Obstetrics and Gynaecology

Hysterectomy

A hysterectomy is a surgical procedure to remove the uterus. There could be many reasons for this procedure to be performed, including:

  • Bleeding, pain or other problems caused by uterine fibroids and adenomyosis
  • Uterine prolapse which is when the uterus moves from its normal position into the vaginal canal
  • Cancer of the ovaries, uterus or cervix
  • Endometriosis

There are different types of hysterectomies:

  • In the case of a supracervical or subtotal hysterectomy, only the upper part of the uterus is removed and the cervix is left in place.
  • In a total hysterectomy, the complete uterus and cervix are removed.
  • If a radical hysterectomy is done, the whole uterus, the adjacent tissue, the cervix and the upper portion of the vagina are removed. This is generally done when cancer has been diagnosed.

In an open surgery hysterectomy, an incision, vertical or horizontal, is made across the lower abdomen and the organs are removed through it. The normal post-operative stay at the hospital is 2 to 3 days.

Myomectomy

A myomectomy is a surgery that is performed to remove uterine fibroids. These are non-cancerous growths that commonly appear in the uterus, most often in women of childbearing age. Unlike a hysterectomy, where the whole uterus is removed, in the case of a myomectomy, only the fibroids are removed and the uterus is reconstructed if required. The procedure is performed when fibroids have been diagnosed and the condition affects a woman’s normal activities. Subject to medical viability and the patient’s safety and health, this procedure is preferred over hysterectomies for women who are of childbearing age and plan to have children.

An open myomectomy is generally done with a horizontal incision low down on the abdomen. This will allow the surgeon to access the uterus and remove the fibroids. The typical post-operative hospital stay is 2 to 3 days, followed by 4 to 6 weeks of rest and recovery at home.

Cystectomy

This condition is said to be present when an ovary becomes twisted around the ligaments that hold it in place. Although the condition can affect women of any age, it is most common among the 20 to 40 age group. Common causes for the condition include:

  • The ovarian ligament that connects the uterus and ovary is longer than normal. This allows the ovary to move and become twisted.
  • The weight of a cyst or other growth in the ovary can cause imbalance and result in it becoming twisted.
  • Higher hormone levels during pregnancy that cause tissue relaxation can allow the ligaments that hold the ovaries in place to flex.

The condition normally affects only one ovary. If the twisting caused the blood flow to the ovary to be cut off, severe pain can result. If the blood flow is cut off for a lengthy period, tissue death is possible.

The symptoms of cystectomy torsion include, but are not limited to:

  • Nausea
  • Vomiting
  • Severe pelvic pain
  • Fever

Because the symptoms of the conditions are similar to kidney stones, urinary tract infections and other ailments, diagnosis and treatment require the highly skilled doctors and medical facilities available at NMC.

Ectopic Pregnancy

Normal pregnancy begins with the woman’s egg being fertilized and then being attached to the lining of the uterus. If the fertilized egg becomes attached outside the uterus, it is called an ectopic pregnancy. The most commonplace for this to happen is the fallopian tube, although an ectopic pregnancy may also occur in the ovary, the cervix or the abdominal cavity. In an ectopic pregnancy, the egg cannot survive and the growing tissue may cause life-threatening bleeding and other complications for the woman.

In an ectopic pregnancy, the initial stages of the pregnancy will be normal, but as the egg grows, serious complications arise. The symptoms of this condition may vary greatly, but in general, they include:

  • Vaginal bleeding
  • Pelvic pain
  • Shoulder pain
  • Lightheadedness or fainting
  • Frequent urges for a bowel movement

If the egg continues to develop in the fallopian tube, the tube itself may rupture and lead to life-threatening bleeding and other consequences. There are various modalities of management available. Conservative non-surgical management include expectant management and also the use of injections to dissolve the ectopic pregnancy. Surgery is also an option. The specialists and world-class treatment and care available at NMC come together to keep the patient as safe as possible and open the door to a speedy recovery.

Ovariotomy

An ovariectomy (also referred to as anoophorectomy) is a surgical procedure to remove one or both of the ovaries. When one ovary is removed it is called a unilateral ovariectomy and when both are removed it is a bilateral ovariectomy. This can be a stand-alone procedure or be done as part of a hysterectomy. There are several reasons why an ovariectomy may be required. Among the most common are:

  • Ovarian cancer
  • Endometriosis
  • Benign (noncancerous) cysts or tumours in the ovaries
  • A preemptive procedure that is done on those women who are at higher risk of breast or ovarian cancer
  • A tubo-ovarian abscess – a pus-filled pocket in the ovary and/or fallopian tube
  • Ovarian torsion – the twisting of an ovary

Regular check-ups at NMC where you will find the best doctors and most up-to-date medical technology will spot any incipient problems in the early stages so that treatment can be done without delay.

Ovarian Tumours

Ovarian tumours are the growth of unwanted cells in the ovaries. These cells can multiply rapidly and in the process, destroy healthy tissue. The cause of the development of the tumours is still being researched. Ovarian tumours are of two types:

  • Malignant – This is an abnormal mass of tissue that is made up of cancerous cells.
  • Benign – This is an abnormal mass of tissue that is made up of non-cancerous cells.

The symptoms of ovarian tumours include:

  • Feeling full more quickly than usual when eating
  • Painful cramps during menstruation
  • Lower back pain
  • Nausea or vomiting
  • Pain during sex
  • Vaginal bleeding after menopause
  • Stomach bloating
  • Increased belly size
  • Stomach or pelvic pain
  • Constipation
  • Either difficulty urinating or urinating frequently

In many cases, symptoms are not noticed until the tumour has grown quite large. Regular check-ups at NMC will enable the early detection of any tumours so that treatment can be started. The earlier the treatment is begun, the faster and more complete the recovery.

Endometriosis

Endometriosis is a condition that occurs when the tissue that lines the inside of a woman’s uterus also grows outside it. The symptoms of the condition include:

  • Severe pelvic pain that is not relieved by medication
  • Difficulty in getting pregnant
  • A growth is noticed in the pelvic region.

Endometriosis resection is the term for surgery to remove the unwanted tissue. Endometriosis is a condition that should not be ignored. The surgery, although fairly common, may affect a woman’s ability to get pregnant in the future. The specialists at NMC will first diagnose the extent of the problem and examine both medical and surgical treatment options . Patients are briefed on the treatment choices available to them and helped to make a decision that is right for them.

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