Expert Care for Gynecological Disorders

Red Underline

Gynaecological Conditions

Red Underline
Endometriosis

Endometriosis

Endometriosis
What is Endometriosis?

Endometriosis is a condition where tissue known as endometrium develops outside the uterus. Endometriosis can
affect the ovaries, fallopian tubes, and the lining of the pelvis. In some rare cases, it may also be found in areas beyond the pelvic
region where organs are situated.

 

Endometriosis can cause pain, with menstrual periods being a common trigger for this discomfort. The pain can vary in intensity and may be severe in some cases.

Treatment for Endometriosis

The type of treatment for endometriosis is affected by factors such as the severity of symptoms, the extent of the endometriotic deposits, and whether the patient has a desire to conceive.

> Medication

For less severe cases, the patient might be prescribed with pain medication such as ibuprofen.

> Hormone Treatment

Hormone treatment helps to slow down the growth and progression of endometriotic deposits through the taking of oral contraceptive pills. These medications need to be taken long-term as discontinuing them can lead to symptom recurrence.

> Surgery

If the patient suffers from significant pain and/or infertility, surgery to remove the endometriotic cysts and deposits would be necessary. The procedure is usually performed through laparoscopy. For more severe cases, traditional surgery may be considered. After surgery, medical treatment may be recommended for prevention of growth of endometriosis in new areas.

Uterine Fibroids

Uterine Fibroids
What is an Uterine Fibroid?

A uterine fibroid, also known as a myoma, is a benign (non-cancerous) growth that can develop in the uterus. These growths can occur on the inner lining of the uterus, within the muscular wall of the uterus, or on the outer surface of the uterus. Uterine fibroids are a common condition affecting many women.

Treatment for Uterine Fibroids

Factors such as the severity of symptoms, the size of fibroids and whether the patient has a desire to conceive, would affect the type of treatment for the patient.

 

> Pain Medication

Patients who suffer from mild pain may be prescribed with pain medication.

 

> Hormonal Medication

Patients who experience severe bleeding may be prescribed with hormonal medication to reduce bleeding during menses. Some medications can also reduce the size of fibroids.

 

> Surgery

For cases where the fibroids are big or growing in size, surgery may be necessary. The procedure involves removing the fibroids (myomectomy). For severe cases, the removal of the entire womb (hysterectomy) may be necesarry. Both procedures can be conducted via laparoscopic approach or traditional open surgery.

Uterine Fibroids
Ovarian Cysts

Ovarian Cyst

Ovarian Cysts
What are Ovarian Cysts?

Ovarian cysts are sacs filled with fluid that develop either on or inside the ovaries, which are a part of the female reproductive
system. The size of these cysts can vary. The majority of ovarian
cysts are non-cancerous (benign) and typically resolve spontaneously without presenting any symptoms or complications. Ovarian cysts can be categorised into two types:

 

Functional Cysts
Functional cysts are small and can form on the ovaries during a woman’s regular menstrual cycle. They are not harmful and usually disappear after a short time. These cysts are a natural part of a woman’s reproductive process.

 

Pathological Cysts
Pathological cysts form due to some changes or problems in the ovaries, and they are not part of the regular menstrual cycle. While most pathological cysts are not cancerous or dangerous, some types may need closer monitoring or treatment.

Treatment for Ovarian Cysts

Treatment for ovarian cysts depends on factors such as the size of the cyst and if there are any abnormal features spotted through ultrasound. Small cysts may be monitored for a few months to track if they become abnormal.

 

> Laparoscopy (Keyhole Surgery)

For patients with low risk of malignancy, the laparoscopy or keyhole surgery approach may be used, as it provides a faster recovery.

 

> Traditional Open Surgery

For patients with large or abnormal cysts, traditional open surgery may be recommended.

 

> Cystectomy

A cystectomy may be recommended to remove a cyst (or cysts) on or within the ovary. This is usually recommended for patients who desire to conceive, as the ovarian tissues for reproductive and hormonal function are preserved.

 

> Oophorectomy

For patients who have high risk of ovarian cancer, oophorectomy may be recommended to remove the entire ovary. This surgical procedure helps to reduce the risk of developing ovarian cancer or cysts in the future. For more severe cases, the removal of the uterus, fallopian tubes and ovaries may be necessary.

Ovarian Tumours

Ovarian Cancer
What are Ovarian Tumours?

Ovarian tumours are abnormal growths or masses that develop in or on the ovaries. These tumors can be either benign (non-cancerous) or malignant (cancerous). While ovarian tumors are fairly common, they can impact women of all age groups, with a higher frequency of diagnosis in women who have entered menopause.

 

In the early stages, ovary tumors may not produce noticeable symptoms. Nevertheless, as they increase in size or develop into cancer, they can result in a range of symptoms, such as abdominal bloating, pelvic pain, alterations in bowel and bladder patterns, reduced appetite, unexplained weight loss, and changes in menstrual cycles.

 

Treatment for Ovarian Cancer

> Surgery

A laparatomy (long cut in the wall of the abdomen) can be done to remove the affected ovaries, fallopian tubes, uterus, nearby lymph nodes.

 

Further treatment after surgery will be recommended based on the stage and aggressiveness of cancer.

 

> Chemotherapy

Chemotherapy may be recommended for patients whose cancer cells are aggressive or have spread. This involves injecting drugs into the bloodstream to kill the cancer cells. After completing chemotherapy, there will be follow-up examinations every three months for the first few years.

Ovarian Cancer
PCOS

Polycystic Ovary Syndrome (PCOS)

PCOS
What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS) is a prevalent hormonal condition affecting women in their reproductive years. In PCOS, the normal maturation and release of eggs in the ovaries are disrupted, leading to the formation of tiny cysts within the ovaries. This can result in enlarged ovaries with groups of fluid-filled cysts on the outer surface. The condition is associated with decreased fertility and an irregular menstrual cycle, characterised by light menstrual flow.

 

Symptoms of PCOS:

> Irregular menstrual cycles – This can mean having infrequent periods or experiencing periods that last longer than usual. Difficulty getting pregnant may also be a symptom.

 

> Elevated levels of androgen hormone – This results in excess hair growth on the face and body, known as hirsutism. In some cases, severe acne and male-pattern baldness may also occur.

 

> Enlarged ovaries – PCOS may lead to the enlargement of the ovaries, with the development of numerous follicles containing eggs along the ovary’s edge. This can potentially affect the ovaries’ regular functioning.

Treatment for Polycystic Ovary Syndrome

Treatment for PCOS depends on the patient’s age, symptoms and desire to conceive in future.

> Hormone Treatment

Hormone treatment may be recommended for patients with higher BMI, in addition to exercise and weight loss. This may help patient to achieve a normal menstrual cycle.

> Diet and Exercise

A healthy diet, regularly exercise and weight loss will promote a normal menstrual cycle and also improve fertility.

> Medication

Certain medications such as oral contraceptive pills can help in regulating menstrual cycles and decreasing the presence of male hormones in the body.

> Laparoscopic Keyhole Surgery

When medication and other treatment fail, the doctor may recommend performing laparoscopic keyhole surgery on the polycystic ovaries.

Stress Urinary Incontinence

Stress Urine Incontinence
What is Stress Urinary Incontinence?

Stress urinary incontinence is a form of urinary incontinence and it occurs when there is unintentional release of urine during physical actions or movements that apply pressure to the bladder. These activities include coughing, sneezing, laughing, lifting heavy objects, or even basic motions like standing up or walking. The term “stress” in stress urinary incontinence denotes the pressure exerted on the bladder during these actions, which can lead to weakened bladder muscles or malfunctioning of the urethral sphincter, the muscle responsible for controlling urine flow.

Who suffers from Stress Urinary Incontinence?

More common in women, stress urinary incontinence affects most especially after childbirth and during menopause. However, it can also affect men, especially those who have had prostate surgery. In women, childbirth and hormonal changes can lead to weakening of the pelvic floor muscles and the support structures around the bladder, increasing the risk.

Treatment for Stress Urinary Incontinence

Individuals with stress urinary incontinence may experience improvement in their condition by weight control (for obese patients) and reducing caffeine intake.

 

> Pelvic Floor Exercises

Also known as Kegel exercises, these involve strengthening the pelvic floor muscles to improve bladder control.

 

> Surgery

Surgery may be necessary for individuals with stress urinary incontinence when other methods have failed. The types of surgery includes:

>>> Synthetic mid-urethral tape

Synthetic mid-urethral tape is a sling of man-made mesh placed under the urethra to provide support and prevent leakage during activities that increase abdominal pressure.

 

>>> Open colposuspension

Open colposuspension is a surgical procedure that involves attaching the neck of the bladder to nearby structures to provide better support and reduce urinary leakage during physical activities. It is also known as Burch colposuspension.

Stress Urine Incontinence
Menopause

Menopause Management

Menopause
What is Menopause?

Menopause is a natural phase marking the end of female fertility. As women get older, the production of the hormones estrogen and progesterone in the ovaries gradually decreases, leading to the cessation of egg production. Menopause is identified when a woman experiences 12 consecutive months without menstruating. This natural process typically occurs between the ages of 45 to 55 years, but it can happen as early as the 30s or as late as the 60s.

 

There are three stages of Menopause that a woman goes through:

Stage 1 – Perimenopause

Stage 2 – Menopause

Stage 3 – Postmenopause

Symptoms of Menopause

> Aches, weakness, or stiffness can occur due to reduced estrogen levels, stress, tension, and a lack of physical activity.

> Urinary incontinence might happen when coughing, laughing, exercising, or carrying heavy items, leading to urine leakage.

> Hot flashes and night sweats, which are hormonal changes, can disturb sleep patterns, especially at night.

> Poor sleep, often due to night sweats, can also be related to anxiety or depression.

> Vaginal changes might lead to discomfort or pain during sexual intercourse.

> Weight gain around the waist can occur because the body starts using calories more slowly.

> An inflamed or irritated urethra may cause frequent urination, an urgent feeling to urinate, or pain during urination.

Treatment for Menopause

Treatment for menopause is focused on managing symptoms and promoting the well-being of the individual.

 

> Menopause Hormone Therapy

Those with severe symptoms may be recommended with Menopause Hormone Therapy (MHT). This may help to alleviate hot flashes, vaginal dryness, and other symptoms.

Uterine Lining Abnormalities

Uterine Lining Abnormalities
What are Uterine Lining Abnormalities?

Uterine lining abnormalities are variations or irregularities in the thickness, texture, or composition of the endometrium, the inner lining of the uterus. These irregularities can impact a woman’s reproductive health and are linked to different conditions or disorders. Some examples of uterine lining abnormalities are:

 

> Thin Endometrium – When the uterine lining is thinner than expected, it may impact fertility and make it challenging for a fertilised egg to implant and develop.

 

> Thickened Endometrium – A thicker than usual endometrium can result from various factors, including hormonal imbalances, polyps, or conditions like endometrial hyperplasia.

 

> Endometrial Polyps – These are growths that develop on the inner lining of the uterus and can cause abnormal bleeding or interfere with pregnancy.

 

> Endometrial Hyperplasia – This condition involves an overgrowth of the uterine lining, which may be caused by hormonal imbalances and can lead to abnormal bleeding.

 

> Endometrial Cancer – In rare cases, abnormal changes in the endometrial lining can be cancerous and require prompt medical attention.

Treatment for Uterine Lining Abnormalities

> Progestin Treatment

This medication can be given orally or as a vaginal cream for women with endometrial hyperplasia.

 

> Dilation and Curettage (D&C)

Sometimes, a D&C procedure may be performed to remove excess endometrial tissue for diagnostic purposes or to treat non-atypical hyperplasia.

 

> Surgery

Surgery is usually recommended for women who are diagnosed with endometrial cancer, which may involve the removal of the uterus, ovaries, and fallopian tubes. In some cases where the cancer has spread beyond the uterus, radiation therapy may be recommended.

Uterine Lining Abnormalities
Uterine Prolapse

Uterine Prolapse

Uterine Prolapse
What is Uterine Prolapse?

Uterine prolapse occurs when the pelvic floor experiences increased pressure, leading to weakening of the muscles and tissues that support the uterus. As a result, the uterus can shift from its usual position and protrude into the vagina or birth canal.

Symptoms of Uterine Prolapse

> Noticing or feeling tissue protruding from the vagina.

 

> Sensation of heaviness or pulling in the pelvic area.

 

> Feeling like the bladder does not fully empty after using the bathroom.

 

> Experiencing urine leakage (incontinence) problems.

 

> Difficulty having a bowel movement.

 

> Experiencing pressure or discomfort in the pelvis or lower back.

Treatment for Uterine Prolapse

> Pelvic Floor Repair

In cases where the urethra, bladder, rectum, or intestines protrude through the vaginal wall, the pelvic floor will be surgically repaired and reinforced using sutures. This procedure aims to correct the prolapse and reposition the organs to their original location.

 

> Sacrospinous Ligament Fixation

Where there is significant uterine prolapse, this procedure is performed to attach the vaginal vault to the sacrospinous ligament, reducing the likelihood of prolapse recurring.