In-Office Procedures

NovaSure® Endometrial Ablation

If you are not trying to become pregnant and are still premenopausal, NovaSure may be the solution to your heavy periods.

NovaSure Endometrial Ablation can reduce or stop menstrual bleeding by cauterizing the lining of the uterus. A triangular mesh device is inserted into your cervix and expands to fit the size and shape of your uterus. Radio frequency energy is delivered through the mesh for approximately 90 seconds.

You can change your life right here in our office.


While there are many birth control options available, not all of them appeal to everyone.

Some women do not want the long-term use of hormones. Many don’t want to undergo invasive surgery.

Essure may be the answer.

Soft, flexible inserts are placed into the fallopian tubes to block them, and an additional form of birth control is used for three months while the body works with the inserts to create a natural barrier.


A hysteroscopy helps your doctor diagnose bleeding problems. By looking into your uterus, your doctor can determine if there is a fibroid or polyp causing the problem.


Dilation and curettage, or D&C, is a common procedure used to diagnose uterine conditions such as uterine cancer, polyps, or endometrial hyperplasia, or uterine fibroid tumors. During the procedure, the uterine lining is removed with a curette for closer examination.


When a PAP smear indicates that you have abnormal cells on the surface of your cervix, your doctor may recommend a loop electrosurgical excision procedure (LEEP). An electrically charged thin wire loop is used to remove a small piece of the cervix with precancerous cells.


If you’ve had an abnormal PAP smear, your doctor may recommend a colposcopy to look for abnormal or unusual cells on your cervix, vagina or vulva. If she finds anything unusual, a sample goes to the lab for further evaluation.


Your labia’s function is to protect your clitoris and vagina from trauma. While some women are born with enlarged or elongated labia, others develop issues as a result of childbirth or aging. Labiaplasty allows you to reshape your labia to alleviate discomfort and irritation, chronic infections or pain during exercise or sex. Or, for cosmetic reasons.

MonaLisa Touch®

Hormone loss—either through menopause or cancer treatment—brings on many challenges, including vaginal dryness, vaginal burning and itching and painful sex.

MonaLisa Touch is a groundbreaking non-surgical laser treatment that can help you reverse many of these symptoms and restore your vaginal health without the use of hormones. The procedure is simple and safe and can help you be you with the fullest confidence. Call us today. Let us help you get back to living a life you love.


Underarm sweat and odor can make you feel self-conscious and worry.  miraDry is a new generation of technology—that is only available in a physician’s office—for the permanent elimination of sweat and odor glands.  Whether you sweat a little or a lot, miraDry can have you looking and feeling your best – without the potential embarrassment caused by underarm sweat and odor. Imagine a lifetime of freedom from the worries of visible sweat stains ruining your favorite clothes with deodorants or antiperspirants, or having the sweat breakout in personal encounters or professional experiences.

Live a life of confidence, cleanliness and freedom with miraDry.  Learn more about miraDry

Minimally Invasive Surgery

Minimally invasive surgical procedures offer several advantages over traditional surgeries.

You’ll have smaller incisions and less blood loss, less post-operative pain, shorter recovery time, and fewer post-operative infections.

Our experienced surgeons perform advanced laparoscopic and robotic surgeries such as:

  • Hysterectomy
  • Removal of ovarian cysts, fibroids and scar tissue
  • Evaluation of pelvic pain
  • Treatment of endometriosis
  • Ectopic pregnancies
  • Tubal ligation

In-Office Convenience

Today’s outpatient procedures are far less disruptive than normal surgeries. They’re less invasive and cause less pain. Recovery time is shorter. Cost is less. And you quickly get back to your new and improved life.

Joining Forces to Save Lives

We partner with Radiologic Associates of Fredericksburg (RAF) to offer you the most sophisticated breast cancer screening and diagnostic services under one roof.

RAF’s on-site certified specialty-trained breast radiologists review all mammograms and ultrasounds and perform breast biopsies themselves.

And if they find anything of concern, we’re right here to help you with any additional breast health needs or concerns.

Calculating Your Risk

At Virginia Women’s Center, we know that early detection is the best defense against breast cancer. That’s why we use the Tyrer-Cuzick screening breast health evaluation tool to calculate the overall risk of developing breast cancer in your lifetime. At each mammogram, we’ll calculate your risk based on your personal and family history. Then depending on your score, we’ll let you know if additional screening is recommended.

Hereditary Cancer Counseling and Testing

When your personal and family history puts you in a different cancer risk category, we’ll help you develop a plan of survelliance that’s right for you.

We offer these testing panels on site:

  • Myriad myRisk Panel
  • Ambry CancerNext Panel
  • LabCorp BRCAssure Panel

Breast Biopsy

When an area of concern in your breast requires further testing, your biopsy can be performed right here in the comfort and familiarity of Virginia Women’s Center.
During a biopsy, breast cells or tissue is removed and sent to be examined under a microscope for signs of cancer.

Needle biopsies are quick, safe and accurate and are performed under a local anesthetic. There are two types: fine needle aspiration and core needle biopsy. Your radiologist will choose the least invasive option that will ensure the best possible results.

The procedure itself takes roughly 15-20 minutes, and you can get back to normal activity within a few days.

We review your results with you, in person, typically within two to three days.

Why 3D Mammography?

Tomosynthesis, or 3D Mammography, is an advanced, FDA-approved breast imaging technology. This new imaging tool allows doctors to see breast masses and distortions more clearly and accurately. It detects 40% more invasive breast cancers than regular mammography while reducing false positives by almost 40%, and that means you can be spared the emotional and economic toll of additional testing when all is fine.
Instead of trying to sort through the complexities of your breasts in a flat 2D image, the radiologist can review a 3D image of your breasts layer by layer, one thin slice at a time. Fine details are more visible and no longer hidden by the overlapping layers of tissues.

3D technology is highly recommended for all women, particularly those with a high risk of breast cancer or a personal history of breast cancer and women with dense breast tissue or implants.

You’ll experience the 3D mammogram in much the same way you do a regular mammogram. Our technologist will position you and compress your breast. The X-ray arm will then move in an arc over your breast, taking multiple images at different angles, creating a 3D image of your breast in one-millimeter slices.

It’s clear. Tomosynthesis is simply the most accurate breast screening tool available at this time.

We partner with Radiologic Associates of Fredericksburg (RAF) to offer you the most sophisticated breast cancer screening and diagnostic services under one roof. RAF’s on-site certified specialty-trained breast radiologists review all mammograms and ultrasounds and perform breast biopsies themselves. Dr. Buhler is one of the talented radiologists that care for the women of Virginia Women’s Center. Here, Dr. Buhler talks about the benefits of 3D Mammography.

Diagnostic Mammography

If you have breast pain, a lump, or nipple discharge, or if a screening test reveals an abnormality, you’ll be scheduled for a diagnostic evaluation.

A diagnostic mammogram lets our radiologist examine areas of concern more closely, with extra images or magnified views. Sometimes, a breast ultrasound is needed for further clarification.

Most of the time everything is fine. Sometimes there are areas that need to be watched more closely with repeat images in three to six months.

Screening Mammography

Early detection is the best way to beat breast cancer.
Screening tests detect cancer before it causes any signs or symptoms.

Detection begins during your annual well woman exam, when your doctor examines your breasts and underarm area.

Then there are screening mammograms – the most effective breast cancer screening tool available today. These yearly x-ray exams are recommended for women starting at age 40.

At Virginia Women’s Center, we also offer tomosynthesis, or 3D mammography. This new imaging tool allows the radiologist to view your breast one thin slice at a time – almost like looking at pages in a book. Fine details are no longer hidden by tissue above or below. Tomosynthesis detects 40% more breast cancers while reducing false positives by almost 40%.

While screening tests can’t prevent breast cancer, they can help find it early—making it easier to beat.

Weight Management

Over the course of your lifetime, your weight may go up, and down. It can happen for any number of reasons: hormonal and metabolic shifts, pregnancy, medical conditions, medications, even stress.

Maintaining a healthy weight can have an amazingly positive effect on your life. Guided by your medical history, we can customize a weight loss program just for you. You’ll get the knowledge and tools you need to reach a healthy weight and stay there.

Sexual Dysfunction

Sexual desire fluctuates naturally over the years. It’s typical to be more interested in sex in the beginning stages of a relationship. Pregnancy, breastfeeding, menopause or major illness can all impact your libido. And some medications can interfere with your sex drive as well.

If you don’t feel like having sex, let us know.

Lack of sexual desire may be a sign of hormonal imbalance or other medical issues.

There are lifestyle changes, hormone therapies and sexual techniques that can help. And for severe dryness or vaginal atrophy, we have a groundbreaking new laser therapy—MonaLisa Touch®.

We can help keep intimacy a part of your life.

Menopause Management

When it comes to getting through menopause, you have quite a few more options than your grandmother did.

The months—and sometimes years—leading up to your final menstruation can be filled with hot flashes, sleep interruption, vaginal dryness, urinary problems, mood swings, loss of libido, weight gain and forgetfulness. But today’s treatments make going through this inevitable and sometimes challenging hormonal change easier and less stressful.

Though it’s possible to experience the onset of menopause as early as 35, most women’s periods stop around the age of 52.

And the other side of menopause can be liberating. There’s sex with no pregnancy worries. No more periods.

Period Problems

Regular, or Not-So-Regular, Menstruation

Women don’t all experience menstruation the same way. What’s a regular monthly occurrence for some might be totally alarming for others.

Menstruation occurs after ovulation when your uterine lining grows to receive a fertilized egg. If the egg isn’t fertilized, your hormones decrease and the lining of your uterus sheds over a period of days. The amount of blood lost during your period varies from month to month.

Menorrhagia, a condition involving heavy bleeding that lasts for weeks, can be debilitating. Dysmenorrhea, or periods accompanied by unbearable pain, can interfere with your life.

Although these conditions may be normal for you, you don’t have to suffer through them. We can help.

STI Screening and Treatment

Sharing the intimate details of your life can be difficult—even awkward. But keeping information from your doctor can lead to serious health issues.

Sexually transmitted infections and diseases are caused by bacteria, parasites or viruses that are spread through sexual contact. Left untreated, they can cause cancer and infertility or, if you’re pregnant, harm to your baby.

Infections often have no visible signs. If you have multiple sex partners, a new sex partner, or share needles for drugs or tattoos, you’re at a higher risk and should be tested more frequently.

Your STD testing and treatment are conducted with complete discretion and privacy, and all conversations are confidential.

Well Woman Care

If you’re like many women, your annual wellness check is your only regular visit with a doctor. So we get the most out of it.At your yearly exam, we assess your overall health and include checks for high blood pressure, cancer screening and bone density loss.  Based on your conversation, your provider may screen for other problems like diabetes, cholesterol and anemia.

We’ll discuss everything from birth control to bladder issues. And we’ll talk about life, its everyday stresses—and what kind of emotional support you may or may not be getting.

Your annual wellness visit is not only about your pelvic and breast health. It’s the key to keeping concerns from turning into problems.

Teen/Adolescent Care

You may be nervous about your first visit to a gynecologist, but it can be a truly empowering experience. By taking control and establishing a trusting relationship with a medical professional, you set the stage for a lifetime of open dialogue and healthy choices.

We recommend having your first visit between the ages of 13 and 15. During early exams, we’ll talk about your body and patterns of normal development and menstruation. Unless you are sexually active, experiencing abnormal bleeding or pain, you often will not have a pelvic exam and Pap smear until you turn 21. You’ll have the opportunity to ask questions and voice concerns about your body.

When the time comes, we’ll help you understand birth control options. And if you’re sexually active, we may recommend certain vaccinations and STD tests.

Our team is committed to having real, honest conversations and making sure you have all the information you need to make healthy choices. We want to develop a long-lasting relationship with you based on trust.


Core Services

  • Bladder Repair Surgery
  • Bladder Surgery
  • Brachytherapy
  • Circumcision
  • Cystoscopy
  • Cystourethroscopy
  • da Vinci® Robotic Surgery
  • Electronic shock wave lithotripsy
  • Incontinence sling procedure
  • Laparoscopic Kidney Surgery
  • Laparoscopic Nephrectomy
  • Lithotripsy
  • Nephrectomy
  • Penile implants
  • Penile prosthesis
  • Prostate procedures
  • Prostate removal
  • Prostate removal (incl TURP)
  • Prostate removal robotic-assisted
  • Prostate Surgery
  • Radical Prostate removal
  • Surgery Robotic Assisted
  • Ureteroscopic lithotripsy
  • Ureterscopies
  • Urethral sling
  • Urinary Incontinence Surgery
  • Urological Surgery
  • Urology procedures
  • Vasectomy
  • Vasectomy reversal

Top Conditions Treated

  • Benign Prostatic Hyperplasia
  • Benign Prostatic Hypertrophy (BPH)
  • Bladder Cancer
  • Bladder disorders
  • Erectile dysfunction
  • Female incontinence
  • Genitourinary cancers
  • Hematuria
  • Inability to urinate
  • Incontinence
  • Infertility
  • Kidney Disease
  • Kidney stones
  • Low testosterone
  • Male infertility
  • Peyronie’s Disease
  • Prostate Cancer
  • Prostate disorders
  • Prostatitis
  • Rectovaginal fistula
  • Renal (Kidney) Cancer
  • Restless Legs Syndrome
  • Sexual dysfunction
  • Testicular Cancer
  • Testosterone Deficiency
  • Urethral stricture
  • Urinary disorders
  • Urinary retention
  • Uterine prolapse
  • Vaginal & pelvic prolapse

Additional Services

This should only house carve-out services