New Gynecological Surgical Program Added to VAPIHCS

VAPIHCS does not have a hospital, so much of the Gynecological services that women Veterans needed were being rereferred out into the community. However, Board Certified Obstetrics-Gynecologist (OBGYN) Dr. Ratheany Sakbun was hired in September of 2023 as the first full-time VAPIHCS Gynecologist.

“Women Veterans get excellent care in mainland VA clinics that is sensitive to their specific needs, and the Women’s Health Program at VAPIHCS is dedicated to ensuring that they can receive that same level of care here as well,” Dr. Sakbun said. “When we speak of Gynecology, people usually think of routine pap smears, but in reality, there are a variety of health concerns associated with reproductive organs.” 

Dr. Sakbun explained that there is some stigma associated with women’s menstrual cycles, and so it may not be widely known that there are treatments available for women who experience things like abnormal bleeding and menstrual cramps. They may go through life exhausted and anemic and be unaware that options exist which could help them to feel better. This is because women are often told not to talk about it, so they may not think to ask for help. 

“So many women suffer in silence because they believe that they are supposed to,” Dr. Sakbun said. “And they don’t even have an accurate picture of the risks they face. Cervical cancer is talked about a lot, but uterine cancer is more common, and you never hear about it. We want to help women get a better picture of what is normal, what they should be concerned about, and what treatment options are available to help them be well.” 

In addition to providing clinical Gynecological care, Dr. Sakbun has also started a Gynecological surgical program. She has privileges at Kuakini Medical Center in Honolulu and has begun to do surgical procedures there. Although she has done less than 10 surgeries so far, she says that all her patients have been thrilled with the treatment they received at Kuakini Medical Center before and after their procedures. They are also excited that VAPIHCS can now provide this type of care. The partnership is proving to be productive.

“One thing that is meaningful is the ability to have more effective pain management in a hospital setting,” Dr. Sakbun said. “Women are so often told that Gynecological procedures don’t require appropriate pain management because the pain is not that severe, but the truth is that procedures like inserting an Intrauterine Device or doing a cervical biopsy can be very painful for some women, and that pain can be better managed in a hospital.” 

Dr. Sakbun immigrated to the United States with her parents as a child. She completed much of her education in Hawaii, though she did attend college in the mainland at Wellesley before returning to attend medical school at the University of Hawaii John A. School of Medicine. She completed her OB/Gyn Residency at NYU. Additionally, she has practiced in a VA hospital in Arizona as well in California for a total of seven years.

“Hawaii has given a lot to me and to my family,” Dr. Sakbun said. “My family all still live here, and coming to VAPIHCS allows me to be near them, and also to give back to the place that raised me by bringing all the knowledge I have gathered back here to help women Veterans.”

At this time, Dr. Sakbun will only be performing minor surgical procedures. However, she has experience in all types of Gynecological surgery, including minimally invasive/robotic surgery. She says that she has big dreams for VAPIHCS, and she hopes to be able to offer many more procedures in the years to come. Building up a program like this takes time, and right now it is in its infancy. However, it is a welcome and needed addition to the VAPIHCS women’s health program. The future is looking bright for women Veterans in the pacific islands with the addition of Dr. Sakbun to our VAPIHCS ohana. 

“As you can imagine, none of what I do can be done alone,” Dr. Sakbun said. “I am very grateful to Dr. Laura Artabazon, who is the Director of the women’s health program. I am also grateful to Denise Koutrouba and all the staff within women’s health and throughout VAPIHCS. Everyone has been helpful, supportive, and kind since I arrived.” 

Quick Facts: 

• Some common health concerns that may be best treated by a surgical Gynecological surgery include ovarian cysts, fibroids, abnormal bleeding, pelvic pain, polyps, intrauterine scar tissue, and structural issues. An OBGYN surgeon may also need to perform a dilation and curettage for various reasons related to reproductive health and wellness. 

• In the past, nearly all attention in the OBGYN community was focus on labor and delivery, with almost no research or health care delivery focused on women’s health and wellbeing outside of childbirth. 

• Historically, women who experienced abnormal bleeding or debilitating pain from their monthly cycle were told that this was normal, and not to talk about it. Women are sometimes still told by doctors that lower back pain and other symptoms that could be attributed to reproductive health are “normal.” 

• The stigma that still exists around women talking about their monthly cycle keeps many women from feeling safe seeking help when they feel unwell. In the past, women who experienced extreme conditions such as uterine prolapse were often encouraged by authority figures in their lives to keep it to themselves and not trouble doctors. 

• The rate of death from cervical cancer is an average of 2.2 women per 100,000 per year in the United States. Meanwhile, the rate of death from uterine cancer is an average of five deaths per 100,000 per year in the Unites States, making Uterine cancer more than twice as deadly. Yet, only cervical cancer screenings are routinely done. 

• Many women experience intense pain during the insertion of Intrauterine devices, known as IUDs. They may also experience ongoing pain and need the device removed; however, doctors commonly tell them that pain is not grounds provide pain management or to remove the device. Gynecological surgeons like Dr. Sakbun advocate for appropriate pain management during all gynecological procedures so that women do not suffer needlessly. 

• A web search of treatments for endometriosis lists the top treatments as: NSAIDS, birth control, psychotherapy, or alternative medicine such as acupuncture. Though this is considered “common wisdom,” it is completely outdated. Surgical treatment options have far better outcomes than NSAIDs and psychotherapy, yet they are rarely recommended by doctors who do not specialize in Gynecological surgery.