Gynaecological Procedures 

What are Gynaecological Procedures? 

Gynaecological procedures are medical or surgical procedures related to the female reproductive system. They diagnose, treat, and manage conditions affecting the uterus, cervix, ovaries, fallopian tubes, and vagina.

Who is Suitable for Gynaecological Procedures?

The decision to have a gynaecological procedure depends on various factors. These can include a woman's age, overall health, medical history, the severity of the condition, tolerance for specific medications or therapies, and personal preference. The most suitable candidates for these procedures are women with conditions that cannot be effectively treated with medications or other non-surgical treatments.

Any woman considering a gynaecological procedure should have a detailed discussion with her doctor about the potential benefits, risks, and alternatives before making a decision.

Benefits of Gynaecological Procedures

Gynaecological procedures can provide various benefits, depending on the specific condition and the type of procedure. Some potential benefits can include:

• Relief from Symptoms: Many gynaecological conditions, such as heavy menstrual bleeding, chronic pelvic pain, or endometriosis, can cause significant discomfort and disrupt a woman's daily life. Gynaecological procedures can often effectively treat these symptoms, providing relief.
• Improved Reproductive Health: Procedures such as laparoscopic ovarian drilling can restore ovulation in women with PCOS, potentially improving fertility. Similarly, surgeries to treat conditions like uterine fibroids or endometriosis can also improve fertility in some cases.
• Prevention or Treatment of Cancer: A hysterectomy can treat gynaecological cancers and pre-cancerous conditions. In some cases, they can also prevent cancer in high-risk women.
• Resolution of Prolapse: Procedures like vaginal prolapse surgery can resolve symptoms of pelvic organ prolapse, improving quality of life.

Types of Gynaecological Procedures

The types of gynaecological procedures can be categorised into several groups based on their purpose and nature:

• Diagnostic Procedures: These include colposcopy, hysteroscopy, and laparoscopy, which are used to investigate symptoms, confirm a diagnosis, or monitor a condition.
• Operative Procedures: These are procedures carried out to treat a condition. Examples include laparoscopic cyst or fibroid removal, dilation and curettage (D&C), endometrial ablation, and hysterectomy.
• Reproductive Procedures: These are procedures related to fertility and reproduction. They can include assisted reproductive technologies like in vitro fertilisation (IVF) as well as surgeries to treat conditions affecting fertility, such as laparoscopic ovarian drilling.
• Preventive or Prophylactic Procedures include procedures like tubal ligation for sterilisation and prophylactic oophorectomy in women at high risk of ovarian cancer.
• Prolapse and Incontinence Procedures include surgeries to treat pelvic organ prolapses or urinary incontinence, such as vaginal prolapse surgery or sling procedures.
• Cancer Treatment Procedures include surgeries to treat gynaecological cancers, such as radical hysterectomy or debulking surgery for ovarian cancer. These procedures may be combined with other treatments like chemotherapy or radiation therapy.

Each procedure has potential benefits, risks, and alternatives, and the decision to undergo a specific procedure should always be made in consultation with a gynaecologist.

Common Gynaecological Procedures

At Dr Adham’s Clinic, we offer the following procedures:

Endometriosis Surgery

This procedure removes the tissue that behaves like the lining of the uterus (endometrium) but grows outside it, causing endometriosis. This can be done through a minimally invasive laparoscopy or a more traditional abdominal surgery. The aim is to alleviate symptoms and improve fertility.

Hysterectomy

This is a surgical procedure to remove the uterus. There are several types of hysterectomies, depending on whether the cervix, fallopian tubes or ovaries are also removed. This procedure is typically performed to treat conditions such as uterine fibroids, endometriosis, pelvic support problems (like uterine prolapse), abnormal uterine bleeding, chronic pelvic pain, or gynecologic cancer.

Bladder Treatments

These could include a variety of procedures to treat conditions such as urinary incontinence or bladder prolapse. Depending on the specific condition and its severity, treatments might involve medication, pelvic floor exercises, pessaries, nerve stimulation, injections, or surgery.

Endometrial Ablation & Hysteroscopy

Endometrial ablation is a procedure that surgically destroys (ablates) the lining of the uterus (the endometrium). It's primarily used to treat heavy menstrual bleeding. A hysteroscopy is a procedure that allows your doctor to look inside your uterus to diagnose and treat the causes of abnormal bleeding. The hysteroscope is a thin, lighted tube inserted into the vagina to examine the cervix and the uterus.

Fibroid Removal (Myomectomy)

Myomectomy is a surgical procedure to remove fibroids without taking out the healthy tissue of the uterus. This is often chosen by women who still want to have children, as hysterectomy involves the removal of the entire uterus.

Ovarian Cysts Removal

This is usually done laparoscopically, involving small incisions and specialised tools. The type of surgery depends on the type and size of the cyst, the woman's age, her symptoms, and her desire to have children in the future.

LLETZ (Large Loop Excision of the Transformation Zone)

This is a common treatment for cervical abnormalities, often following abnormal cervical screening results. It involves removing a small section of the cervix using a thin wire loop heated with an electric current.

Colposcopy

This diagnostic procedure examines the cervix, the vagina, and the vulva. It's typically performed when results of cervical cancer screening show abnormal changes in the cells of the cervix.

Mirena, Copper IUD Insertion

These intrauterine devices (IUDs) are inserted into the uterus for long-term birth control. The Mirena releases a hormone called levonorgestrel, which can help with conditions like heavy periods. In contrast, the Copper IUD releases copper, which is toxic to sperm, providing contraceptive action.

Preparation Before a Gynecological Procedure

• Medical History and Physical Examination: Your gynaecologist will need a thorough understanding of your medical history and current health conditions. You might also need a physical examination.
• Preoperative Testing: Depending on the procedure and your health, you might need some tests before surgery. These could include blood tests, a chest X-ray, an EKG (electrocardiogram), or imaging studies like an ultrasound.
• Medication Review: If you take any medications, herbs, or supplements, your gynaecologist might instruct you to modify the dose or stop taking them before the procedure. This includes over-the-counter medications like aspirin that can affect blood clotting.
• Fasting: You will likely be instructed to fast (no food or drink) for a certain period before the procedure, often from midnight the night before.
• Preparation Instructions: You might be given special instructions depending on the procedure. For example, you may need to take a laxative or perform a bowel prep before some procedures.

Gynecological Procedure Steps

A gynaecological procedure can vary widely depending on the procedure and your health circumstances. However, here are some general things you may need to do or expect:

• Most gynaecological procedures require some form of anaesthesia, ranging from local anaesthesia (numbing a small area) to general anaesthesia (where you're asleep).
• The specifics of the procedure will depend on the type. It might be minimally invasive (like laparoscopy or hysteroscopy) or more extensive (like a hysterectomy).
• Your vital signs (heart rate, blood pressure, and oxygen levels) will be continuously monitored during the procedure.

Post Gynecological Procedure Expectations

After the procedure, you'll be moved to a recovery room where healthcare professionals will monitor your vital signs as the anaesthesia wears off.

It's common to have some pain after a surgical procedure. You'll likely receive pain medication to keep you comfortable.

Before you leave the hospital or clinic, you'll be given instructions on how to care for yourself at home. This could include wound care, activity restrictions, and when to seek medical attention.

You'll likely have a follow-up appointment with your gynaecologist to monitor your recovery and discuss the procedure's results. In some cases, further treatment might be necessary.

Prognosis of Gynaecological Procedures

For most benign conditions, the prognosis after gynaecological procedures is generally good. Many women experience significant symptom relief, improved quality of life, or the resolution of the issue, such as successful pregnancy following fertility-enhancing surgery.

For cancer-related gynaecological procedures, the prognosis can depend on the type and stage of cancer, the success of the surgery, and the use of additional treatments like chemotherapy or radiation.

Risks of Gynaecological Procedures

As with any surgical procedure, gynaecological procedures carry some risks. These can include:

• General risks associated with anaesthesia, such as allergic reactions or breathing difficulties.
• Infection or bleeding.
• Damage to surrounding organs or tissues, such as the bladder, bowel, or blood vessels.
• Blood clots, which can lead to deep vein thrombosis or pulmonary embolism.
• Complications related to the specific procedure include changes in menstrual bleeding patterns after endometrial ablation or early menopause after removal of the ovaries.
• Emotional or psychological effects, particularly for procedures that may impact fertility or hormone levels.

Delaying Gynaecological Procedures

The implications of delaying a gynaecological procedure depend on the nature and severity of the condition being treated. Sometimes, a delay might have minimal impact, particularly if the procedure is elective or other treatment options are available.

However, in other situations, delaying a gynaecological procedure could lead to worsening symptoms, progression of the disease, or potentially serious complications. For example, delaying surgery for ovarian cancer could allow the cancer to spread, which could reduce survival rates.

Delaying a procedure could also impact a woman's quality of life. Conditions like heavy menstrual bleeding, endometriosis, or uterine prolapse can cause significant discomfort and disrupt a woman's daily activities.

Any decisions about the timing of a procedure should be made in consultation with a gynaecologist, considering the potential benefits, risks, and alternatives.