintaining the wellness of anyone with a female reproductive system. Whether you’re just hitting sexual maturity or beginning to experience the effects of menopause, it is important to monitor your body for signs and symptoms of illness. But there are certain health issues that require routine visits with a professional to catch, treat, and prevent them. That’s where your annual women’s wellness exam comes in.

When Should a Woman Have a Wellness Exam?

When should a woman have a wellness exam? The American Congress of Obstetricians and Gynecologists suggest a first reproductive health visit with a gynecological professional should be between ages 13 and 15. In this introductory visit, there will typically not be any kind of exam unless the patient is experiencing symptoms. It is treated more as an informational experience, teaching the young woman about her body and the basics of reproductive health/sexual safety.

Practitioners typically use this time to discuss:

  • Puberty and sexual development
  • Birth control and contraceptives
  • Prevention, screening, and treatment for sexually transmitted infections (STIs)
  • Breast self-examination
  • General health practices for adolescents

It isn’t until age 19 that annual breast and pelvic exams become necessary. Pap tests are not added into the routine until 21. That said, knowing the ages at which testing begins doesn’t necessarily lend a real understanding of what to expect at an annual women’s health exam. It’s not uncommon to experience anxiety around gynecological visits, as vaginal health can be a sensitive issue. Knowing what to expect can help lessen that anxiety and allow patients to feel a sense of control walking into the room.

What to Expect at an Annual Women’s Health Exam

Depending on your situation, you may be meeting with a gynecology physician or turn to your primary care physician, certified midwife, or other accredited professional for your reproductive health needs. All practitioners will likely conduct their visits in similar ways, beginning with collecting your vital signs—heart rate, blood pressure, height, and weight—as well as information on your medical history and that of close relatives. You will answer questions pertaining to your sexual and reproductive health.

Be prepared to answer questions such as:

  • When was your last period?
  • Are you sexually active/when was the last time you were sexually active?
  • Do you use birth control and/or contraceptives?
  • Are you currently, or have you ever been pregnant?
  • Have you had any gynecological surgeries?

You should also come prepared to discuss any problems you’ve had or are currently experiencing with your reproductive health or sexual function. Though you should ask your gynecologist all the questions that seem relevant to your visit, there are certain questions you may not even think to ask. There are a few specific symptoms of which you should remain conscious of and address with your provider.

They include (but are not limited to):

  • Menstrual abnormality – missed periods, heavy periods, unusual spotting
  • Pelvic discomfort – pain, bloating, bowel or urinary troubles
  • Sexual issues – painful intercourse, bleeding during or after sex
  • Unexpected changes – differences in the appearance of your vulva or feeling of your breasts
  • Signs of Menopause – irregular periods, hot flashes, mood, and sleep issues

Once the important data is collected, your provider will most likely begin physical exams and health screenings. Some of the tests you can expect include:

Pelvic Exam

The pelvic exam is done in three parts:

  1. A visual exam checking the health of the vulva
  2. An internal inspection of the vaginal walls and cervical area using a speculum
  3. A physical examination of the uterus and ovaries using a gloved hand

During this exam, it is not uncommon for women to experience some mild discomfort or pain. But, if for any reason you struggle with this portion of your visit due to anxiety or severe pain, be sure to communicate this with your practitioner. There are many options for alternate strategies to ease your discomfort or help you find calm during your exam experience. Patients with certain painful conditions such as vulvodynia may benefit from the use of a numbing lidocaine gel or a smaller speculum. If your concerns stem from psychological distress (i.e., sexual trauma, body dysmorphia, gender dysphoria), sharing this information with your gynecologist can help them understand your needs and how to help keep you comfortable during the exam.

One illness screened for during this exam is cervical cancer. Previously, women were told that they needed to have a cervical screening every year. Recently, the standards have changed. For women in their twenties, a cervical screening is needed every three years. Once they reach 30, however, the screening is only needed every five years. These cervical exams, known as “pap smears,” are conducted during the speculum-aided, internal portion of your pelvic exam. They are done by your practitioner gently scraping a sample of cells from your cervix to be analyzed by a laboratory for any sign of cervical cancer.

The largest cause of cervical cancer is an illness known as HPV, short for human papillomavirus. The pap smear done in the physical exam is not the only way to test for HPV. It is just one of the STDs screened for. If you are sexually active and have had a new partner since your last gynecological visit, your practitioner will most likely order a routine test for STIs.

STI Screening

  • Gonorrhea – urine test, genital swab test
  • Chlamydia – urine test, genital swab test
  • Syphilis – blood test for those without symptoms, swab test when symptoms are present
  • Genital Herpes – blood test for those without symptoms, swab test when symptoms are present
  • Trichomoniasis – visual exam, swab test, or discharge sample
  • HPV – visual exam for genital warts
  • HPV – pap smear during cervical exam
  • HIV – finger prick blood test

During this visit, your gynecologist will also perform a breast exam to check for any potential signs of breast cancer. Younger women will simply receive a manual exam where the practitioner feels for any lumps or differences in the texture of your skin and visually checks for nipple discharge. Around the age of 40 is time to discuss the need to introduce mammogram screenings into your wellness plan. A mammogram is a diagnostic test done by flattening the breast tissue to take an image from which your provider can detect signs of breast cancer or other abnormalities. Regular mammograms aren’t recommended until age 50, at which point they should be conducted every one to two years.

How to Prepare for Your Exam

A gynecological exam is not that much different than any other medical visit. Where it does differ is that certain biological functions will determine the timing of your exam. Remember, it is best to schedule your visit during a time when you know you are not going to be on your period. You will also want to avoid sexual contact or use of topical products for a day or two prior to your test, especially if you are going to be receiving a pap smear.

Otherwise, as with any other doctor’s visit, be sure to bring all the basics:

  • Driver’s License/Photo identification
  • Medical insurance card/plan information
  • A list of your allergies
  • The names and dosages of all the medications you are currently taking
  • Notes of any symptoms you are experiencing, questions you want to ask your doctor, or tests you wish to request that fall outside the scope of a regular wellness visit (some practitioners will not perform certain tests, like Herpes, unless you are showing symptoms or request it to be performed)

Schedule Your Annual Women’s Health Checkup Today

Need to schedule your annual women’s health checkup? Arizona Gynecology Consultants have multiple locations in the Phoenix and Mesa areas, offering a full spectrum of gynecological health services and procedures. While Arizona Gynecology Consultants is a go-to for primary care services for women in Arizona, their team of experienced clinicians and surgeons draw clients from across the nation. With specialists in all areas of women’s health, they aim to create a personalized experience for every patient in their care.

A Guide to Hysterectomy and vNOTES for Arizona Patients

A New Minimally Invasive Hysterectomy Procedure

A Guide to Hysterectomy and vNOTES for Arizona Patients

Each year, nearly 500,000 women face the prospect of undergoing a hysterectomy—the surgical removal of the uterus. In some cases, women may also experience the removal of the cervix, ovaries, Fallopian tubes, or other elements of the female reproductive system and its support structures. In the past, this procedure involved the use of either open abdominal surgery or laparoscopic surgery, leaving many women anxious about potential scarring, lengthy recovery times, and other common side effects of traditional hysterectomy surgery.

Now, Arizona Gynecological Consultants is proud to announce the availability of a new, minimally invasive hysterectomy procedure—vaginal natural orifice transluminal endoscopic surgery, or vNOTES. Our own Dr. Heather Zechman has completed advanced training on this highly specialized approach, and since Arizona Gynecological Consultants began offering the procedure in July of 2020, she has performed more vNOTES surgeries than any other surgeon in the state. In addition, Dr. Zechman is one of a select few surgeons in Maricopa County who are highly qualified to perform vNOTES. What is vNOTES? What advantages does vNOTES offer over traditional hysterectomy procedures? Read on to learn more about vNOTES and why it is such a significant advancement in women’s health.

Dr. Heather Zechman

What Is Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES)?


Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is an advanced gynecological technique first developed in 2012. While the traditional approaches to hysterectomy—open abdominal surgery and laparoscopic surgery—rely on making one large or

four small incisions into the abdominal cavity, vNOTES avoids abdominal skin incisions altogether. Instead, vNOTES utilizes the vagina as an access path to the uterus and other female reproductive organs and employs innovative technology to improve surgical outcomes. During a vNOTES procedure, the surgeon inserts a vNOTES device known as the GelPOINT® V-Path transvaginal access platform through the vagina and into the pelvic cavity. Then, the vNOTES device inflates the patient’s abdomen with carbon dioxide, giving the surgeon access to the uterus, fallopian tubes, ovaries, and the remainder of the pelvic cavity. The space provided by the device allows the surgeon to both see and operate on the organs inside.

The vNOTES device contains numerous, special openings through which the surgeon can insert the long, thin, surgical tools necessary for a hysterectomy procedure. Also, the surgeon employs the use of a specialized, high-definition camera, which can be inserted through the same access points; the camera allows extensive visualization into the area and allows the utmost precision. Once removal of the uterus is completed, the vNOTES device is removed, and the excess carbon dioxide can escape.

What Advantages Does vNOTES Offer Over Other Types of Hysterectomy Surgery?

As mentioned, the vNOTES procedure does not require any incisions into the patient’s abdominal cavity, instead using the vaginal opening to access the uterus or other reproductive organs.

As a result, vNOTES offers multiple advantages over open abdominal or laparoscopic hysterectomy, including:

  • No visible scarring. Since there are no abdominal skin incisions, vNOTES allows the patient to completely avoid the abdominal scarring caused by traditional hysterectomy procedures.
  • Shorter operating times. As this efficient procedure does not require creating or closing skin incisions, it takes less time in the operating room than other types of hysterectomy surgery. Traditional hysterectomy surgery can take over three hours, with the average lengths of laparoscopic, other vaginal surgery, and vNOTES requiring much closer to 1 to 2 hours. ? Reduced postoperative pain. Skin incisions and high abdominal pressure are major sources of postoperative pain regardless of the surgery involved. By eliminating skin incisions entirely and reducing the necessary abdominal pressure, vNOTES effectively minimizes the amount of postoperative pain experienced by most women.
  • Reduced need for pain relievers. As a direct result of decreased postoperative pain, vNOTES helps to reduce the dosage of pain relievers needed after surgery and can help shorten the length of time they are needed.
  • Shorter hospital stays. Unlike other hysterectomy procedures, vNOTES can be performed on an outpatient basis. Research revealed that more vNOTES patients leave the hospital within 12 hours as compared to laparoscopic patients, data that echoes Dr. Zechman’s working experiences. “The vast majority of my patients are able to go home on the same day they were admitted for their vNOTES hysterectomy procedure,” she noted.
  • Reduced recovery time. Reduced pain, fewer pain relievers, and shorter hospital stays, coupled with minimal bleeding, mean that vNOTES patients can return to their regular activities much more quickly than either laparoscopic or open surgery patients.

The HALON Study—published in 2019 in BJOG: an International Journal of Obstetrics and Gynecology—affirmed the above advantages of vNOTES. Conducted over two years between 2015 and 2017, this study consisted of a randomized and controlled clinical trial of 70 women, aged 18 to 70, at Imelda Hospital in Bonheiden, Belgium. All were set to undergo hysterectomy for non-cancerous conditions and randomly assigned either vNOTES or laparoscopic procedures. As a result of this study, both the American Association of Gynecologic Laparoscopists (AAGL) and American College of Obstetricians and Gynecologists (ACOG) recommend vNOTES over other procedures whenever possible.

Uses of vNOTES

As vNOTES is a transvaginal procedure—a procedure that takes place via the vaginal opening—it allows surgical access to many of the primary and secondary organs of the female reproductive system. As a result, vNOTES can give surgeons and patients a non-invasive hysterectomy option for the treatment of uterine conditions like uterine prolapse. However, vNOTES provides a non-invasive path for use in other circumstances, as well, including the treatment and removal of uterine fibroids, abnormal bleeding, chronic pain, the removal of adnexal masses, prophylactic ovarian surgery, sterilization, cancer prevention, and more. vNOTES has been successfully employed to perform the following Ob/Gyn surgeries:

  • Cystectomy – removal of an abnormal growth or cyst from any of the female reproductive organs
  • Salpingectomy – removal of the Fallopian tubes
  • Oophorectomy – removal of the ovaries
  • Salpingo-oophorectomy – removal of both the Fallopian tubes and ovaries

However, hysterectomy is by far the most common surgery performed using vNOTES, and is one of the most common surgeries experienced by women. Learn more about hysterectomy surgery and what you can expect from the vNOTES procedure in our guide below.

About Hysterectomy Surgery

One out of every nine women will undergo a hysterectomy at some point in her life, making the procedure the second most common type of surgery in women (only cesareans occur moreoften). As a result, obstetrician-gynecologists (Ob/Gyns), gynecologic surgeons, gynecologic oncologists, and general surgeons have dedicated a great deal of research to develop the safest, least-invasive surgical options. Your gynecologist and your gynecologic surgeon can help you determine which option may be best for your situation.

While the average age of a woman undergoing hysterectomy falls between 40 and 45, all women can benefit from reducing the invasiveness of the procedure. As a result, as proven by the HALON study, the least invasive hysterectomy procedure proves to be the best option. Here at Arizona Gynecology Consultants, Dr. Zechman firmly believes in the use of transvaginal natural orifice transluminal endoscopic surgery (vNOTES).

What Conditions Lead to a Hysterectomy?

In part, hysterectomies are so common because they are a practical solution for many gynecological issues after more conservative treatments have failed. Women undergo hysterectomies to treat a variety of conditions, including (but not limited to):

Uterine Fibroids

Uterine fibroids are noncancerous muscular and fibrous tissue growths that protrude from the areas in and around the uterus. Fibroid growths vary in size and typically appear during a woman’s childbearing years; some fibroids may shrink during or shortly after menopause. The cause of fibroids isn’t well understood, though they can sometimes be successfully treated with medications.

Severe fibroids can cause:

  • Pain during and after sex
  • Painful menstruation
  • Excessive menstrual bleeding
  • Excessive urination or constipation

In many cases, physicians recommend a hysterectomy to treat severe fibroids that produce heavy, painful bleeding.

Uterine Fibroids

Uterine Prolapse

Uterine prolapse occurs when the muscles and ligaments of the pelvic floor are so weakened that the uterus is no longer held in place. In some cases, the uterus slips so severely out of place that it begins to protrude into the vagina.

Most cases of prolapsed uterus are caused by childbirth and can lead to:

  • Difficult, painful sex
  • Incontinence
  • Back pain

If you don’t desire to have any more children, your Ob/Gyn may recommend a hysterectomy to treat a prolapsed uterus.

Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease, or PID, is a bacterial infection of the reproductive system. In most cases, antibiotics are all that’s needed to address the infection; however, if the disease is not discovered early enough, antibiotics may not be sufficient. In these cases, PID can cause extensive damage to the uterus, fallopian tubes, and other reproductive organs and cause additional, prolonged pain. If your PID is causing you severe pain and you no longer wish to have children, hysterectomy may be an option for you.


uterine cancer

One of the most common reasons for hysterectomy is a cancer of one of the elements of the reproductive system. If you have uterine cancer, cervical cancer, ovarian cancer, or cancer of the fallopian tubes, your oncologist may recommend a hysterectomy. In most cases, hysterectomy becomes an option if cancer is not well-controlled through other methods or if cancer has spread.

Is Hysterectomy an Option for You?

For many women with cancer—especially advanced cancers of the uterus or cervix—a hysterectomy is one of the only options to prevent its further spread. For women experiencing other conditions, however, it is crucial first to determine whether a hysterectomy is the best treatment option.

Discuss the following questions with your physician:

  • Are you finished having children, or are you satisfied remaining child-free?
  • Are you prepared for the possibility of early-onset menopause?
  • Have you attempted other, less-invasive treatment options for your condition?
  • Are your symptoms continuing to affect your quality of life negatively?

If you answered yes, hysterectomy is likely a potential solution to your gynecological health issue. However, it’s crucial to note that each case is different and should be evaluated separately. For that reason, it’s important to thoroughly discuss all treatment options with your doctor before deciding on a hysterectomy.

Different Types of Hysterectomy

Different Types of Hysterectomy

Many conditions may lead to a hysterectomy, and there are multiple types of hysterectomy your physician may recommend. For instance, your physician may recommend the removal of other organs in addition to the uterus—or may want to leave a portion of your uterus as is.

The types of hysterectomy can be broken down into four common categories:

  • Complete hysterectomy – this is the type of hysterectomy most people think of when referring to the procedure. In a complete hysterectomy, the surgeon will remove the entirety of the uterus as well as the cervix.
  • Partial hysterectomy – in a partial (supracervical) hysterectomy, the surgeon only removes the upper portion of the uterus, leaving the cervix intact.
  • Radical hysterectomy – this hysterectomy is the most complete and is usually performed in cases of uterine, cervical, or other cancer. All portions of the female reproductive system are removed, including the uterus, cervix, ovaries, fallopian tubes, upper vagina, and nearby lymph nodes.
  • Hysterectomy with bilateral salpingo-oophorectomy – this is the removal of the uterus and both ovaries and fallopian tubes.

Methods of Hysterectomy Surgery

As with most surgical procedures—especially procedures as common as hysterectomy—there are multiple approaches surgeons can take. The type of procedure your surgeon will select depends on his or her skill level, comfort with the procedure, as well as other extenuating circumstances like insurance requirements, hospital scheduling, caseload, available technology, and more. In addition, your surgeon may choose a procedure based on other concurrent procedures you require.

The procedure selected also depends on factors related to your case, such as the condition necessitating the hysterectomy, your symptom severity, and the type of hysterectomy recommended. Factors like the shape of your uterus, the presence of pelvic adhesions, and whether your case is considered emergent can also determine which surgical method is used. Currently, most surgeons in the US rely on one of three surgical methods for hysterectomies.

Traditional Hysterectomy

A traditional hysterectomy—known as an open hysterectomy—requires the surgeon to make a large incision into the abdomen. Typically about five inches, though the size can vary depending on multiple factors, this incision can be placed either vertically or horizontally along the bikini line to minimize scarring on the most visible parts of the abdomen. After incision, the surgeon can view the uterus and the surrounding tissues and remove the uterus and other necessary organs. For particularly large fibroids or a radical hysterectomy, the traditional approach may be necessary for adequate visibility and removal of all the necessary tissue.

Laparoscopic Hysterectomy

As with many modern surgical procedures, surgeons can benefit from the aid of a small camera (or laparoscope) situated at the end of a narrow tool. This camera allows the surgeon to view the interior of the abdomen without making a large incision to expose it. Instead, the surgeon makes multiple, small incisions for the camera and tools and removes the necessary portions of the uterus piece by piece. As the incisions are much smaller, the recovery time is much shorter than from a traditional hysterectomy.

Vaginal Hysterectomy

In a vaginal hysterectomy, the surgeon can avoid making an external incision altogether; instead, a tiny, internal incision is made at the top of the vagina. Using long-handled tools, the surgeon can separate the uterus from its connecting blood vessels and repair any damage. Then, the

uterus (as well as the cervix, fallopian tubes, or ovaries, in some cases) can be removed, piece by piece, through the vaginal canal. This type of hysterectomy makes use of the body’s natural openings and is by far the least invasive type of hysterectomy.

What Is the Best Type of Hysterectomy?

Best Type of Hysterectomy

As mentioned, much goes into a surgeon’s decision regarding the type of hysterectomy to recommend. Some conditions may require a traditional hysterectomy due to the sheer size of the uterine fibroid; other surgeons may prefer to perform the type of hysterectomy with which they are most familiar. However, in general, if all else is equal, the best hysterectomy procedure is the one that is the least invasive.

Why? Less invasive surgeries require smaller (or no, in the case of vaginal hysterectomy) external incisions. Utilizing fewer or smaller incisions, particularly through the muscular tissue of the abdominal wall, reduces blood loss during the surgery, minimizes the pain associated with the procedure, and shortens recovery time afterward. Also, fewer complications exist with minimally invasive procedures, reducing your chances of needing to re-enter the hospital or undergo another procedure.

ACOG-Recommended Hysterectomy Procedure [H2] As noted, of the various hysterectomy procedures available today, the American College of Gynecologists and Obstetricians (ACOG), as well as the American Association of Gynecologic Laparoscopists, recommends vNOTES over the others, whenever possible. HALON study research discovered that a vNOTES hysterectomy is just as effective as other methods and offers a superior outcome compared to laparoscopic and traditional hysterectomies. Also, this method is minimally invasive, carries fewer risks, and offers a shorter recovery time than other methods.

Another reason ACOG recommends vNOTES is patient satisfaction. Since this method requires a much shorter surgical time than other methods of hysterectomy and requires less hospital time after surgery, it is also less costly. Also, when surveyed after the surgery and recovery are complete, more patients say they are satisfied with the results of their hysterectomy than patients experiencing either laparoscopic or traditional hysterectomy.

Availability of vNOTES

While the ACOG and gynecologic surgeons alike see the benefits of vaginal hysterectomy over other procedures, the procedure cannot be accessed everywhere. In fact, less than 25% of all hysterectomies are performed vaginally. Two-thirds were performed using the traditional method—despite ACOG support and evidence of better outcomes achieved by vaginal hysterectomy. The reasons for using the method differ, but many surgeons cited lack of training for performing the more effective vaginal method and lack of comfort with the low degree of visibility available in most vaginal hysterectomy surgeries.

This is a set of circumstances especially notable to Dr. Zechman. “Surgical societies see the benefits of minimally invasive vaginal hysterectomy, but the procedure is rarely performed because of the difficulties involved in seeing and accessing critical anatomy. vNOTES solves these challenges using innovative technology designed to enhance patient outcomes,” Dr. Zechman says.

Implementation of vNOTES devices means surgeons can experience greater visibility of the abdominal area necessary for effective hysterectomy surgery. With the device and proper training, more surgeons can perform vNOTES surgery, resulting in a greater overall rate of effectiveness for hysterectomy surgeries.

What to Expect from Your vNOTES Procedure

Like other laparoscopic surgeries, vNOTES takes place while you are under general anesthesia, which means you’ll be asleep during the procedure. A small incision will be made internally, via the vaginal opening, allowing your surgeon to place the special vNOTES device that will provide access to the uterus and any other organs necessary. As with other laparoscopic surgeries, your abdomen will be gently inflated with carbon dioxide to provide room for the procedure.

vNOTES Procedure

The surgeon will utilize the specially placed openings within the vNOTES device to place a high-definition camera. Using the camera to visualize the area, the surgeon will remove the necessary structures with specialized vNOTES instruments. Once complete, the surgeon will remove the vNOTES device, close the internal incisions, and remove excess carbon dioxide.

In most cases, you’ll be able to return home the same day and will need minimal pain relief for a brief time. Most patients can return to normal activities after two to four weeks and heavy lifting, vigorous exercise, and even sex after about six weeks. However, it is critical that you speak with your physician to determine the appropriate recovery time necessary for your unique case.

vNOTES at Arizona Gynecology Consultants

Arizona Gynecology Consultants is pleased to announce the availability of the minimally invasive vNOTES at our facility. This advanced technique offers many of our hysterectomy patients the option to experience a shorter hospital stay, reduced recovery times, minimal pain, and zero external scarring. Dr. Heather Zechman is a minimally invasive gynecologic surgery (MIGS) specialist and continues to be one of Arizona’s foremost practitioners of this innovative technique.

As with any gynecologic procedure, it is essential to consult with your OB/GYN and Arizona Gynecology Consultants to discuss whether a hysterectomy utilizing vNOTES is right for your condition. We are committed to helping you develop a better understanding of your condition and your treatment options, including vNOTES. Reach out today to see how vNOTES may be a viable option for you.

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*Editor’s Note: This article was originally published Sep 29, 2020 and has been updated May 7, 2021.



Fibroid Client Testimonial

Arizona Gynecology Consultants Fibroid Client Testimonial

This entry was posted in Testimonials and tagged on by .

A wonderful patient of ours shared this detailed and thoughtful testimonial of how our services helped her with her fibroid issues. We asked for her permission to share it with all of you. She kindly agreed. Below are her exact words. Her name, face and personal details are not included to protest her privacy.

“Today, I had my post-op appointment with Dr. Kelly Roy. My incisions look good, and my swelling is going down, slowly but surely. I was advised to continue resting for another week, with walking and returning to my regular diet, and I can start working out in a couple of weeks. My swelling makes me look like I have a baby bump, which actually works well when trying to navigate sidewalks (folks get out of the way, haha). All in all, this was an amazing experience.

I am 32 years old, and I have been dealing with fibroid issues for the past decade of my life. It is an understatement to say that my issues interfered with my life, as complications only increased as the years went on. From eating to attempting to walk to classes on campus, and everything in between, my life was at the mercy of my fibroids.

Still, I lived my life, and I was able to accomplish quite a bit. I survived law school; I traveled to Europe and South America, and expanded my advocacy networks to encourage and empower marginalized communities. I was a leader, a mentor, a tutor, and an agent of change. However, at the end of the day, I constantly battled with feelings of insecurity attached to being a “normal” woman. Biological markers of womanhood were malfunctioning, and I felt that I would not find respite.

I met with myriad doctors, and I underwent multiple imaging procedures. As the fibroids grew, I watched medical providers explain to me the negative effects of their size and positioning. I also held back tears as they refused to operate and remove the fibroids from my body. I was told, not asked, what future plans I had, and how the operation could complicate them. “You’ll want to get pregnant,” I was told, as I was offered yet another type of hormone. The alternatives never worked long-term, and I learned to carry-on living “my best life” while making multiple concessions.

Working with BridgeHealth and Dr. Kelly Roy was the FIRST time I felt like my voice was incorporated into the conversation on my health and my body. As a black, disabled, LGBTQ individual, I am no stranger to marginalization, micro-aggressions, or systemic silencing. However, I had hoped and prayed that advances in social justice and equitable medical care would have opened the doors for a woman to not be typecast into select “convenient” options.

Ben never asked me if I was certain about wanting my procedure, and he did not try to convince me to wait until I fulfilled some feminine ideal expectation. He asked me questions related to my comfort level with traveling, and what type of providers I preferred. Dr. Roy took my desire to be without fibroids seriously, and she offered me diagnostic and operative procedures that would help me find relief from debilitating symptoms. Each and every interaction I had with these two individuals made me feel elated, safe, and hopeful for my future. In the end, the weight of the FIVE tumors removed weighed more than 3x the weight of an average uterus. I’m still in shock thinking about this fact.

In the next six weeks, I’ll be making plans for my future that include fitness, travel (Lord willing), new clothes, and much more. I won’t be restricting what pants I wear based on whether or not I’ll be three inches wider in my waist; I won’t walk around crowds with anxiety that I’ll start bleeding; and I won’t attend dinner dates in fear that I may need to run to the ER. That feels absolutely amazing.

Please continue to nurture the relationship established between BridgeHealth and Dr. Roy’s practice. She is a phenomenal provider, and I would recommend no one else for gynecological care. Further, I hope that more insurance providers realize the value of BridgeHealth and how your company’s ability to provide coverage for life changing procedures matters in this world. Not only did you alleviate a financial burden, but you helped me navigate a process with ease and confidence.”

Fibroid Client Testimonial

Getting Help for Fibroid Issues in Arizona

A note from our medical team on getting help for your own fibroid issues. Uterine Fibroids are a common problem for women. They can cause severe pain and infertility issues. Our team at Arizona Gynecology Services specializes in helping women in the greater Phoenix area and surrounding communities better understand, manage, and treat their condition so they can still achieve the family they desire.

Learn all about the signs, symptoms and treatments of uterine fibroids here. Or, contact us to schedule an appointment to discuss your concerns.

Thanks Nurses

Our Community Heroes

This entry was posted in News on by .

“As a nurse, we have the opportunity to heal the heart, mind, soul and body of our patients, their families and ourselves. They may not remember your name but they will never forget the way you made them feel.” – Maya Angelou

AZ Rep Nurses Ad

Thank you nurses for your relentless commitment to our community and the patients we serve.

Emily Calligan, BSN
Becky Calligan, RN
Julia Anne Cyr, DNP
Kris Calligan, FNP
Nikkeya Boyd, FNP

Our team of advanced practice nurses and surgeons collaborate to bring women, of all ages, the most advanced gynecologic care. Accepting new patients for clinic and telehealth services.

How Arizona Gynecology Consultants is Addressing the Coronavirus

How Arizona Gynecology Consultants is Addressing the Coronavirus (COVID-19)

Arizona Gynecology Consultants continues to monitor the Coronavirus disease 2019 (COVID-19) very closely.

Here at AZGYN we are taking every precaution to prevent the spread of this disease at all of our clinical sites across the valley. Our dedicated staff is committed to adhering all of the CDC’s Clinical Guidance.

At this time, we have extended our clinical reach by providing telehealth services for many GYN related issues you may be faced with, including:

  • Breast discharge
  • Breast pain
  • Depression
  • Frequent urination
  • Missed periods
  • Rashes
  • Sinusitis
  • Skin inflammations
  • Pelvic pain
  • Bladder infections
  • UTIs
  • Vaginal discharge
  • Vaginal itching
  • Yeast infections
  • Heavy or irregular menstrual bleeding
  • Menopausal symptoms

For any urgent matters, our clinics currently remain open and expect to honor all existing patient appointments. Please take advantage of our telehealth services for any non-urgent matters. We will be scheduling out Wellness/Annual visits until after April 5th, this promotes social distancing under the CDC’s guidance.

Schedule a Telehealth Visit

Please call 602-358-8588 or schedule a Telehealth visit, or existing patients can request an appointment via the patient portal.

We understand that these are difficult times. We stand united and will overcome this pandemic together. We look forward to serving you and continuing to be an advocate for your care.

Thank you and stay healthy,

The Arizona Gynecology Consultants Management Team