J. Kyle Mathews, MD, DVM  
Male, 63
Plano, TX

Specialties: Urogynecolog, Pelvic Reconstructive Medicine

Interests: Women's Health, Bladder Diseases
Plano Urogynecology Associates
Obstetrics and Gynecology
Plano, TX
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Vaginal vs. Laparoscopic Hysterectomy: Which is the Best Choice … or Not a Choice At All

Feb 19, 2014 - 1 comments



Robotic Surgery

Vaginal vs. Laparoscopic Hysterectomy: Which is the Best Choice … or Not a Choice At All
Dr. J. Kyle Matthews
by Dr. J. Kyle Matthews |  December 17th, 2013

More than 600,000 hysterectomies are performed annually in the United States. In fact, hysterectomies are the second most common major surgical procedure for women (of reproductive age) performed in the U.S.

Why Recommend a Hysterectomy?
Image source: National Cancer Institute
There are several reasons a hysterectomy may be recommended by Dr. J. Kyle Mathews. Patients may have uterine fibroids, severe vaginal bleeding, uterine prolapse, endometriosis or chronic pelvic pain. Regardless of the diagnosis, women have a choice in how the surgical procedure is performed.

Deciding on a Hysterectomy Surgical Procedure
Abdominal hysterectomy, which requires a large incision and close to two months of recovery time, is still the most common route of hysterectomy in spite of a large amount of evidence to support less invasive approaches. Women should have the option for a vaginal, laparoscopic, or robotically assisted hysterectomy.

A vaginal hysterectomy is a minimally invasive surgical procedure in which an experienced urogynecological surgeon like Dr. Mathews removes the uterus through the vagina. This is the least invasive, most cost effective route of hysterectomy but requires the most skill to perform. With a one to two-week recovery time, a vaginal hysterectomy accounts for less time in the hospital (home the same day or one over night stay). It also leaves no visible scarring. Vaginal hysterectomies were thought to only be appropriate women without a previous caesarean section, and with a small uterus and small fibroid. This thought process has proven to be outdated and the decision to perform a hysterectomy vaginally has more to do with your surgeons experience, skill, and expertise.

A laparoscopic hysterectomy, also minimally invasive, may be performed as an out-patient procedure or one night stay. Dr. Mathews will insert a small camera through a tiny incision in the abdomen to remove the uterus. Most women experience a recovery time of one to two weeks, and there is only slight scarring. While an option for almost all women, laparoscopic hysterectomy may not be the best procedure for women with multiple lower abdomen surgeries or a very large uterus.

A robotically assisted hysterectomy is similar to the laparoscopic approach but with the addition of the da Vinci Surgical System which allows more complicated case to be done in a minimally invasive manner. Dr. Mathews has a vast experience treating complex gynecological conditions with this state of the art technology.

Dr. J. Kyle Mathews is an expert in the field of urogynecology, minimally invasive laparoscopic and robotic surgery, and reconstructive gynecologic surgery. If you’re suffering from severe pelvic pain, endometriosis, fibroids, severe uterine bleeding or other gynecological medical conditions, contact the Plano office of Dr. J. Kyle Mathews.

Please visit our website for more information. www.drjkm.com

Don't Feel Embarrassed to Ask

Jan 10, 2014 - 14 comments




Don’t Feel Embarrassed to Ask a Urogynecologist about Incontinence
by Dr. J. Kyle Matthews |  August 31st, 2013

A relatively new field of medicine exists to greatly improve a woman’s quality of life, and address the most closely guarded women’s health issues. Unfortunately, many women suffer in silence from problems that a urogynecologist can correct, often with in-office procedures.

Dr. J. Kyle Mathews, a specialist trained in urogynecology in Plano, combines the services of a gynecologist and urologist to provide higher level care to women.

What is a Urogynecologist?
Urogynecology is a medical and surgical sub-specialty combining urology and gynecology. Specialists like Dr. Mathews are obstetricians/gynecologists that pursued advanced training in syndromes that involve the organs and systems of the pelvic floor.

Your pelvic floor supports the bladder, vagina, rectum and uterus. The muscles and connective tissues in the pelvic region are susceptible to the ‘wear and tear’ of pregnancy and childbirth, weight gain and age. Previous pelvic surgeries or genetics can also lead to problems that a urogynecologist can correct.

Urogynecologists like Dr. Mathews use the latest surgical and non-surgical techniques to treat women’s health issues, such as:

• Urinary incontinence or leaking
• Fecal or bowel incontinence
• Pelvic organ prolapse (fallen bladder, vagina, uterus or rectum)
• Interstitial cystitis (painful bladder syndromes)
• Overactive bladder syndromes
• Vaginal rejuvenation or vaginoplasty

Why Partner with a Urogynecologist?
A urogynecologist like Dr. Mathews provides continuity of care, with specialized training in pelvic floor disorders for higher-level care. Your Ob/Gyn or general practice physician may refer you to a urogynecologist when problems arise.

Statistics show that a third of women will suffer from pelvic floor disorders in their lifetimes.

Some women decide to see a urogynecologist for annual well woman visits, and develop a relationship before any specific problem develops. In addition to pelvic floor disorders such as incontinence and prolapse, Dr. Mathews sees patients for annual Pap smears, menopause management and infertility.

If you want to proactively partner with a urogynecologist, or currently experience incontinence, recurring UTIs or painful intercourse, contact Dr. J. Kyle Mathews in his Plano urogynecology practice.

Hormone Replacement Therapy and the Truth About Bioidenticals

Sep 12, 2012 - 15 comments



hormone replacement


Hormone replacement therapy




J. Kyle Mathews


Dr. Mathews

While the debate rages on about Bioidentical hormones an interesting review of the subject by the Cleveland Clinic Journal of Medicine has gain shown "Bioidentical Hormones" to be more of a marketing scheme than science.  Dr, Sandra Fryhofer discusses the findings.  

Dr. Sandra Fryhofer speaks on  Medicine Matters; the topic, hormone replacement therapy and the truth about bioidenticals. A new review in theCleveland Clinic Journal of Medicine clears up common misconceptions and sets the record straight.[1] Here's why it matters.

In 2002, the Women's Health Initiative dramatically changed medicine's views on the safety of hormone replacement therapy (HRT).[2] After that, discussions on HRT expanded from the doctor's office to self-help books, talk shows, and celebrities with product endorsements.

We now have a different lingo for talking about hormones. The new buzz term is "bioidentical," but what does that really mean?

The term indicates that the molecular structure of the drug is identical to the endogenous hormones estrogen, progesterone, and testosterone. Three estrogens circulate in the human body:

17-beta estradiol, the most biologically active;
estrone, a derivative of estradiol and the second most dominant estrogen; and
estriol, a very short-acting estrogen and the least biologically active.
The first misconception is that US Food and Drug Administration (FDA)-regulated drugs are not bioidentical. This is wrong. A long list of FDA-approved hormone products contain 17-beta estradiol and, therefore, are bioidentical. Examples include oral esterase, estradiol transdermal patches (Climara®, Vivelle®) and the vaginal ring (Estring®). Prometrium® is an oral FDA-approved bioidentical progesterone product.

The next misconception is that progesterone-containing skin creams protect the endometrium. This is false; these creams are not strong enough. In addition, some creams contain an inactive progesterone precursor that the human body can't metabolize.

Many topical forms of progesterone -- gels, lotions, creams -- are made at compounding pharmacies. Some can be purchased over the counter at health food stores. Such progesterone creams are not strong enough to raise blood levels sufficiently to protect the endometrium from estrogen stimulation. Transdermal progesterones therefore do not protect against endometrial cancer in patients taking estrogen.

Another misconception is that compounded therapy is safer. That just isn't so. Compounded therapy may be marketed as being safer, but these claims are false and misleading. Because these products are not FDA-approved, there are no guarantee as to their purity, potency, and efficacy. There is also no proof that compounded products are more effective or that they have fewer side effects. They also often aren't covered by insurance and therefore may cost more.

The final misconception regards saliva hormone testing. It's a gimmick. Although the concept of making a hormone combination just for you sounds appealing, the FDA says that saliva hormone testing has no scientific basis, and it's not reliable.

These are just some key points from this study. For more details, read the entire review.[1] For Medicine Matters, I'm Dr. Sandra Fryhofer.  http://www.medscape.com/viewarticle/769969?src=mp


J. Kyle Mathews, MD

Plano OBGyn Associates

Plano Urogynecology Associates

Hysterectomy and Risk of Heart Attack and Stroke

May 10, 2011 - 15 comments









Heart Attack

Hysterectomy for benign, non cancerous, indications is one of the commonest surgical procedures in women, but the association between the procedure and the increase risk of cardiovascular disease (CVD), heart attack and stroke is not fully understood.

Hysterectomy has traditionally been considered the method of choice for treating a variety of benign, non-cancerous, gynecological disorders due to the low surgical complication rate and definite cure of these diseases.  Incidence rates of hysterectomy in the USA and in western European countries have remained relatively stable despite recent years introduction of minimally invasive treatment options, such as endometrial ablation, for conditions, such as heavy periods and fibroids.

The majority of hysterectomies are preformed in women before menopause and the removal of ovaries after the age of 40 is common.  The removal of ovaries is often recommended as a measure to reduce the risk of developing ovarian cancer.  A number of studies have suggested that hysterectomy with the removal of ovaries prior to age 50 may increase the risk for heart attack and stroke.  Given the fact that cardiovascular disease is the leading cause of death in women, and hysterectomy is such a common surgery, further investigation was warranted.  

A recent European study published in the European Heart Journal has helped bring this issue to the forefront.  This large study looked at 800,000 women under the age of 50.  The authors conclusions were: “Hysterectomy in women aged 50 and younger substantially increases the risk for cardiovascular disease later in life and removal of ovaries further adds to the risk of both coronary heart disease and stroke.”  Erik Ingelsson  

J. Kyle Mathews, MD
Plano OB Gyn Associates
Plano Urogynecology Associates