Gynecological Surgeries
TERMINATION OF PREGNANCY:
For a patient seeking termination of pregnancy the mode of termination depends on the period of gestation ( weeks of pregnancy), patients choice and presence of any associated complicating factors. There is always room for detailed discussion and counselling session before such important decisions are made. An ultrasound is always required to confirm the pregnancy and its intrauterine location, and in many cases if the decision is made in the early stages, some tablets may be all that is required, but for pregnancies more than 2 months a quick surgical procedure is often the best option and can be arranged at short notice. The surgery is simple and easy to recover from physically. The operation should not affect your chances of having children in the future in any way. It can be combined with insertion of a IUCD to ensure future contraception if desired.
OVARIAN CYST REMOVAL :
Symptomatic or persistent or suspicious ovarian cyst should always be removed. Cysts may be asymptomatic, but they can cause pain and irregular bleeding. Almost all ovarian cysts can be removed laparoscopically as a day procedure.
INVESTIGATION OF PELVIC PAIN:
An ultrasound scan can indicate potential causes of pelvic pain, but a laparoscopy is the only complete investigation which would confirm or refute gynaecological cause. Endometriosis is one of the most common causes of cyclical pain in women, and it can only be diagnosed by a visual assessment of the pelvic contents. Scarring or adhesions are less often the reason, but can result from old infection, or previous surgery. Tubal blockage and swelling often causes chronic discomfort.
BARTHOLINS CYST/ABSCESS:
These extremely painful swellings of the vulva develop over few days and can be associated with fever. They can burst and resolve themselves, or with a course of antibiotics, but often surgical treatment is required. This is quickly and easily performed under a local/ regional anaesthetic taking 10 minutes as a day case, and gives instant relief.
STERILISATION:
Laparoscopic sterilisation is a permanent and should be regarded as an irreversible form of contraception suitable for those women who have completed their family, and should be considered for older women in particular for whom continued use of the contraceptive pill has increased health risks. It is a 10 min operation performed under a general anaesthesia.
ECTOPIC PREGNANCY:
An ectopic pregnancy is a pregnancy that implants outside the womb cavity. Typical symptoms include abdominal pain and bleeding in the early stages of pregnancy, but occasionally they are picked up incidentally at the time of an early pregnancy scan. You should contact us for an emergency appointment if you are worried about an ectopic pregnancy. Women who have previously had an ectopic, or have had pelvic surgery or pelvic infection in the past are particularly at risk. An early scan and hormone level (ßhCG) measurements will usually confirm the diagnosis. The majority of ectopics are managed surgically by laparoscopic surgery (laparoscopic salpingectomy or laparoscopic salpingostomy).
HYSTERECTOMY:
Hysterectomy is suitable for women who want no more periods, and for whom other medical or surgical treatments for problematic periods have failed. The operation can be performed laparoscopically, vaginally or through an abdominal incision. The most suitable route will be discussed prior to the procedure. A hysterectomy may be combined with removal of the ovaries, but this is only recommended in older women or for those with ovarian problems or severe endometriosis.
THERMAL ABLATION OF ENDOMETRIUM / TCRE:
Heavy regular periods can be treated surgically by removing the layer of womb lining that normally comes away each month. The treatment is less successful for women who have fibroids but may be considered in some cases. Thermal ablation is a short operation taking 15 minutes, where a balloon filled with hot water is introduced into the womb cavity. The heat destroys the womb lining, significantly improving bleeding in up to 90% of cases. Trans-cervical resection of the endometrium (TCRE) involves surgical removal of the entire womb lining under direct vision using a telescope. It takes up to 30 minutes and in most cases can also be performed as a day case. These procedures are not suitable for women who have not completed their family.