Gynaecology

Gynaecology is a speciality of medicine which deals with the care of woman' s reproductive system. Its important role is to deal with well being of woman's reproductive system, screen , diagnose and treat the diseases related to it. This speciality includes treating menstrual disturbances, hormonal imbalance ( eg.Pcod), infections of female reproductive system and urinary tract, any local pathology of the system ( eg. fibroids, ovarian cysts, endometriosis) , all laparoscopic and open surgeries on uterus, tubes and ovaries and gynae cancer surgeries.

Gynaecology

Gynaecology is a speciality of medicine which deals with the care of woman' s reproductive system. Its important role is to deal with well being of woman's reproductive system, screen , diagnose and treat the diseases related to it. This speciality includes treating menstrual disturbances, hormonal imbalance ( eg.Pcod), infections of female reproductive system and urinary tract, any local pathology of the system ( eg. fibroids, ovarian cysts, endometriosis) , all laparoscopic and open surgeries on uterus, tubes and ovaries and gynae cancer surgeries.
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Gynaecology

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Gynaecology

Gynaecology is a speciality of medicine which deals with the care of woman' s reproductive system. Its important role is to deal with well being of woman's reproductive system, screen , diagnose and treat the diseases related to it. This speciality includes treating menstrual disturbances, hormonal imbalance ( eg.Pcod), infections of female reproductive system and urinary tract, any local pathology of the system ( eg. fibroids, ovarian cysts, endometriosis) , all laparoscopic and open surgeries on uterus, tubes and ovaries and gynae cancer surgeries.

Services:

  • Laparoscopic surgeries of Uterus, Tubes and Ovaries
  • Hysteroscopy
  • Fibroid management
  •  Gynae cancer surgeries
  • Adolescent Clinic
  •  Menopause Clinic
  •  Urogynae Clinic
  • Infertility treatment; IUI

Laparoscopic surgery

Laparoscopic or minimal invasive surgery, sometimes known as keyhole surgery is a specialised technique of performing abdominal and pelvic surgeries. In this laparoscope ( a special fiberoptic instrument) inserted through a small 10mm incision made at belly button. By laparoscopy all abdominal and pelvic organs can be examined by visualising them on high resolution video monitors in the operating room. With additional two to three small 5 mm incisions almost every pelvic surgery can be performed.
This system allows the surgeon to perform same traditional surgeries but with smaller incisions.

Advantages of Laparoscopic surgery over open traditional techniques:

  • Lesser blood loss
  •  Less pain
  •  Less scarring
  •  Less chances of infection
  •  Quicker postoperative recovery
  •  Shorter hospital stay

    Laparoscopic procedures in gynaecology:

  • Diagnostic Laparoscopy (Gold standard for diagnosis of many gynaecological conditions )
  • Laparoscopic ovarian cystectomy
  • Laparoscopic hysterectomy ( removal of uterus)
  • Laparoscopic myomectomy (removal of fibroid)
  • Laparoscopic salpingectomy( in cases of hydrosalpinx or ectopic pregnancy)
  • Management of endometriosis
  • Tubal ligation

Fibroid uterus

Fibroid is a benign muscular growth in uterus that can develop during the childbearing period of a woman’s life. Uterine fibroids are quite common and frequently found incidentally during a routine pelvic examination.

Fibroid is a benign muscular growth in uterus that can develop during the childbearing period of a woman’s life. Uterine fibroids are quite common and frequently found incidentally during a routine pelvic examination.

What causes fibroids ?

The cause of fibroids is not well understood. Risk factors includes Genetic/ family history, early onset of puberty, Obesity.

What are the symptoms ?

Fibroids can be asymptomatic. Many patients with fibroids don’t have any symptom. In those who do, symptoms can be influenced by the location, size and number of fibroids.
Common signs and symptoms are:

  • Heavy bleeding during periods
  • Menstrual periods lasting more than a week
  • Heaviness/pain in lower abdomen
  • Pressure on bladder / bowel
  • Chronic backache

How to diagnose ?

Diagnosed during a regular checkup/Ultrasound . Sometimes doctor may suggest MRI, Hysterosalpingography/ Sonosalpingography, Hysteroscopy for further evaluation.

Treatment options ?

Expectant : Majority of cases don’t require any treatment.

Medical :

Medicines help to relieve pain and control heavy menstrual bleeding. Few medicines can shrink small fibroids. However fibroids do not disappear completely with medicines.

Surgical :

Surgery is required in case heavy bleeding does not get controlled with medicines or size of fibroid is large and causing pressure symptoms.
Surgical options are Laparoscopic/ Open myomectomy or hysterectomy.
In case of submucosal fibroid hysteroscopic myomectomy is a good option.
Alternative to myomectomy/ hysterectomy, Uterine artery embolization ( UAE) can be done in some cases. UAE decreases the vascularity of fibroid, thus shrinking its size and relieving symptoms.

Do fibroids affect fertility?

Fibrod directly doesn’t cause Infertility but depending on its size and location it may affect fertility in some patients. Fibrods if indenting the endometrium or distorting the uterine cavity, obstructing the openings of tubes in uterus ,or blocking the path for sperms to ascend can lead to difficulty in conception and require treatment.

Polycystic ovarian syndrome( PCOS)

PCOS is a very common condition affecting 5-10% of women in reproductive age group(12-45 yrs).
Its a hormonal imbalance ,in which ovaries don’t work well and makes many small follicles instead of one big mature follicle. In this condition ovaries become enlarged containing many immature or partially mature eggs,giving appearance of small cysts on the outer edges of the ovaries.

What are symptoms?

Clinical presentation is variable ranging from asymptomatic to having Gynaecological, dermatological or metabolic manifestations. Insulin resistance is also one of the main features.
Common symptoms are:

  • Menstrual disturbances; Irregular, scanty or absence of periods
  • Weight gain/ Obesity
  • Oily skin and acne
  • Unwanted hair growth on face and body ,including on back, belly and chest
  • Loss of scalp hair
  • Dark patches of skin in folds and creases
  • Infertility: Difficulty in getting pregnant

How to diagnose?

For diagnosis of Pcos patient should have two of three main features;

    • High androgen (male hormones) levels
    • Irregular/ scanty / absence of periods
    • Polycystic appearance of ovaries on ultrasound
    • Ultrasound and blood tests can confirm the diagnosis.

All women with Pcos or suspected of having Pcos should be screened for Metabolic abnormalities ( eg. Type 2 Diabetes mellitus, dyslipidemia, Hypertension) , thyroid dysfunction, hyperprolactinemia and non classical congenital adrenal hyperplasia.

Treatment:

Lifestyle changes like weight loss , calorie restricted diet and exercise are the primary treatment for Pcos. Losing just 5-10% of your body weight can help regulate menstrual cycle and improve Pcos symptoms.

Medical management:

    • Metformin is the first line medication for metabolic manifestations such as hyperglycaemia.
    • Hormonal contraceptive are first line therapy for Irregular menstruation and dermatological manifestations like acne and hirsutism in patients who are not actively trying for pregnancy.
    • For patients who are trying for pregnancy Ovulation inducing medicines like Clomiphene and Letrozole can help

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