Procedures

PROCEDURES

What is Hysterectomy?

In simple words, hysterectomy is a surgical procedure that is carried out to remove the womb or uterus. As the uterus is removed, you will no longer be able to conceive. While all women go through the phase of menopause, some can be faced with symptoms of menopause after undergoing a hysterectomy surgery if the ovaries have also been removed; no matter what their age is. A hysterectomy surgery is commonly recommended by healthcare experts for women with conditions such as multiple fibroids or prolapsed uterus. The extent of this surgery varies widely, depending on the reason for surgery. In some cases, doctors remove the uterus completely, while in some others, they remove both, the ovaries and the fallopian tubes. The fallopian tubes are the structures that help in safe transportation of the eggs from the ovary to the uterus. Leaving the ovaries behind prevents the onset of menopause after the surgery in younger women

Why is Hysterectomy Carried Out?

A hysterectomy is commonly suggested by doctors when other treatment options are not available or have been unsuccessful. Depending on your case history, a hysterectomy surgery is needed if you have:

  • Cervix, uterus or ovary cancer
  • Multiple uterine fibroids
  • Heavy periods
  • Endometriosis
  • Uterine prolapse
  • Adenomyosis

Are There Any Types of Hysterectomy?

There are different types of hysterectomy, which include:

  • Partial Hysterectomy – As the name suggests, in a partial hysterectomy, only a portion of the uterus is removed. The cervix is left intact.
  • Total Hysterectomy – In a total hysterectomy, the uterus is removed entirely, including the cervix by a health care professional.
  • Hysterectomy and Salpingo- Oophorectomy – In this procedure, the uterus along with one or both the ovaries and even the Fallopian tubes are removed. In case both the ovaries are removed, you may need to consider hormone replacement therapy.

How Is Hysterectomy Performed?

A hysterectomy surgery can be performed by a qualified gynaecologist by three different methods. Irrespective of the way in which it is performed, general or regional anaesthetic (spinal or epidural anaesthesia) is necessary.

  • Vaginal Hysterectomy – In this type of surgery, a small incision is made inside the vagina to remove the uterus.
  • Laparoscopic Hysterectomy – A tiny instrument, which is a long and thin tube, having a high-intensity light and high-resolution camera called a laparoscope is used. Incisions are made in the abdomen, through which, the health care expert cuts the uterus into small pieces to remove it.
  • Abdominal Hysterectomy – In an abdominal hysterectomy, an incision is made in the abdomen through which the surgeon performs the removal of the uterus.

What Is Tubectomy?

Over the years, Tubectomy has become an increasingly prevalent form of contraception in India. Also called as Tubal Ligation, this surgical procedure is carried out to ensure that the fallopian tubes in your body are blocked-clamped, sealed or severed. The main aim of this surgery is to prevent the sperm from reaching the egg to fertilise it. It is a permanent method of sterilisation and there is no going back. Professional surgeons at Wif Hospital perform this surgery using state-of-the-art facilities.

What Is the Procedure of Tubectomy?

Tubal ligation may be done while you’re recovering from vaginal childbirth (using a small incision under the navel called a mini-laparotomy) or during a cesarian or C-section delivery. It can also be carried out as an outpatient procedure (interval tubal ligation) that is separate from childbirth.An interval tubal ligation is usually done with a laparoscope- a thin tube equipped with a camera lens and light- under short-acting general anaesthesia. The complete procedure is carried out in an operation theatre. However, our experts at Wif Hospital advise that the risk of complications during surgery are higher if you undergo tubal ligation surgery when you have had previous pelvic or abdominal surgery.

Is There Any Way to Reverse the Procedure?

A tubectomy is a permanent form of contraception for women, and there is no going back. It is a permanent method of birth control. However, there are instances where women tend to ask for a reversal. In such a case, surgery will need to be carried out. However, they are not guaranteed of a successful reversal. Some studies have shown that tubal reversal, a microsurgery that reverses the effect of a Tubectomy, has shown a successful reversal. However, the pregnancy rate post the reversal is quite low.

LAPAROSCOPIC HYSTRECTOMY

If you have been advised a hysterectomy for any reason such as for fibroids, then laparoscopic hysterectomy is an option that a healthcare expert may suggest. A minimally invasive surgical procedure, a laparoscopic hysterectomy will be performed by an experienced surgeon, in our state-of-the-art centre at Wif Hospital.

What Is Laparoscopic Hysterectomy All About?

A laparoscopic hysterectomy is a surgery that is undertaken to remove the uterus or womb. Removal of the uterus means that you no longer can conceive. Apart from the uterus, the ovaries, and fallopian tubes may also be removed, and this surgery is called as salpingo-oophorectomy.

How Is Laparoscopic Hysterectomy Performed?

A laparoscopic hysterectomy surgery requires a small or half-inch-long incision in your abdomen. The pelvic region can be clearly seen by inserting the laparoscope (a tube with a light source and a tiny camera that allows your surgeon to see your internal organs) through these incisions. Some instruments are then inserted through the other small incisions in your abdomen or vagina, to remove your womb, the cervix and any other parts of your reproductive system.

Why You Need a Laparoscopic Hysterectomy?

A laparoscopic hysterectomy is performed for numerous health issues. Some of the common problems include:

  • Fibroids
  • Cervical or womb cancer
  • Heavy or irregular periods
  • What is Total Laparoscopic Hysterectomy?

Total Laparoscopic Hysterectomy (TLH) is an advanced procedure. During a total hysterectomy, your womb and cervix (neck of the womb) are removed. It is also called as a keyhole surgery. It is done using small incisions in your abdomen through which a laparoscope is inserted and other instruments to perform the surgery. In simple words, in this surgery, your uterus is removed completely through the vagina. One or both of the ovaries and fallopian tubes may also be removed.

Benefits of Laparoscopic Hysterectomy

A laparoscopic hysterectomy is associated with less pain as there are only small incisions made in the abdomen. It has a low risk of infection and blood loss. Recovery is fast, and the patient can go home early.

Screening tests are an essential part of health care. At Wif Hospital, we strongly urge our patients to regularly go in for health checkups, to ensure that the signs of cancer can be detected in its earliest stages and make sure that treatment can begin long before the spread of cancer and onset of symptoms. With instances of patients suffering from cancer affecting the breast, ovarian and uterine on the rise, the importance of procedures like a PAP test become immediately apparent.

What Exactly Is A PAP Test?

A PAP test is a simple screening tool that is used to locate the abnormal cells on the cervix. A PAP smear test can help in identifying the abnormalities before the development of the cancer cells. It is a great tool for cervical cancer screening.

Screening with a Pap smear must start every year beginning three years after the first sexual encounter or by age 21 whichever is sooner. After three normal Pap tests, you can lengthen the interval to every three years. However, it must be annually for those at high risk such as those with high-risk sexual lifestyle/partner with high-risk sex lifestyle, those with HPV infection, those on oral contraception for over five years, early marriage, teenage pregnancy, those who smoke. Cervical cancer is unlikely to develop in women over 64 and Pap screening can stop at this age if you have had normal Pap tests in the previous ten years and 3 or more documented standard Pap tests. If you have not been sexually active with a man, your chances of developing cervical cancer are very low, and you may, therefore, choose not to have a screening test.

It’s important to remember that, although a cervical smear is the best way to check the health of your cervix, it isn’t an absolute test.

Sometimes, screening can show possible signs of cervical cancer when in fact there is no problem. Up to one in 10 cervical smear tests have to be re-taken because of a problem with the test. This can happen if you have an infection, if not enough cells were collected during the smear test or if the cells were hidden by blood or mucus.

The best time to be screened is usually 14 days after your last period. You can’t be screened during your period. If you’re pregnant – it’s usual to wait until three months after you have had your baby.

If minor cell changes were found on your test, you would need to have a repeat screening test – usually in six months. If the repeat screening test is normal, you will be asked to have one more test in the next six to 12 months. If this is normal, you will return to routine testing. If the repeat test still shows the borderline changes, you may be asked to have a colposcopy.

How is the Test Conducted?

A PAP smear procedure is simple and is a routine gynaecological exam. The test or procedure is painless and quick. In this procedure, the cell samples are obtained from the cervix. The cervical cells are then collected using a broom or spatula and a brush. Once the PAP smear for cervical cancer is completed, the cells are sent to a laboratory. To get the best results, our in-house laboratory experts at Apollo Cradle examine the cells minutely under the microscope.

What Exactly is Colposcopy?

Colposcopy procedure is a simple procedure, in which, the doctor uses a magnifying device to have a look at your vulva, vagina, and cervix. This helps in identifying the abnormal cells easily. If a problem is observed during a colposcopy, a biopsy may be taken. One of the benefits is that it helps in examining the external genital area i.e. the vulva, cervix, and the vagina.

The procedure for the test is the same as a PAP test. It is vital to know that a colposcopy procedure is not carried out while you are menstruating. Also, you will be asked by the colposcopy clinic to avoid intercourse, any vaginal medication, tampons or douches 24 hours before the test.

PAIN MANAGEMENT

Pain medications such as the nonsteroidal anti-inflammatory drugs (NSAIDs) or naproxen may be prescribed to help ease painful menstrual cramps.

Getting regular exercise can help relieve symptoms.

HORMONE THERAPY

Hormone therapy: Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. It may recur after stopping the course of therapy.

SURGERY

Conservative surgery: If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery however, endometriosis and pain may return.

The procedure may be done laparoscopically or through open abdominal surgery in more extensive cases.

Assisted reproductive technologies such as in vitro fertilization, to help you become pregnant are sometimes suggested if conservative surgery is ineffective.

What Is Urinary Incontinence?

Also known as involuntary urination, Urinary Incontinence is the unintentional passing of urine. It is also commonly referred to as ‘loss of bladder control’. This condition can be embarrassing at times, and is often faced by expecting mothers during pregnancy. The severity of this condition can either range from a few drops of urine leakage while sneezing or coughing to an uncontrollable urge to urinate without being able to get to a toilet in time. While both, men and women can be affected with this condition, it is more commonly seen in females. At Wif Hospital, we understand how this condition can affect your daily life, and specialise in Urinary Incontinence treatments for women.

Types and Symptoms of Urinary Incontinence

There are around four types of Urinary Incontinence commonly seen in patients:

  • Stress Incontinence – This type of incontinence occurs when your bladder is under pressure such as when you cough or laugh.
  • Overflow Incontinence -This type of incontinence is typically faced when you experience frequent or sometimes even constant dribbling of urine, which is mostly due to a bladder that doesn’t empty completely.
  • Urge Incontinence – As the name suggest, in this type of incontinence, you get an intense and uncontrollable urge to urinate, followed by an uncontrollable loss of urine. Patients suffering from this condition tend to urinate more frequently, and the exact cause of this condition is unknown.
  • Functional Incontinence – This condition is usually faced by patients who are unable to reach a toilet in time. Patients suffering from conditions leading to immobility or one that interferes with the mental function may face functional incontinence.

Causes of Urinary Incontinence

In women, the most common type of Urinary Incontinence faced is Urge and Stress Urinary Incontinence. Urinary Incontinence may have other easily treatable causes such as

  • Urinary tract infection -Infections can irritate your bladder, causing you to have strong urges to urinate, and sometimes incontinence.
  • Constipation-The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.

Urinary Incontinence may be a persistent condition and may be associated with:

      • Obesity
      • Hereditary
      • Pregnancy and vaginal birth- A vaginal delivery can weaken the muscles needed for bladder control and also damage the bladder nerves and supportive tissue. Thus, leading to a dropped (prolapsed) pelvic floor.
      • Age- Ageing of the bladder muscle can interfere with the capacity of the bladder to store urine.
      • Hysterectomy- During surgery, there may be damage to the supporting pelvic floor muscles, which can lead to incontinence
      • Neurological disorders- Parkinson’s Disease, stroke, brain tumour or spinal injury can all interfere with the nerve signals that control the bladder, resulting in incontinence.

Urinary Incontinence Treatment

Our healthcare experts at Wif Hospital strongly suggest that you take a few simple measures to improve the symptoms of the condition being faced. Improvement can be made, either by changing your lifestyle, losing weight, pelvic floor exercises or even bladder training. According to your case history, there are also certain forms of medications that may be prescribed by our consultants.

In cases where such measures fail to help, surgical procedures can also be suggested for effective Urinary Incontinence treatment. Treatment for frequent urination that our healthcare experts may recommend include a sling procedure that reduces pressure on the bladder, surgery on the pelvic floor for prolapse, retropubic suspension or tension-free vaginal tape surgery. Schedule a health check-up or an appointment with us to get a detailed diagnosis and advice.

What Is Pelvic Inflammatory Disease?

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, usually caused by a sexually transmitted infection (STI). If left untreated it can cause infertility. PID can also result in the case of an infection that spreads from the vagina and cervix (neck of the womb) to the womb (uterus), ovaries and fallopian tubes (the tubes that go from the ovaries to the womb). PID can become a long-term health problem and can regularly flare up and affect the quality of your life.

At Wif Hospital, our healthcare professionals are experienced in diagnosing and providing the treatment for pelvic inflammatory disease. While there is no single test to diagnose PID, our doctors will diagnose you on the basis of your symptoms and a gynaecological examination. Schedule an appointment with our healthcare givers to ensure that you get a prompt diagnosis and treatment if needed.

Symptoms of Pelvic Inflammatory Disease

Symptoms associated with Pelvic Inflammatory Disease tend to vary. However, some of the common symptoms include:

  • Irregular periods
  • Pain in the lower abdomen
  • Painful sex
  • Pain during urination
  • Chills or high fever
  • Vomiting
  • Nausea
  • Vaginal discharge accompanied with foul smell
  • Back pain
  • Fatigue
  • Diarrhea

Impact of Pelvic Inflammatory Disease

PID is also one of the primary preventable causes of infertility. If you do not receive treatment for your pelvic infection in time, you may have flare-ups of the disease, or you could have an ectopic pregnancy (when the pregnancy occurs outside the uterus such as in the fallopian tubes). If a pregnancy occurs, it may be associated with complications such as a preterm pregnancy or passing on the infection to your newborn.

Who Is at Risk of Pelvic Inflammatory Disease?

Some factors put a woman at risk for Pelvic Inflammatory Disease. Patients who are most at risk for this condition include:

  • Women who have had Pelvic Inflammatory Disease earlier
  • Women with Sexually Transmitted Diseases (STD)
  • Women with many sexual partners are prone to STD and ultimately PID
  • Teenagers who are sexually active

Pelvic Inflammatory Disease Treatment

Mild cases of Pelvic Inflammatory Disease can be treated by antibiotic medication is taken orally. Severe cases, though, may require a combination of oral and intravenous antibiotics.

In case you have symptoms of nausea, high fever or vomiting, or you have symptoms that mimic an ectopic pregnancy, you might need to be hospitalised for a detailed examination. A pelvic exam will be performed that will confirm the tenderness in the pelvis. The exam will also help in identifying the location of the infection. Suitable treatment of PID will be started after swabs of your vagina and cervix are sent for examination.

It is essential to take the full course of antibiotics to cure the infection completely.

You may be advised a surgical procedure such as laparoscopy to confirm the diagnosis and also to deal with any adhesions that may have resulted from the infection and contribute to infertility.

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