LeConte Women’s Healthcare Associates

We provide comprehensive gynecologic services for women through all stages of life, including:

• Pelvic exam and pap smear
• Abnormal pap smear
• Irregular, heavy, and painful periods
• Infections of the vagina and female pelvic area
• Birth control and surgery to prevent pregnancy
• Hormone evaluation
• Pelvic pain
• Ovarian cysts
• Endometrial ablation
• Menopause management
• Minimally invasive gynecologic surgery
• STD screening and education
• Urinary incontinence
• Urogynecology and pelvic support

When You Should Get a Pap Smear, Pelvic, and Clinical Breast Exams

Pelvic and clinical breast exams, and a pap smear, are important for routine women’s healthcare. They help detect abnormalities that can lead to cancer.

Pelvic Exam

We recommend you receive an annual pelvic exam as soon as you become sexually active, regardless of age. This important exam allows us to monitor the female organs for changes in size or shape and signs of disease like inflammation, masses, or fibroids. If any changes are discovered during your exam, we will recommend additional testing, such as a pelvic ultrasound for further examination.

Pap Smear

During your pelvic exam, we can perform a pap smear to test the cells in the cervix for any changes that could lead to cancer. The American College of Obstetricians and Gynecologists (ACOG) recommends:

• Every woman should get her first pap smear test at 21 years old and continue to do so every three years until she turns 30.
• Women aged 30-65 years old: every five years

An abnormal pap smear doesn’t always mean cancer. Many women experience cervical cell changes, and often those changes go back to normal on their own.

Should you receive an abnormal pap smear, we will request additional testing like a colposcopy or cervical biopsy for closer examination of the changes. If results of follow-up tests indicate significant changes, the abnormal cells will be removed. You will need follow-up testing after treatment and regular cervical cancer screening after the follow up is complete.

Clinical Breast Exam

It’s important to conduct monthly self breast exams to know what is normal for your breasts so you can notice small changes and report them right away.

ACOG advises women get a clinical breast exam:

• Every one to three years for women 20-30 years old
• Every year for women aged 40 and older

You should talk with us about your risk factors to make a decision about whether to have a clinical breast exam.

The PAP smear is a screening tool used to detect potentially abnormal cells on the cervix. If there is evidence of abnormalities then we can utilize a microscope (Colposcope) to evaluate the cervix in more detail.

If we determine that there are significant pre-cancerous cells on the cervix then one option for treatment is a LEEP procedure. LEEP stand for Loop Electrocautery Excision Procedure.

After numbing the cervix with a local anesthetic we shave off the area of abnormal cells using a wire loop.  Using over the counter Ibuprofen or Naproxen may help minimize any cramping. You will be able to drive yourself home from the office.

If you’re certain that you do not wish to become pregnant again and if your periods are heavy and negatively affecting your daily life then you may want to consider an outpatient surgical option.

Uterine (Endometrial) ablation is a minor procedure designed to destroy the majority of the lining tissue inside of the Uterus. Typically the procedure itself takes about fifteen minutes to perform and gives approximately a 90% probability of reducing your bleeding significantly.

You are quickly back to normal activity with no long recovery time.  Some lucky patients never have menstrual bleeding again!

We offer both in-office as well as outpatient surgical choices.

Warning Signs

Contact us immediately at 865-908-9888 if any of these symptoms occur:

• Foul-smelling drainage from your vagina
• Fever or chills
• Severe pain in your abdomen (stomach)
• Heavy bleeding, or heavy bleeding longer than 2 days after the procedure
• Trouble peeing

We offer minimally invasive permanent surgical sterilization. This procedure is done in the office under local anesthesia with a hysteroscope.

A hysteroscope is a very thin camera device used to look into the uterus and view the openings of your tubes.  An inert coil is placed under direct visualization into the opening of each tube.

It is very important that you plan on continuing some other form of reversible birth control for at least three months.

Three months after the procedure is complete it is very important to have an X ray test called a hysterosalpingogram (HSG) to confirm that both tubes are now completely blocked before relying on the procedure alone for birth control.

Laparoscopic Hysterectomy

Certain gynecologic problems may ultimately require hysterectomy (or removal of the uterus). This can be accomplished several different ways. The old fashion abdominal incision is sometimes necessary. A hysterectomy can also be performed vaginally. There are many instances when removal of the uterus may be accomplished through the laparoscope and the patient may be able to go home the same day. If the hysterectomy is performed laparoscopically the patient can also often returned to normal activities within 2 weeks. Laparoscopic hysterectomy would require 3 small incisions in the abdomen each approximately 1/2 inch long.

Urethral Slings

Stress urinary incontinence or accidental leakage of urine with coughing, laughing, or lifting is a very common problem. Sometimes lifestyle changes such as pelvic floor exercises can make a big difference. If surgery is necessary the TVT Abbrevo suburethral sling is a very effective means of surgically correcting this incontinence problem. This involves a very small piece of nonabsorbable material placed through a vaginal incision less than 1 inch long. Typically the patient is able to go home same day and return to normal activities within just a few weeks. This has a very high success rate and patient’s experience very little discomfort with the procedure.

Uterine Ablation

Uterine or endometrial ablation is an outpatient procedure that treats the lining of the uterus in such a way that the periods are much lighter or, for some patients, actually stop altogether. It is important that the patient is certain that she has completed her family before proceeding with this.  This procedure is not intended as a sterilization procedure so it would be important that she have a sterilization procedure of some type.  The sterilization may be done at the same time as the ablation.  The endometrial ablation can be done in the office under certain circumstances but can also be done under anesthesia in the operating room. Either way, this is an outpatient procedure and the patient is able to return to normal activities very quickly.

Uterine Prolapse

This is the dropping of the uterus into the vaginal canal. Quite commonly this problem can occur after childbirth and can cause pressure, pain, or bulging from the vagina. Although surgery is typically needed to correct this problem the newer options can be performed on an outpatient basis with a quick return to most activities.

Bladder/Vaginal Prolapse

Similar to uterine prolapse, the bladder and the vagina itself can drop after childbirth or injury. The symptoms are similar. Sometimes these prolapse problems do not cause any significant symptoms and may not need to be treated.  There is a nonsurgical option called a pessary. This is a device that can be placed, removed, and replaced into to vagina to basically prop things back where they belong.  There are also surgical options available.

Cystocele and Rectocele Repair

Cystocele refers to the specific bulge below the bladder that may occur after childbirth. It is often associated with Stress Urinary Incontinence but can cause other problems as well. Rectocele refers to a bulging into the vagina from the rectal wall. Constipation, pressure, and splinting (the need to apply pressure in the vagina to allow for bowel movements) are common symptoms. Kaegel exercises (pelvic floor muscle exercises), physical therapy, pessaries, and outpatient surgeries are common corrective measures discussed for the problems.

As you begin the exciting journey of pregnancy, our team is here to help you along the way – from planning to birth. Learn more about our pregnancy services.

• Infertility
• Prenatal care
• Prenatal ultrasound
• High-risk pregnancy complicated by diabetes, hypertension (high blood pressure), thyroid disorders, and asthma

We deliver babies at LeConte Medical Center. For women with high-risk pregnancy complications, we partner with the perinatologists at Fort Sanders Perinatal Center.

Here is some additional information about navigating your pregnancy.

As you begin the exciting journey of pregnancy, we will meet with you regularly to monitor the growth of your baby. Below is information explaining what you can expect during your visits with us and the prenatal care you’ll receive before your baby is born.

Prenatal Care Appointments

At your first appointment, we will confirm your pregnancy with lab tests and begin developing a personalized care plan for you and your baby. You can also expect to:

• Hear your baby’s heart beat for the very first time
• Receive a health exam
• Get a prescription for prenatal vitamins and a full list of which medicines not to take during your pregnancy

As your pregnancy continues, you’ll have more prenatal visits, including:

• Monthly checkups during your first two trimesters
• Every two weeks when your 28 weeks pregnant through 36 weeks
• Weekly visits until you deliver your baby

At each prenatal appointment, we’ll monitor your health and your baby’s growth by checking your weight, blood, and urine. You’ll also get to see your baby on ultrasound.

Along the way, other tests may be necessary, but we’ll discuss with you any additional testing.

During your appointment, we’ll answer all your questions. If you have concerns between appointments, your calls are always welcomed. We want you to feel comfortable and confident as you begin this journey!

During your pregnancy, you will have several ultrasounds to monitor your baby’s growth. Below is information regarding when and why you may have an ultrasound.

Prenatal Ultrasound Schedule

First Trimester (Up to the end of week 12)

During the first trimester, we will:

• Determine your baby’s due date
• See if you have one or more babies and check your placenta
• Diagnose an ectopic pregnancy or miscarriage
• Examine the uterus and other pelvic anatomy
• In some cases detect if something is wrong with your baby

Click here to learn more about your first trimester.

Second Trimester (13-27 weeks pregnant)

Next, ultrasound is used in your second trimester to:

• Confirm the due date (a due date set in the first trimester is rarely changed)
• See if you have one or more babies and check your placenta
• Help perform tests, such as an amniocentesis
• Examine your baby for any problems with his or her body
• Check the amount of amniotic fluid (the fluid surrounding your baby)
• Monitor blood flow from you to the baby
• See your baby’s behavior and activity
• Measure the length of your cervix
• Monitor your baby’s growth

Click here to learn more about your second trimester.

Third Trimester (28 weeks pregnant until delivery)

Finally during your third trimester, we’ll:

• Monitor your baby’s growth
• Check the amount of amniotic fluid
• Determine the position of your baby
• Examine your placenta

Additional studies may be scheduled, depending on your unique case.

Click here to learn more about your third trimester.

Our Dolly Parton Birthing Unit at LeConte Medical Center in Sevierville, TN is honored to offer Tennessee families the very best in comprehensive, top-quality maternity services and birthing care.

Our center has been the recipient of many prestigious awards for our exceptional birthing facility and staff.

LeConte Medical Center is named among four Covenant Health hospitals with the BEST for Babies Award by the Tennessee Department of Health and the Tennessee Hospital Association.

LeConte Medical Center’s Dolly Parton Birthing Unit is proud to be one of only four hospitals in the state of Tennessee recognized by Newsweek as a “Best Maternity Hospital.”

LeConte Earned a Bronze Seal for Safe Sleep, and is certified as a Safe Sleep Hospital. As such, we are dedicated to providing education and vital tools about safe sleep to the parents of newborns delivered in our birthing unit.

Learn more about the Dolly Parton Birthing Unit.