CONSIDER THIS BEFORE ANY INVASIVE GYNECOLOGICAL SURGERY

 

 Women with complaints of abnormal uterine bleeding, heavy menstrual bleeding, menorrhagia, ovarian cysts, thick endometrial lining, fibroids and so on who have been recommended for painful biopsies, exploratory surgeries or Dilation and Curettage (D&C) should opt for painless Transvaginal Ultrasounds or Sonohysterography says  Dr Steven R. Goldstein MD, an expert Gynecologist in NYC for a second opinion before any gynecologic surgery.

 

These procedures are painful, expensive, require anesthesia and recovery time and not guaranteed to properly diagnose the cause of bleeding or other conditions. Surgery should not be the first method of diagnosis.

 

Dr Goldstein prefers using non-invasive methods for diagnosis and treatment instead of blind endometrial biopsies or unnecessary and painful surgeries. In 1989 Dr Goldstein was the first to suggest that simple cysts in postmenopausal ovaries were benign and did not require surgery. This became the standard of care in 2009.

 

Since 1995 Dr Goldstein has argued against blind endometrial biopsies, instead recommending saline infusion hysterograms. This was finally endorsed by the American College of Obstetrics and Gynecology (ACOG) in 2012.

 

In 2004 Dr Goldstein was the first to warn against unnecessary biopsies in nonbleeding postmenopausal patients with an incidental finding of thick endometrial lining. This was affirmed by ACOG in its practice bulletin in 2009, and reaffirmed in 2015.

 

Instead of painful exploratory surgeries, Dr Goldstein, a top gynecologist in NYC uses non-invasive methods such as Transvaginal ultrasounds (water sonograms) and Sonohysterography to obtain clear images of the ovaries, fallopian tubes, uterus and endometrial lining. Dr Goldstein performs each of these procedures himself and does not delegate it to a technician.

 

For instance, with abnormal uterine bleeding, it may be caused by hormonal factors, which Dr Goldstein can easily detect using the 2 non-invasive methods.

 

Upon conclusion and review of the images from Transvaginal Ultrasounds or Sonohysterography, Dr Goldstein sits personally with each patient to discuss the findings for their condition and discuss possible treatment options.

 

Doctor Steven R. Goldstein MD is one of the nation’s top Obstetricians and Gynecologists and is well known internationally for ground breaking work in gynaecological ultrasound and imaging. He is regarded as one of the nation’s top doctors in Gynecology. He is a Professor of Obstetrics and Gynecology at New York School of Medicine, served as former Director of Gynecologic Ultrasound at New York University Medical Center and is a past President of the American Institute of Ultrasound in Medicine.

 

If you are suffering from abnormal bleeding, heavy periods, post menopausal bleeding etc. do not opt for painful exploratory procedures or surgeries. Instead you may contact Dr Goldstein, an expert NYC Gyn  at his New York office to schedule a consultation

 

SALINE INFUSED SONOHYSTEROGRAMS FOR INFERTILITY

 

 A source of decreased fertility in women is submucosal myomas. These submucosal myomas are also indicative of an increased risk for pregnancy loss. Another indication of infertility problems in women are Endometrial polyps.

 

Dr. Steven R Goldstein MD, a top Gynecologist in NYC is one of the most highly recognized and regarded individuals in the field of vaginal probe ultrasounds. He is an expert in Saline Infused Sonohysterograms (SIS), which can be used in patients experiencing infertility problems or are at an increased risk for pregnancy loss.

 

By using fluid enhanced Sonohysterograms, Dr Goldstein can tell if any of these conditions are present in women and differentiate between them. It can also consistently diagnose intra and pericavitary lesions in infertile women. In addition, this saline infused sonoysterography is widely used to diagnose the shape of the uterine cavity in cases of suspected uterine malformation.

 

Dr Goldstein has championed the use of these Saline Infused Sonohysterograms (SIS). During a saline infusion sonohysterogram (SIS), a tiny catheter, the size of a swizzle stick, goes into the cervix a couple of inches tops, and about a tablespoon of sterile saline is injected. Dr Goldstein, a Gynecologist in NYC, developed a tiny catheter for these purposes.

The injection of a tablespoon of water into the uterus via catheter pushes the front and back walls of the uterus apart and enables us to see the uterine lining with microscopic precision. Any submucosal myomas or conditions that can cause infertility become visible. Sonohysterograms are a non-invasive, painless, less expensive way of diagnosing conditions in women and take only a few minutes in the office of Dr Goldstein.

 

Dr Goldstein has been in practice for over 25 years and is a Professor of Obstetrics and Gynecology at New York University School Of Medicine. He is also a Past Chairman of the American College of Obstetrics and Gynecology, New York section, Past President American Institute of Ultrasound in Medicine and is a former Director of Gynecologic Ultrasound at NYU Langone Medical Center.

 

If you are a woman suffering from infertility problems then schedule a consultation with Dr Steven R Goldstein MD, a top Gynecologist in NYC for a non-invasive Sonohysterogram.

 

WHAT ARE CHEMICAL PREGNANCIES?

 The advent of the home pregnancy test has revolutionized early pregnancy and our understanding of its failure. Patients can now diagnose a pregnancy event by the time they have their missed menstrual period with very sensitive home, over-the-counter pregnancy tests. Research indicates that as many as 22% of conceptual events (in other words, when an egg meets a sperm) will develop minimally and then bleed at or around the time of the expected menses. These have been dubbed “chemical” pregnancies and may be as high as 22% of all conceptions.

 

Dr Steven R. Goldstein, a top Gynecologist in NYC, says many patients feel they have suffered a miscarriage. Data, however, shows that the occurrence of such an event, although clearly sad, and parents can and should “mourn” the loss of their pregnancy—still need to realize that the prognosis for a healthy pregnancy is 35% in the next month and has high as 83% in the next six months! In other words, such a chemical pregnancy failure is a very good prognostic sign.

 

It means that the woman is ovulating, her partner produces sperm, at least one tube is open, and she is capable of capacitating her partner’s sperm. The prognosis for a couple who have such a chemical pregnancy is infinitely better than her sister, friend or coworker who would like to be pregnant but simply gets her period month after month after month.

 

Dr Goldstein’s practice in NYC offers early pregnancy monitoring services for women who are expecting. This is an important service to protect against arriving in the emergency room due to a miscarriage. Especially important for patients who have a history of recurrent miscarriages. Dr Goldstein uses painless transvaginal ultrasounds to monitor the pregnancy, making sure that the milestones of a healthy pregnancy are being met.

 

Dr Steven R Goldstein MD is a leading Gynecologist in NYC in practice for over twenty five years and a Professor of Obstetrics and Gynecology at New York University School of Medicine. He is regarded as one of the best Gynecologists in the United States. His clinical research has had a significant influence on the way gynecology is practiced, with much of his research adapted by the American College of Obstetricians and Gynecologists (ACOG) as the standard of care.

 

Should you be worried about an abnormal pap smear?

 

 

Abnormal pap smears are no need for alarm, as all they indicate is that there has been a change in the cervical cells can be due to infection, inflammation, or changes in the menstrual cycle. In some cases, pre-cancerous or cancerous cells are present.

 

Dr Steven R. Goldstein MD is a top Gynecologist in NYC who strongly recommends women have a Pap Smear exam done annually to help detect the presence of any cervical cancer cells. Cervical cancer has been on the decline over the last decade thanks to pap smears. Dr Goldstein, performs pap smear exams in his office and evaluates patients with abnormal pap smear results.

 

We now understand that abnormal cervical cells are related to the HPV virus. There are over 100 strains of HPV. Virtually all sexually active women will be exposed to HPV but most clear the virus on their own.  Pap smear recommendations should be closely aligned with sexual history and number of partners not just age.

 

In these cases Dr Goldstein, an Obgyn in NYC, will carefully review your case and determine if further tests are needed or if necessary, advise of the best available non-invasive treatment options available to you. There are several additional tests which can be performed in the case of abnormal pap smear results.

 

A Colposcopy is a procedure where a colposcope is used to see the vaginal and cervical cells in detail.

-         An Endocervical curettage is a procedure where a small spoon-shaped tool (curette) collects a sample of cells from the endocervical canal.

-         A Biopsy is where a small sample of cervical tissue is removed and sent to a lab to be studied under a microscope.

If additional testing determines treatment of the abnormal cells is needed, Dr. Goldstein may recommend one of the following options:

-         A Cyotherapy destroys abnormal tissue through freezing.

-         Laser therapy destroys or removes abnormal cells with the use of a narrow beam of intense light.

-         Conization is where a cone-shaped piece of tissue is removed with a knife, laser or LEEP technique.

 

Dr Goldstein, one of the best Gynecologist in NYC personally performs all these exams. If you are in need of a pap smear or have had a pap smear with abnormal results, then contact Dr Steven R. Goldstein MD.  Dr Goldstein is a Professor of Obstetrics and Gynecology at New York University School of Medicine, Director of Gynecologic Ultrasound at NYU Langone Medical Center and the author of over seven books on Gynecology. He is regarded as one of the best Gynecologists in the US.

 

Dr Steven R. Goldstein - The Benefits of Early Pregnancy Monitoring

 

 

Dr Steven R. Goldstein, an obgyn in NYC, works closely with pregnant patients or those considering a family in early pregnancy monitoring to make sure that all aspects of the pregnancy are covered and meeting established milestones.

One of the ways this is done is by analyzing the Human Chorionic Gonadotropin (HCG) levels. A developing pregnancy will produce detectable hormone of pregnancy by eight days post conception. That means it is there and present prior to being late for one’s menses. Home pregnancy tests turn positive at around the time of the expected menses (approximately fourteen days after conception). The rate of rise of hCG in normal healthy pregnancies is extremely well established.

Thus, if there is any concern for the health of a pregnancy, measuring the hCG rate of rise at 48 hour intervals will tell us a great deal about the health of the pregnancy (although, it does not tell us anything about the pregnancy’s location). Usually the hCG level doubles at 48 hours. However, there is a minimum rate of rise of approximately 35-45% in early pregnancy depending on the starting value of testing. Early pregnancy monitoring is particularly helpful for those patients who have had a previous miscarriage or those prone to recurrent miscarriages.

As a leading obgyn in NYC, Dr Goldstein uses non-invasive transvaginal ultrasounds to monitor pregnancies. Serial observation with transvaginal ultrasound allows gynecologists following such pregnancies to be sure that they maintain the milestones that are very predictable and that are the best sign of embryonic well being. If a pregnancy were to fail, Dr. Goldstein is able to make such a diagnosis prior to spontaneous passage (miscarriage) and allow for an elective D&C (dilatation and curettage) so that miscarriage in the middle of the night, and emergency D&C is unnecessary.

Dr. Goldstein has published and lectures extensively on early pregnancy, both its detection by transvaginal ultrasound and how to diagnose pregnancy failure before miscarriage, as well as, diagnosing ectopic pregnancy early enough to be treated non-surgically with medication.

Dr Steven R. Goldstein, an  obgyn in NYC, Dis a Professor of Obstetrics and Gynecology at New York University School of Medicine, a former Director of Gynecologic Ultrasound at NYU Langone Medical Center, a pioneer in the field of gynecologic ultrasound and considered one of the nation's top doctors in gynecology.