Gynecologic Services

Abnormal uterine bleeding refers to uterine bleeding of abnormal quantity, duration or schedule. Menstrual periods less than 24 days apart or more than 38 days apart are considered abnormal. Prolonged menstrual bleeding is defined as menstrual bleeding lasting greater than 8 days. Heavy menstrual bleeding occurs when the volume of blood lost interferes with the day to day activities and the quality of life. When measured directly, it is a volume lost of greater than 80 ml of menstrual blood per cycle. In our office, we will perform a complete evaluation of the abnormal bleeding, determine the etiology and offer the latest treatments to resolve the abnormality.

Urinary Incontinence is a very common condition. It occurs in as many as one out of four women over forty years old. However, it can be successfully treated and or cured in most cases. On the patients in which surgery is recommended, this can be done in our office or at an outpatient center with a minimally invasive surgical approach.

Take the Incontinence Quiz

Do you know the signs of urinary incontinence?

  • Do you lose urine when you cough, sneeze, laugh, lift, jump or run?
  • Do you have to hurry to the bathroom to empty your bladder when it's full?
  • Do you sometimes have difficulty making it to the bathroom in time?
  • Do you find it necessary to use some kind of protection, i.e. pads, panty liners, diapers, etc?
  • Do the sight and sound of running water cause you to lose urine?

At our institute, patients are evaluated only by our board certified gynecologist, who is proficient in the latest treatments for urinary incontinence. Elias Mualin M.D., F.A.C.O.G. has treated a very large number of patients with excellent results. For the treatment of stress urinary incontinence the midurethral slings are proven extremely effective. In addition to a speedy recovery, risk is minimized with this technique. The patient can see results immediately after the surgery. The surgery as mentioned before can be performed in office or at an outpatient surgical center with minimal postoperative pain. The surgery can also be combined with other procedures.

Pelvic organ prolapse is the herniation of pelvic organs to or beyond the vaginal walls. It can occur in up to 50 % of women who have had a vaginal birth. Pelvic organ prolapse can lead to pelvic pain and pressure, urinary incontinence, and sexual symptoms. Dr. Mualin will complete a thorough evaluation, determine the extent of the prolapse and offer a multitude of treatment options including pelvic floor therapy, vaginal pessary and surgical treatment.

The choice of a contraceptive method is a complex decision. We offer the latest options for contraception including oral contraceptive pills, vaginal rings, contraceptive patch, injection, subcutaneous implant, IUDs and permanent sterilization. Dr. Mualin will help you decide which contraceptive is right for you.

Pelvic pain is defined as a pain in the lower abdomen or pelvic area which may be diffuse or localized
and in some cases can include musculoskeletal pain. The pain can be sporadic or constant and it can also
be sharp or dull. It can commonly occur secondary to a gynecologic abnormality. We offer in office
pelvic sonogram for a more rapid and convenient way to detect the underlying abnormality. After
thoroughly evaluating the source of the pelvic pain, then Dr. Mualin will determine the best treatment
options available.

Patients with ovarian cysts may be asymptomatic or may present with many symptoms including pelvic pain, pain with intercourse and abdominal fullness or swelling. Ovarian cysts can be suspected on physical examination and confirmed by pelvic sonogram. Depending on the sonographic characteristics of the cysts, then Dr. Mualin will offer the best available options for management.

Uterine fibroids are non cancerous growths of the uterus. They are made up of muscle and connective tissue. Uterine fibroids can be either asymptomatic or they can cause a multitude of symptoms including heavy or painful bleeding, pelvic pain, abdominal fullness, painful intercourse and low back pain. Dr. Mualin specializes in less invasive ways to manage uterine fibroids, including hysteroscopic myomectomy and transcervical ablation of uterine fibroids.

Vaginitis refers to vaginal inflammation which causes vaginal discharge, itching and pain. There are many causes including infection, irritation secondary to chemicals in creams or sprays and also secondary to lack of estrogen. The treatment depends on the etiology of the vaginitis. In our office, we will perform a comprehensive evaluation of your symptoms and then treat accordingly.

Sexually transmitted infections can lead to chronic pelvic pain, upper genital infections and infertility. We perform a complete STI screening. Treating an STI early can prevent many complications and reduce transmission in the community.

We utilize cervical cytology and human papillomavirus testing for cervical cancer screening. These results will then guide further evaluation and management. Management can include repeating cervical cytology, performing cervix colposcopy with biopsies including cervix mapping and excisional procedures. Early detection and treatment of abnormal cells is critical in prevention of cervix cancer.

Dr. Mualin will perform a comprehensive history and physical examination for early detection of any gynecologic abnormality. This will include a pap smear, breast examination and pelvic examination. He will order a screening mammogram, breast ultrasound and bone densitometry as necessary.

Gynecology Procedures:

A procedure in which a telescope like device is inserted into the uterine cavity to diagnose intrauterine pathology and treat certain conditions. Dr. Mualin performs in office hysteroscopy under local anesthesia for a faster recovery and without the risks of general anesthesia. He routinely performs hysteroscopic polypectomies and myomectomies in the management of abnormal bleeding.

It is a minimally invasive procedure in which the thin layer of the lining of the uterus is destroyed to effectively control heavy vaginal bleeding. Dr. Mualin performs endometrial ablations in office under IV sedation. Post ablation amenorrhea rates are usually 30-40 % , with a significant reduction in vaginal bleeding in 80-90 % of patients. Patient satisfaction is approximately 90 %.

It is a procedure that treats submucosal and intramural fibroids by utilizing radiofrequency ablation. The procedure is performed transcervically and thereby avoiding an abdominal surgery. There is a quick recovery and can be performed in office. It has been shown to reduce menstrual bleeding by 95 % after the first year.

Loop electrosurgical excision procedure is performed to remove precancerous cells from the cervix. Precancerous cells are usually identified after an abnormal pap smear with colposcopy and cervix biopsies. Dr. Mualin performs this procedure in office under local anesthesia.

A large number of women reports a labia minora ( smaller inner lips) longer than the labia majora ( outer lips). If this occurs the patient can experience discomfort especially when wearing tight clothes or during sexual intercourse. Also, they can be extremely uncomfortable with their appearance reporting this as their primary concern.

Laser reduction labioplasty is a surgical procedure which reduces the labia minora by utilizing the laser. The end result is a shorter, thinner and more aesthetically appealing labia. The laser technology has allowed us to create more precise incisions, with minimal blood loss and fast recovery. This procedure can be performed in office.

These are minimally invasive gynecologic procedures in which there are smaller incisions and a shorter recovery time. It can treat conditions such as ovarian cysts, endometriosis and uterine fibroids.

A midurethral sling is a minimally invasive surgery in which a suburethral sling is placed in the midurethra in a tension free manner for the management of stress urinary incontinence. It has a high effectiveness and low risk of complications.

Pelvic prolapse is the herniation of pelvic organs to or beyond the vaginal walls. The hernia can occur in the anterior vaginal wall, posterior vaginal wall and apical compartment. Symptoms include a vaginal bulge, pelvic pressure, urinary retention or difficulty in defecation. Vaginal reconstructive surgery can repair prolapse eliminating all of the associated symptoms. The patients in our center are evaluated comprehensively to determine the type of vaginal reconstructive surgery that is ideal for them.