Gynecology is a branch of medical study dealing with the treatment and maintenance of women reproductive system. Its counterpart known as Andrology deals with the same purpose but in men. Literally, the word is referred as “the science of women” among the layman.
Patients with severe adhesions have been treated in the Vital Health with life-saving surgery performed by the gynecologists in India. Endometriosis patients and adhesion patients are provided extensive follow-up care post surgery
What is Adhesion?
A girdle of scar tissue in between the adjoining structures and organs are known as Adhesions. They can cause the organs to be fused together.
The formations may be either like fine cobwebs or like bulky hard glue. Pelvic inflammatory infection, endometriosis disease, post abdominal surgery injury are some the reasons that can cause adhesions. In some cases, adhesions can be formed even without any reason.
Tissue or organ involvement affect the showcase of symptoms in adhesion patient’s body. Painful, pulling sensation due to the presence of a cyst in the ovary is the result of ovarian scarring or adhesion to the pelvic wall. But if intestines have adhered, the symptom would be cramping pain due to obstructed motility in the gut. When adhesion of a section of bowel takes place, the restriction can cause nausea, vomiting, abdominal pain along with diarrhea and constipation. In extreme conditions, frozen pelvis, bladder, large bowel, uterus, bowel tube and ovaries can be fused to one another by severely dense adhesions. It is quite rare to see the whole abdominal cavity being blocked out by critical adhesions. As a result, the pelvic anatomy is distorted making it quite complicated for the surgeons to analyze the pelvic organs before precariously dissecting the adhesions.
The gynecology specialist removes a conical tissue from the central area of the cervix during cone biopsy. In the bottom of the uterus that opens into the vagina, an extensive sample of cervical tissue is collected through cervical biopsy.
After the failure of colposcopy and cervical biopsy, cone biopsy finally detects the possibility of cervical cancer and makes a promising diagnosis
Identifies and treats abnormality in cervical cells
Evaluating the severity and extension of cancer along with guiding the patient to make proper treatment decision after the confirmation of cervical punch biopsy, pap smear, and colposcopy
This is the surgical repair of any disorder in the vaginal wall. A cystocele is a condition where the bladder thrust into the vagina and rectocele is when the rectum is forced into the vagina. They both are treated via Colporrhaphy. Unless the patient shows symptoms of any daily life prolapse, gynecologists do not suggest surgery to the patients.
Colporrhaphy may be performed on both the front (anterior) and back (posterior) wall of the vagina. The front colporrhaphy is for treating an urethrocele or cystocele disorder, whereas, a posterior colporrhaphy soothes rectocele.
The ailing patient is first given regional, general or local anesthesia so that a speculum can be pushed through the vagina. The vagina is held open for the actual procedure. To analyze the detected fascia of the underlying skin of the vagina, an open slit is made by the surgeons. The separated fascia from the vaginal skin allows the defect to be folded over and stitched together. Any additional vaginal skin is cut out and then the opening is stitched closed.
The concise surgery of Dilation and Curettage dilates the cervix with a special instrument to scrape the lining of the uterus. The pre and post-operative measures are very important for the easy recovery of the patients. The patient can get relieved from his worries once he knows the prime factors about the surgery.
Reasons for D & C :
Removing harmful tissue during and after abortion or miscarriage along with removing placenta pieces after childbirth for preventing heavy bleeding and infection
Diagnosing and treating abnormal bleeding from the uterus. The dilation and curettage diagnoses and treats the anomalous growth of fibroids and polyps. Hormonal imbalances, endometriosis, and uterine cancer can also be soothed through this treatment. For checking the abnormality of the cells, the extracted ones from the surgery are examined under a microscope.
The method to destroy the endometrium or uterine lining is known as Endometrial ablation. Abnormal uterine bleeding can be cured through this effective process. A viewing instrument with the name of hysteroscope allows the gynecology specialist to see the inner state of the uterus.
Means of endometrial ablation:
Thermal ablation using heat
Laser thermal ablation using laser beam
Thermal balloon ablation with 85ᵒC or 185ᵒF heated saline filled balloon
Normal heated saline
Using rectoscope with a loop or rolling ball electrode
Scarring with endometrium heals and restricting uterine bleeding
Endometrial ablation is a surgical procedure that can easily be done within 45 minutes in any doctor’s facility. Though general anesthesia is given sometimes, local or spinal anesthesia is sufficient for the procedure.
The way with which gynecologists take a small section of the uterus for looking under a microscope is known as Endometrial Biopsy. An endometrial biopsy assists the doctors to identify a problem in the hormone level balance in the endometrium.
There are numerous ways to perform the biopsy procedure. Gynecology specialists suggests,
Extracting out sample through a straw like soft device. As this is a quick method, it may cause some initial cramping
A bit uncomfortable yet effective method of electronic suction via Vabra aspiration
Liquid spray named jet irrigation for clearing off tissues that are on the outer line of the uterus with the help of a medically authorized brush
The cause of the abnormality in the uterine bleeding can be identified by the endometrial biopsy. This can effective in checking lining overgrowth or any possibility of cancer
If a woman has hard times getting pregnant, the actual situation of the lining to support the pregnancy can also be diagnosed with the help of an endometrial biopsy
Hysteroscopy and endometrial biopsy can be done at the same time to allow the doctor to have a look at the uterine lining through a small blue tube
The surgical procedure to remove part of the uterus or the whole organ is known as Hysterectomy. Removing the cervix, ovarian or fallopian tubes along with other surrounding structures is also a part of Hysterectomy. A gynecology specialist performs super cervical (without removing the cervix), or complete (total removal of fundus and cervix of the organ) removal. The high rates of these surgeries have led to the thought that many gynecologists in India operate the uterus without a major reason.
Reasons for hysterectomy:
Pain bleeding and other disorder of the uterine fibroids
Uterus slipping out of the normal position towards the vaginal canal known as uterine prolapse
Uterine, cervical or ovarian cancer
Chronic pain in the pelvis
Abnormality in vaginal bleeding
Failure in all other non-cancerous treatment
Thickened uterus or adenomyosis
The radiological procedure also known as uterosalpingography is for investing the shape, and patency of the uterine cavity and fallopian tube. Injected radio-opaque material into the cervical canal usually results in intensified image when fluoroscopy is done. A normal patient will show that the uterine cavity is filled with injected material. The material is also bilaterally filled in the fallopian tube. If cases of tubal rupture, material spillage, and peritoneal cavity are valid, then it is better observed with the radiological test.
The procedure can be referred to as a type of x-ray that looks into the womb of the woman. A contrast material is used for the detection so that the doctors can get a clear image of the fallopian tube and the uterus. The fallopian structure is called fluoroscopy that is ideal for the creation of video images rather than a still picture.
Any blockage in the fallopian tube can be observed through the test along with analyzing the disorders in the uterus.
The surgical procedure allows the gynecology specialists to have a look at the internal situation of the uterus. Diagnosis of the abnormal uterine bleeding is the prime reason for performing the procedure. Doctors use a thin and lighted tube known as hysteroscope for diagnosing and operating the ailing woman.
The procedure is performed by veteran gynecologists in India. It is to confirm any disorder in the uterine region. The x-ray dye test checks the women reproductive system in the pathology or doctor’s office. The test can also be suggested after other methods are unable to confirm particular physical condition such as uterine cancer or ovarian cancer.
Besides, the procedure follows to keep an eye of the patient’s condition before or after laparoscopy and Dilation and Curettage. Gynecologists insert a refined camera with a thin tube known as endoscope through a created incision into the abdominal region for getting the view of the outer situation of the patient’s situation.
The operative procedure rectifies the abnormality of any incident in the uterine cycle. The diagnosis of the disorder in the organ can be rectified at the same time to avoid any further surgical procedures. For a successful surgery, small instruments are used along with the endoscope to avoid any possibility to injure the internal area.
The surgical method of myomectomy removes any harmful fibroids and restricting any critical condition of the uterus. Patients with symptoms of fibroids may wish for children in the near future and thus need to have a myomectomy first.
As fibroids are able to re-grow in the body, the effective procedure of myomectomy may have to be performed more than once. Women who are still young are more likely to relapse with the problem than those who are nearing towards menopause.
The surgical procedure can be performed in various ways. The size, location and a number of the fibroids can affect the eligibility for laparoscopic or hysteroscopic myomectomy.
The operational procedure is for removing portions of the ovary or the entire organ from the reproductive system for resisting storage and release of eggs in the patient’s body. Sometimes, oophorectomy is needed as a part of hysterectomy so that the gynecology specialists can address the pelvic ovarian disease in the patient’s body. In many cases, ovarian hormones cause breast cancer or worsen severe endometriosis.
Reason for the procedure
10% of women suffer from a serious condition that needs oophorectomy in addition to hysterectomy. The diseases that need the special attention include:
Abnormal hereditary genes risk the development of ovarian cancer before the age of 70. If the patient’s mother or sister develops this type of cancer, they should be carrying BRCA gene and should consider removing the ovaries before getting any misuse. But always consider that you cannot conceive after getting your ovaries removed. Other than reducing the risk of ovarian cancer, the surgery also reduces the risk of breast cancer in the patients due to BRCA1 and BRCA2 genes.
Any suspected disease regarding the ovaries can lead to extensive tests and operation if needed. Premenopausal women are generally advised to remove a single ovary during the removal of the uterus for avoiding any further complications. But, removals of both the ovaries are not suggested until and unless any vigorous disease is found.
The surgery close to a woman’s fallopian tube is known as Tubal ligation. The tube connects the uterus with the ovaries and thus woman who undergoes this surgery have no longer the prospect of being pregnant. The term sterile suggests to these type of post-surgical cases.
A hospital or an outpatient clinic is ideal for performing these type of surgeries on any woman provided that she gets general anesthesia. If you get a spinal anesthesia or a medicine to make you sleepy, you may not feel the pain. The surgical procedure does not take more than half an hour to get completed.
One or two incisions around the belly button are a must for inserting the tools. For expanding the belly for helping the doctors to view the inner positions, medically approved gas is pumped in.
Endoscope i.e. a small camera is inserted through the small holes with a laparoscope and doctors can see the abdominal region in the screen system in the operation theater.
The tubes are either cauterized (burned shut) or clamped off with a tiny ring or clip (band)
The procedure is quite common with women who have just undergone a delivery procedure. Te caesarean section is quite suitable for performing the tubal ligation in a mother’s body.
In the alternative method, a coil is placed in the fallopian tubes at the exact point where they connect the two organs. As the procedure is done through the cervix, it does not need any additional cuts in the body. As a result, the office setting and general anesthesia are enough for the gynecology specialist to perform such surgery.