We are a unique individualized, one-of-a-kind specialty clinic. The focus here is on Gynecology and Women’s Health. Without involving the extensiveness of Obstetric care in our clinic, our team can concentrate on well women’s visits, menopause, menstrual issues, pelvic pain, pelvic prolapse, incontinence, pain with intercourse, gynecologic aesthetics and much more.

Gynecologist Bismarck ND

Minimally Invasive Gynecologic Surgery

A variety of conditions may affect a woman’s reproductive organs over the course of her life. Common types of gynecologic conditions – such as heavy or irregular periods, incontinence, endometriosis, uterine fibroids, and pelvic organ prolapse – can cause significant quality of life issues for women. Sometimes, the process of treating these conditions can lead to surgical intervention.

No one wants to have surgery.  But you can trust that our goal is to proceed surgically with the least invasive technique, ensuring safety as the number one priority.

At Bradley Gynecology, we will work with you to understand all your options, both medical and
surgical.  Where surgery is required, the most advanced and least invasive procedures will be used.

Pelvic Prolapse Treatment

Pelvic organ prolapse is a condition in which the tissues of the pelvic floor relax, causing organs to drop down and press against or bulge into the vagina. Prolapse can affect the bladder, rectum, or uterus. Commonly, if one organ falls, others do as well.

Symptoms of prolapse include fullness or pressure in the vagina or pelvis, aching in the pelvis, a bulge in or through the vagina, back pain, pain with intercourse, urine leakage, or issues having a bowel movement.

Pelvic organ prolapse can be treated conservatively or surgically.

Pelvic floor muscle exercises can improve symptoms for some patients and allow the patient to avoid surgery. If after consultation it is felt that this is an appropriate option for you, we will facilitate for you a referral to Pelican Health, a pelvic specialty clinic to focus on conservative options.

In addition, a vaginal pessary is a device that can be fitted to your vagina to support the tissues without surgery.  The benefits and side effects of a pessary will be discussed with you, so you understand this option well.

Surgery to improve prolapse is performed through the vagina, using your own tissue, no mesh, no foreign body. Your own tissue is tightened for appropriate support. Dr. Bradley has more than 20 years’ experience doing vaginal surgery for pelvic prolapse without using mesh. This surgery can often be done as an outpatient procedure.

We will educate you on all the above options to best collaborate on the plan that fits your needs perfectly.

Incontinence Treatment

Urinary incontinence is an unfortunate but common condition that many women will deal with in their lifetime. Dr. Bradley believes that approaching these symptoms in a wholistic manner can produce the best outcomes. Appropriate testing of the bladder is necessary to rule out pathology and provide information to lead to the next available options for treatment.

The two main types of urinary incontinence are Urge Incontinence and Stress Incontinence. There are multiple conservative options for the treatment of both. Dr. Bradley works with the excellent providers at Pelican Health to provide education, testing, and conservative treatment options.

Urge incontinence is the leaking of urine associated with a rushed urgency to make it to the restroom. There can be different etiologies of this type of incontinence, most of which are well treated with conservative options. This is where working together with the providers at Pelican Health can be a tremendous source of education, information, and treatment choices.

Stress urinary incontinence is the leakage of urine with a pressure event: laugh, cough, sneeze, run, jump. For some, even going from sitting to standing can produce leakage. There are conservative options available for stress incontinence, all of which will be explained to you in detail. If conservative options don’t improve your quality of life enough, surgery may be an excellent option to stop symptoms and help you regain dryness and confidence.

The most common type of surgery for incontinence is called a Single Incision Sling. In this surgery, the smallest amount of sling is placed immediately under the urethra to support the tissue in times of stress. This can be done in an outpatient setting, with minimal time off work. Some restrictions are present after surgery, but it is usually not a difficult or painful surgery to heal from.

We are ready to consult with you to work together to find the best way for you individually to improve incontinence.

Annual Exams and Well Women Visits

Wellness visits are also called gynecological exams, pelvic exams, annual exams, or well woman exams. These visits are an important part of taking care of your health. Although a Pap Smear is not routinely needed yearly, your annual health maintenance visit is. It is important to monitor your blood pressure, have a breast exam, pelvic exam and depending on your age, laboratory or mammogram testing yearly. We will keep track of when your Pap smear is needed (every two years in your twenties, every three years after thirty), but you should continue to make a yearly annual exam visit for all of the other benefits it gives you. These visits also allow the patient to be part of the decision-making process for preventive health services relevant to her age. Dr. Bradley and Stacie Moritz are both here working together for your annual exam needs.

Treatment of Menstrual Disorders – Heavy Periods

If you are experiencing heavy periods, irregular periods, painful periods, or pelvic pain there are many options for treatment. If any of these symptoms are affecting your quality of life, it is important for you to be educated regarding all your available treatment options.

First, we will provide testing to ensure that these symptoms are not a sign of something worrisome. Once we have ruled out any concerning pathology, we will carefully explain all the possible treatment options available, and whether you are at a time in which proceeding to treatment is right for you.

There are medical and surgical options available for multiple menstrual issues. Surgical options can be both conservative and definitive, depending on your preference of care.

Medical options for treatment of the above symptoms include hormonally controlling the periods with a pill or an IUD or anything in between. The benefits and downside of many options are discussed at length during your visit.

Surgical options include conservative surgery, such as a Novasure endometrial ablation. This is an outpatient surgical procedure that involves no incisions and allows for a next day return to work. It requires permanent contraception, either a partner’s vasectomy, or a tubal ligation. Tubal ligation can be performed at the same time as the Novasure.

Definitive surgical therapy can include options of different types of hysterectomy, depending on your needs. Proceeding to hysterectomy is a significant decision for a patient, and we will work with you to be certain that if hysterectomy is the right choice for you, you understand it completely. If you are not already in menopause, you can keep your ovaries with you at the time of a hysterectomy, so that your hormone status stays the same, you do not feel any different hormonally, and you go through menopause at your genetically programmed time. If you are near or in menopause, you may choose to have the ovaries removed at the time of hysterectomy to eliminate the risk of cancer from these no longer functioning organs. The decision with how to proceed with the ovaries is yours. Dr. Bradley will only discuss risks and benefits with you to ensure you can make the best educated decision.

You do not have to live with periods that are taking over your life. We are ready to ensure your safety with testing, and offer you many different treatment options, from which you will choose what is right for you.

Ovarian Cyst Treatment

An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. The ovaries are a pair of small, oval-shaped organs in the lower part of a woman’s abdomen. About once a month in a premenopausal woman, one of the ovaries releases an egg. The ovaries also release multiple hormones, including estrogen and progesterone. These play roles in pregnancy and the menstrual cycle.

There are different kinds of ovarian cysts. They can occur for various reasons, and they may need different treatments. A cyst can vary in size. Ovarian cysts are very common in women of childbearing age, but uncommon in women after menopause.

Treatment for an ovarian cyst will depend on the type of cyst, your age, and your general health. Most women will not need treatment. You may be told to watch your symptoms over time. An ovarian cyst will often go away with no treatment in a few weeks or months.

In some cases, you may need to have follow-up ultrasound tests. These are to check if your cyst has gone away or is not growing. You may not need any other treatment.

If the cyst is persistent or enlarging or overly painful, we may discuss surgical options with you. It is important that cysts are tested or followed for the possibility of concerning signs. Cysts are often treated with minimally invasive surgery. It is important that we can discuss conservative and surgical options with you to determine which is best for you.

Pelvic Pain Treatment

There are many possible sources of pelvic pain for women. Some are gynecologic. Some are not. Our goal is to listen, test as needed, and offer many possible treatment options.

First, we will provide testing to ensure that these symptoms are not a sign of something worrisome. Once we have ruled out any concerning pathology, we will carefully explain all the possible treatment options available, and whether you are at a time in which proceeding to treatment is right for you.

The treatment of pelvic pain varies by what the cause is, how intense the pain is, and how often the pain occurs. Sometimes pelvic pain is treated with medicines, such as hormonal therapy or antibiotics. Physical therapy can be helpful in some cases. Occasionally, surgery is the next option for the treatment of pelvic pain. It is important that we can test for your safety and provide you will all option for treatment during your consult.

Endometriosis Surgical Excision

Endometriosis is a quality of life changing gynecologic disorder that affects many women differently. We will focus on your symptoms, rule out pathology, and offer many different treatment options.

Endometriosis can cause pain and infertility. It is important that if diagnosed, we treat your pain to improve your quality of life. Also, it is important to protect the pelvis from future infertility with appropriate treatments for endometriosis.

Endometriosis can only be diagnosed surgically. Dr. Bradley has 20 years’ experience of treating endometriosis surgically, using minimally invasive techniques. Endometriosis can be surgically excised. Surgical excision is the gold standard of treatment for endometriosis. Excision of endometriosis is an important tool for deep implant endometriosis, and is part of the treatment plan we provide. In certain cases, adding an appendectomy prevents future issues, and this will be discussed as well.

At times, instead of proceeding to surgery, patients receive a possible diagnosis of endometriosis based on symptoms, proceed to treatment, and see if their symptoms improve. For some, using medical therapy and avoiding surgery is the best option.

Endometriosis is a complex disease that can require multiple providers with different skill sets to fully treat. Bradley Gynecology focuses on the medical and surgical aspects of endometriosis treatment. There are many other excellent providers locally that can improve endometriosis symptoms. We feel strongly in approaching treatment with many different methods and will refer you as needed to get the best complete care.

From diet, exercise, and physical therapy to medical or surgical therapy, your treatment course will be individualized to our needs. Focusing on what is best for you at this time in your life, and best for your future.

Menopause

Often times, women of menopausal age feel unseen or unheard in healthcare settings as they navigate the potential symptoms of menopause. At Bradley Gynecology we do not focus on obstetric care, therefore we can give more time to women as they age through their reproductive years and beyond.

The systemic symptoms of menopause: the hot flashes, mood changes, sleep disturbances may or may not need to be treated depending on how much they affect your quality of life. These symptoms will usually improve for women over time. How long they last for each person is an unknown, however we will discuss natural, hormonal, and non-hormonal treatment options with you to assess which, if any, is right for you.

The pelvic symptoms of menopause: the vaginal dryness, pain with intercourse, dryness with intercourse, vulvar irritation, urinary or vaginal infections will only get worse for women over time. The tissues of the vagina and bladder are responsive to estrogen, and every year they go without estrogen they will get thinner and drier. We will discuss with you treatment options for the progressive menopausal changes in the vagina and bladder, so that you can make lifetime maintenance choices to keep your quality of life.

Menopause is an inevitable time in a women’s life that can be simple for some, and difficult for others. Our goal is to listen to all your potential symptoms, rule out any possible associated pathology, and offer many types of treatment options. Only you can decide if you are interested in treatment options for menopause. Multiple options will be offered to you, including natural therapies and traditional hormone therapies.

This is a gynecologic clinic where treating menopause is a priority. We are ready to listen to your menopausal needs.