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Recent fears about the risks of blood transfusion (December 2006) prompt me to mention this technique which is available at Queen Elizabeth II Hospital. It is used mainly in Obstetrics (Maternity care) where the volume of blood lost is often much greater than in Gynaecology.
It enables the patient's own spilled blood to be retransfused thereby preventing any worry about transfer of infections from pooled blood. |
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The long awaited vaccines to protect women against cancer of the cervix have now been licensed for use in the UK. |
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We have a new domain name to make things easier. "http://www.GynaeUK.com"
Please update your bookmarks. |
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When I discuss an operation with a patient, I like to give her a leaflet to take away with her which summarises important points of our discussion. As I might be in several consulting rooms in any week, there may often be no suitable leaflet to hand. I have therefore written some leaflets which I believe complement my discussions. If you find them of help you are welcome to use them. Remember that any points should be discussed with your gynaecologist. No responsiility can be taken for any misunderstanding or difference of opinion. |
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Heavy periods may be distressing and may lead to anaemia. There are many techniques involving drug therapy or minor operations that can remove the need to consider hysterectomy. |
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Surgical removal of a fibroid (myoma or leiomyoma) is called myomectomy. This is often performed through a large incision but can be performed through tiny incisions ("keyhole"). |
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Hysteroscopy might be suggested to you to find out causes of heavy periods or any other unexplained bleeding, causes of miscarriage or several other less common problems. Using special instruments many operations may be performed inside the womb by hysteroscopy. |
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Endometrial (or Hystero) resection is a procedure used as a treatment
for women with menstrual problems. It may be used instead of an
hysterectomy. |
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Sometimes adhesions in the belly can cause pain which is cured by dividing them |
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You may be considering hysterectomy or it may have been recommended for a
variety of reasons |
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A new type of smear test, which uses liquid to store cells from the cervix, has been shown to be more accurate than the traditional slide smear, resulting in fewer false-negatives and inadequate smears |
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Pain is a distressing symptom of many conditions and a result of surgery. We have several techniques to alleviate pain which enables a tailored treatment. |
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Fibroids are non-malignant growths occurring in the uterus (womb), usually
growing very slowly over a number of years, although they may grow
intermittently. They can be present for some time without causing
any trouble and can be left untreated but should be regularly
monitored by your doctor |
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This simply means opening the abdomen (Lapar: "belly", Tomy: "cut"). We will usually indicate what we expect to do inside but often the operation is exploratory in order to find out what is wrong. |
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The urge to reproduce affects most couples and failure to produce a child can be very distressing. Any such failure should not be blamed on either partner. It is always a "team effort".
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Many couples, these days, wish to postpone having a family until after a career has been established. This causes anxiety about declining fertility. |
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Recent reorganisation of the National Health Service means that decisions about which treatments will be funded by the NHS has been passed to local Primary Care Trusts (PCTs). They hold the funds and ?purchase? or commission the services on behalf of the patients. |
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Many women are unnecessarily distressed when a cyst is mentioned at an ultrasound examination. It is normal, in a healthy menstrual cycle, to produce a follicle in the ovary which grows to approximately 25mm (an inch) in diameter before it bursts to release the egg. It is spherical and contains a watery fluid and so is often termed a cyst. Some cysts are follicles which have not burst but have continued to expand. |
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If the mouth of the Bartholin's Gland of the vulva becomes blocked, the secretion (a vaginal lubricant) causes the gland to swell. It may then occasionally become infected when it forms an abscess. |
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There are many causes of prolapse. Weakness of the pelvic floor permits bulging of the vaginal walls and feeling a lump. |
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First aid for Prolapse can be achieved with a ring pessary. However proper correction requires surgery. A cystocele is corrected by Anterior Colporrhaphy (Anterior Vaginal Repair). A Rectocele is repaired with a posterior colporrhaphy. |
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This operation is used to correct prolapse of the front wall of the vagina. It may be combined with specific techniques to correct stress incontinence if present. |
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Bleeding more than six months after the menopause (the last menstrual period) is termed "Post Menopausal Bleeding". It is vital that anyone who suffers this symptom consults their GP. They will normally be referred to a gynaecologist. |
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The lips of the vulva may develop asymmetrically at puberty or be damaged in childbirth or by piercing. |
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An overview of the "Change of Life" or Climacteric, its cause and effects. The "menopause" is the technical term for the first day of the last ever menstrual period. The "Climacteric" describes the whole time of life when a woman loses her fertility and ability to make oestrogen. |
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Polycystic Ovarian syndrome is a complex hormonal condition that may cause infertility, excessive weight gain, acne or excessive hair growth. |
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There are 2 ways of looking into the abdomen. In years past and for major problems, one will frequently use laparotomy
("lapar-" : belly, "-tomy" : cut), meaning a large cut and a traditional type of operation. However, there are many advantages to using laparoscopy ("lapar-" : belly, "-scopy" : look inside). |
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For initial evaluation, two semen samples should be examined |
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If a woman is not totally sure that she will never, in any circumstances, want children in the future, she should not opt for sterilisation and should rely upon one of the other very reliable methods of contraception. |
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Many conditions and drugs may alter the factors in the blood stream which promote or prevent clotting. |
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Endometriosis is an enigmatic condition which is extremely common. Those with access to the internet will find many sites discussing severe disease but the vast majority is of a much more minor nature. The condition was first described in 1869 but even now it is poorly understood. |
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Many women find difficulties in holding their water and suffer the embarrassment and discomfort of urinary leakage. There are many reasons for these problems and at times, the skill of the doctor can be severely tested in trying to discover the root cause. |
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This is a simple test in which we measure the pressure exerted by the muscle coating of the bladder. It helps us to understand why leakage of urine is occurring and which treatment is likely to be most effective. |
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A look inside the bladder is termed Cystoscopy. It is a very minor diagnostic procedure. |
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The mainstay of treatment for urinary urgency and urge incontinence is drug therapy. Several drugs are used to calm an overactive bladder. Recently a new drug duloxetine (Yentreve, Eli Lilly and Co.) has been licenced for use in stress incontinence. Results of early trials suggest that it will be very useful, particularly for those without pelvic floor weakness. |
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Interstitial cystitis is an enigmatic disabling
condition associated with chronic inflammation of the bladder. |
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It is surprising how many women suffer an involuntary loss of urine when they squeeze their bladders with a cough or sneeze. Pelvic floor exercises can help to improve bladder control in these circumstances as the pelvic floor muscles tend to become weaker with age. |
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Self help for urinary frequency |
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A new technique has been devised which overcomes the modest success rate of pelvic floor exercises and avoids the pain and long hospital stay of the more major operations for female incontinence. |
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Injection of a bulking agent into the tissue around the urethra ( the tube down which urine passes from the bladder to the outside) is used to correct some cases of Stress Incontinence. The choice of this technique would depend upon investigation such as Urodynamic Assessment. |
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Some surgeons would recommend that you stop your HRT preparation some weeks before an hysterectomy. However, that risks return of symptoms for little discernible benefit. |
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If your ovaries are removed at the time of hysterectomy, this effectively removes the factory for oestrogen production. If you are a young woman and used to fairly high levels of oestrogen, this may result in particularly unpleasant withdrawal symptoms unless you have HRT. |
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If you have had periods following the procedure for endometrial ablation, these may become irregular in the years leading up to the menopause (the last ever period). Sometimes HRT will be recommended to control this irregularity and the preparation should be one containing oestrogen and progestogen in cyclical fashion so that it mimics a normal menstrual cycle. |
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Loss of a pregnancy before the age of viability (previously 28 weeks, now 24 weeks) is called a miscarriage in colloquial English. In medical parlance it is termed an abortion. |
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Miscarriages are very common. It is therefore statistically quite likely that anyone might suffer more than one. The definition of Recurrent Miscarriage has more to do with the likelihood of finding a cause that we can treat than any actual number. Some years ago, when very few causes were known, it was normal to avoid investigation until six miscarriages had occurred. Now we will usually consider investigating the couple after three consecutive similar occurrences. This happens for approximately 1% of couples trying for a baby. |
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Pregnancy can be a worrying time. We have the possibility of checking for certain abnormalities. |
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Prenatal diagnosis of chromosomal disease involves screening after which an invasive test may be offered. |
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Mole pregnancies occur @ approx 1 per 1000 registered births in the UK. It is known that the pregnancy goes wrong at the time of fertilisation of the egg by the sperm, but we do not know yet why this happens. |
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There is no medical reason to circumcise the Newborn. However there are many religious and social indications. |
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Thursday, 28 August 2008
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