COULD IT BE ENDOMETRIOSIS?

 

 

Dr Steven R. Goldstein is a NYC Gyn and specialist for Endometriosis in NYC. Endometriosis is an all-too-common gynecologic condition where the glands that lie inside the uterine cavity can come to lie outside the uterus in the pelvis. When the endometrial glands bleed (that is a period) these glands located outside the uterus bleed as well. This can cause some scar tissue. If there is a collection of this blood within the ovary, it is referred to as an endometrioma (or sometimes called a “chocolate cyst”).

Endometriosis can also take the form of small deep implants of endometrial tissue in many different places in the body, including the wall of the bladder, the anterior abdominal wall, the bowel wall and the uterosacral ligaments, as well as other pelvic sites. Rarely endometriosis can occur in sites such as the lung, potentially causing hemoptysis.

What are the symptoms of Endometriosis?

The exact cause of endometriosis is unknown and there are multiple theories. Endometriosis does not always show symptoms. There appears to be a higher incidence of endometriosis in women who are diagnosed with infertility and pelvic pain. Symptoms of Endometriosis include pelvic pain, painful periods, heavy bleeding during periods, or bleeding between periods.

 

Painless Diagnosis of Endometriosis by NYC Gyn

Increasingly, transvaginal ultrasound can make a very strong presumptive diagnosis of endometriosis without any surgical laparoscopy which, until recently, was the gold standard for making a definitive diagnosis. An endometrioma of the ovary has a classic appearance and, when present, can confirm the absolute diagnosis of endometriosis.

However, there are times where there is no obvious endometrioma, but the presence of scar tissue can result in structures becoming adherent to each other and be a source of pain. Such abnormal mobility can be judged by transvaginal ultrasound but only if it is done dynamically. Unfortunately, this is not generally practiced here in the United States where a technician instead takes dozens of still two-dimensional images which are later read by the radiologist.

What is a dynamic Transvaginal Ultrasound for Endometriosis?

Dr. Goldstein, an Endometriosis Specialist NYC, as well as most European doctors, performs his own ultrasound, and movement of structures at the time of the exam can often give a strong clue to adhesions associated with endometriosis, as well as eliciting pain with the probe and the abdominal examining hand which can also be indicative of a high likelihood of endometriosis.

Dr. Goldstein, a leading NYC Gyn has helped to author a paper entitled, “An evidence-based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis.”

What can you do about Endometriosis in NYC?

If you suffer from pelvic pain and think there is a suspicion of any endometriosis, a dynamic ultrasound performed by an expert sonologist like Dr. Goldstein can be extremely helpful in making the diagnosis without surgery, and then beginning medical intervention for treatment. Schedule an appointment with Dr. Steven R. Goldstein, a top NYC Gyn for an evaluation.

 

 

 

 

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.

 

USING TRANSVAGINAL ULTRASOUNDS TO HELP DIAGNOSE ENDOMETRIOSIS

 

 

 Endometriosis is a painful condition which occurs in women. It is a very unusual gynecologic disease, whereby the glands that normally lie inside the uterine cavity and are the ones that are shed with a normal period, somehow come to lie outside the uterine cavity almost always in other places in the pelvis. Thus, when bleeding from a period occurs, these glands will have a tiny amount of bleeding internally. This can cause some scarring (adhesions) as well as inflammatory changes that are a well-known source of pelvic pain and sometimes infertility.

 

Usually, the pain is worse with the menses, although it can often occur between periods as well. Implants of endometriosis can occur anywhere; however, the more common areas of involvement include the bladder wall, ureter, and anterior abdominal wall in patients who have had abdominal surgery such as a prior C section or laparoscopy.

 

Endometriosis of the bladder wall appears as a fusiform solid thickening of the wall itself. A non-functioning kidney may be the result of chronic ureteral obstruction that is silent and present as a result of endometrial implants impinge on the ureter. In patients who have had prior abdominal surgery, endometriosis may present as a hard, solid mass in the anterior abdominal wall in the region of the scar.

 

Dr Steven R. Goldstein, a leading NYC Gyn, uses painless, non-invasive Transvaginal Ultrasounds to diagnose whether women experiencing pelvic pain, painful periods and heavy bleeding during periods have endometriosis.

 

Transvaginal ultrasound, something that Dr. Goldstein has pioneered, can help to make a strong enough presumptive diagnosis of endometriosis so that patients can be treated without the surgical procedure of laprascopy. Laprascopy was the gold standard for making a differentiation for pain that might be from endometriosis versus “dysmenorrhea,” which is Latin for painful periods. Thus, not all patients with severe period pain have endometriosis. Dr. Goldstein does not recommend laparoscopies, but uses painless, non-invasive Transvaginal Ultrasounds to diagnose your condition.

These transvaginal ultrasounds are performed in the comfort of Dr Goldstein’s office in a few minutes without anesthesia or the painful effects of surgery. In addition to what Dr Goldstein sees on the screen, these transvaginal ultrasounds lead to the production of clear, high-resolution images of the uterus, endometrial lining, fallopian tubes, ovaries and so on to allow Dr Goldstein to make a precise diagnosis and preserve the images for any other specialist who may need to see them.

 

Dr Steven R. Goldstein MD is a top NYC Gyn.  He has been in private practice for over 25 years and is a Professor of Obstetrics and Gynecology at New York University School of medicine, a former Director of Gynecologic Ultrasound at NYU Langone Medical Center and a Past President of the American Institute of Ultrasound in Medicine.

 

Women experiencing painful periods or heavy bleeding during periods may schedule a consultation with Dr Steven R. Goldstein MD, a top ranked NYC Gyn.

 

 

Does having a thick uterine lining require surgical intervention?

 

 Many patients have been told that they have a thick uterine lining and possibly in need of invasive surgical procedures. Dr Steven R. Goldstein MD, an obgyn in Manhattan, was the first to suggest in 1991 that a thin, distinct endometrial echo on transvaginal ultrasound in postmenopausal bleeding did not indicate the need for a biopsy. This was finally adopted as the standard of care by the American Congress of Obstetricians and Gynecologists (ACOG) in 2009.

 

Unfortunately, many doctors, both radiologists and gynecologists, have misinterpreted all of the early data to believe that a thick lining without bleeding requires some sort of intervention. The data has shown that as many as 1 in 8 postmenopausal women will have thick uterine lining without any bleeding.

 

Such women do not require any type of biopsy or other intervention unless they have any bleeding or brown discharge. If you have had a vaginal sonogram and been told that your lining is thick but have had no bleeding do not allow any invasive intervention.

 

Dr. Goldstein, a gynecologist in Manhattan, has championed this concept, although unfortunately, it is not widely understood by many practitioners.

 

Dr. Steven R. Goldstein MD is long considered one of the nation’s top doctors in gynecology. Dr Goldstein is a Professor of Obstetrics and Gynecology at New York University School of Medicine, a Past Chairman of the American College of Obstetrics and Gynecology, New York Section, and Honorary Fellow, Royal College of Obstetrics and Gynecology and a Certified Menopause Practitioner. Dr Goldstein is the recipient of the Thomas A. Clarkson award for many outstanding contributions to menopause related clinical or basic science research.

 

If you have been told you have a thick uterine lining then contact Dr Steven R. Goldstein, a top obgyn in Manhattan for a consultation. You may visit his website at for more information on him and to schedule an appointment.

Dr. Steven R. Goldstein MD - Uterine Polyps

 

Dr. Steven R. Goldstein MD is an Abnormal Uterine Bleeding Specialist in NYC and has been in practice for over 25 years. He is regarded as one of the nation’s top gynecologists.

Dr. Goldstein usually encounters patients with uterine polyps. These are growths of the endometrial lining tissue. They are characterized by having their own central feeder vessel. They are sometimes inactive, although, they may be in synchrony with the menstrual cycle. They are rarely malignant. However, they can cause either heavy menstrual bleeding or bleeding between normal periods. They may also impact fertility.

Dr. Goldstein, a gynecologist in New York for heavy bleeding, can easily diagnose these uterine polyps in an office setting with minimally invasive techniques that Dr. Goldstein has championed (sonohysterography or the newer disposable office hysteroscopes).

If polyps truly are present and need to be removed, this is done in a simple outpatient procedure with anesthesia.

 

Dr. Steven R. Goldstein MD is recognized as a pioneer in the field of gynecologic ultrasound. His research in the field has significantly changed the way gynecology is practiced and, in many instances, has become the standard of care with the ACOG. This dedication and expertise led to Dr. Goldstein being the Recipient of the 2018 Joseph H. Holmes Clinical Pioneer Award from the American Institute of Ultrasound in Medicine (AIUM). This is in recognition of Dr. Goldstein’s distinguished career in ultrasound in medicine and their making outstanding contributions to the growth and development of medical ultrasound.

 

Dr. Goldstein has helped thousands of women who suffer from heavy bleeding. He is the top gynecologist in New York for heavy bleeding conditions in women.

 

Dr. Goldstein is also a Professor of Obstetrics and Gynecology at New York University School of Medicine, the Director for Gynecologic Ultrasound, Department of Obstetrics and Gynecology at New York University Langone Medical Center, and serves on the editorial board of more than 6 scientific journals.

 

If you have been told you have uterine polyps, then schedule a consultation with Dr. Steven R. Goldstein MD, a top Abnormal Uterine Bleeding Specialist in NYC. You may also visit his website at www.goldsteinmd.com for more information.