Tonsillectomy is the surgical removal of the tonsils. Tonsils are glands located on both sides of the opening to the throat) that serve as protection against infections. When the tonsils become enlarged or inflamed, they can cause infections in the throat and the ear and can obstruct breathing. Enlarged adenoids (lymphatic tissue located in the back of the throat) can also obstruct breathing and can be removed at this time. This is called an adenoidectomy.

An ear, nose and throat surgeon (ENT) performs the operation, usually in an outpatient setting. While the patient is under general anesthesia, the surgeon uses a device to hold the mouth open to expose the tonsils and/or the adenoids. The tonsils are either cut away with an instrument or burned away using cautery. Some surgeons will chose to cauterize the adenoids instead of removing them, because cautery heals naturally without stitches and has a minimum of blood loss. The recovery can take up to two weeks. The patient may have some throat and ear pain the first few days. The use of ice packs, sucking on ice chips and eating ice cream can help provide comfort.

A hysterectomy is a surgical procedure in which the uterus is removed through an incision in the abdomen. As part of the hysterectomy, the fallopian tubes and cervix may also be removed.

Hysterectomies are performed for uterine fibroids (benign tumors in the uterus), abnormal uterine bleeding, endometriosis (the formation of cells outside of the uterus), and uterine prolapse (loosening of support muscles and tissue in the pelvic area). A hysterectomy can also be performed to treat cancer of the uterus.

Types of hysterectomies include:

• Total Abdominal Hysterectomy – The surgeon removes the uterus and the cervix through an incision in the abdomen, similar to an incision used for a Cesarian section.
• Partial Hysterectomy – The surgeon removes only the uterus and the fallopian tubes. The cervix is left intact to help support the vagina.
• Radical Hysterectomy – This involves the removal of the uterus, the cervix, tissue surrounding the cervix, and some removal of the upper vagina. This procedure is usually performed for early cervical cancer.

Transurethral bladder surgery is performed to repair the bladder, to place incisions or insertions for drainage, and to remove cysts and tumors. For this surgery, a cystoscope (a tube with a tiny camera used to perform tests and surgeries) is inserted through the urethra into the bladder. This procedure is performed under regional or general anesthesia. No abdominal incision is necessary. After surgery, the patient is usually released the same day or after an overnight stay.

During this procedure, it is possible to irrigate and evaluate clots, perform biopsies, inject directly to tissue, remove tissue, use cryosurgery or laser procedures to remove tumors, or insert stents. The surgeon may also perform a meatotomy, which is an incision to enlarge the opening.

Tubal ligation is a surgery where a woman's fallopian tubes are cut and sealed. It is commonly known as “tying one's tubes.” Tubal ligation permanently sterilizes a woman by preventing an egg from traveling from the ovary down to the uterus, so that the male sperm cannot make contact with the egg. If the sperm and the egg cannot make contact, fertilization cannot take place and pregnancy cannot occur.

Tubal ligations can be performed in a hospital or an outpatient setting under general anesthesia. It can be performed at any time when the patient is not pregnant. Often, tubal ligations are performed following childbirth in a hospital setting.

During this procedure, the physician makes one or two small incisions in the abdomen (usually below the navel) and a laparoscope (a tiny camera) is inserted. Using surgical instruments, the fallopian tubes are sealed shut with either cautery (burned), or a small clip placed on the tube. (Cautery heals naturally without stitches and has a minimum of blood loss.) The skin incision(s) is then stitched closed. The patient can return home a few hours after the procedure. Most patients recover fully within a week.

• Stress Incontinence – Occurs with an activity that can put stress on the bladder, such as coughing, sneezing, exercise, or laughing.
• Urge Incontinence – Involves a strong sudden urge to urinate followed immediately by bladder contraction and involuntary loss of bladder control.

Urinary incontinence is most common among the elderly. Additionally, women are more likely to experience urinary incontinence due to the stress placed on the urinary tract by childbirth. Men can experience urinary incontinence due to prostate problems. Nerve problems and diseases such as diabetes and stroke can affect urinary incontinence in both sexes.

There are several surgical options for both men and women.

• Sling – For the male, the surgeon creates support for the urethra by wrapping a strip of material around the urethra and attaching the ends of the material to the pelvic bone. For female patients, the surgeon fashions a piece of material or muscle into a sling that lifts the urethra back into a normal position.
• Artificial Sphincter – This implanted device for men has three parts: a cuff that fits around the urethra, a small balloon reservoir placed in the abdomen, and a pump placed in the scrotum. The patient squeezes the pump when he wants to urinate, which deflates the cuff and allows the urine to flow. When the bladder is empty, the cuff automatically refills to keep the urethra tightly closed.
• Retropubic Suspension – This surgery for women lifts the sagging bladder neck and urethra by attaching their supporting tissues to the pubic bone.

All surgeries are performed using general anesthesia in a hospital setting. Stays in the hospital can average one to two days but could be more depending on the type of surgery and whether or not an abdominal incision is involved.

A vaginal hysterectomy is a surgical procedure in which the uterus is removed through the vagina. As part of the hysterectomy, the fallopian tubes and cervix may also be removed.

Hysterectomies are performed for uterine fibroids (benign tumors in the womb), abnormal uterine bleeding, endometriosis (the formation of cells outside of the uterus) and uterine prolapse, which involves the loosening of support muscles and tissue in the pelvic area. A hysterectomy can also be performed to treat cancer of the uterus.

In a vaginal hysterectomy, the uterus is removed through the vagina. A laparoscopic-assisted vaginal hysterectomy is performed with the help of a tiny lens that allows the surgeon to inspect the abdomen while performing surgery through small incisions.

Types of vaginal hysterectomies include:

• Partial Hysterectomy – The surgeon removes only the uterus and the fallopian tubes. The cervix is left intact to help support the vagina.
• Radical Hysterectomy – This involves the removal of the uterus and the cervix and tissue surrounding the cervix and some removal of the upper vagina. This procedure is usually performed for early cervical cancer.

All hysterectomies are performed in a hospital setting and involve a stay of a few days.

A vasectomy is a surgical procedure to tie the vas deferens of a man to cause sterility by preventing the sperm from leaving the testes. The vas deferens is located in the testicle as a small tube that carries the sperm to the semen. The procedure is recommended for adult men who are certain that they wish to prevent future pregnancies (permanent sterilization). There will still be a fluid ejaculate, but no sperm will be in the fluid, so the man cannot impregnate his partner.

Vasectomies are performed by an urologist in the office using a local anesthetic. There are two types of vasectomies:

• Conventional or Traditional – The surgeon uses a scalpel to make one or two incisions in the skin of the scrotum to expose the vas deferens in each testicle. The vas deferens is then lifted, cut and tied and returned to the scrotal sac and the incisions are closed with a few sutures.
• No Scalpel Vasectomy – The surgeon will locate the vas deferens in the scrotum manually, and will hold the tube in place with the use of a small clamp. A tiny puncture is made in the skin to form an opening for the vas deferens to be lifted, cut and tied, and put back into place. A suture can be used but most incisions are so small that none are needed.

Soreness is common, along with swelling and discomfort in the first few days. Most can return to normal activities within a week.