Georges Memorial Medical Centre boasts of a gynecology clinic which provides a broad range of expertise to meet the needs of women with complex conditions. Our experienced gynecologists provide minimally invasive surgery for some conditions, which has decreased the length of stay in Hospital and length of the patient’s recovery period.
Our Gynaecologist provide specialist medical as well as surgical management of all types of gynaecological problems i.e. Menstrual abnormalities, prolapse, fibroids and other tumours of the uterus and ovaries, and treatment of the infertile couple. Special expertise is available for Gynaecological Endocrinology problems. Menopausal women are cared for in our menopause clinics and facilities exist for Hormone Replacement Therapy where required.
Some of our Elective Gynaecology services include;
- Diagnostic and Operative Laparoscopy
- Diagnostic and Operative Hysteroscopy
- Ultrasound scan
- Open Surgery
Ovarian Cyst Surgery
Ovarian cysts are sacs filled with fluid or a semisolid material that develop on or within the ovary. These cysts are common in women and most ovarian cysts are not cancerous (benign).
Typically, ovarian cysts are functional (not disease related) and disappear on their own. During the days preceding ovulation, a follicle grows. At the time of expected ovulation, the follicle fails to rupture and release an egg.
Ovarian cysts that do not appear to be functional may require surgical removal by laparoscopy or exploratory laparotomy. Surgical removal is often necessary if a cyst is revealed that is larger than 6 centimeters or that persists for longer than 6 weeks.
If surgery is needed, often the cyst can be removed without removing the ovary. Even if one ovary has to be removed, it is still possible to become pregnant as long as one ovary remains.
The older you are the more likely you are to have the cyst removed because the risk of cancer increases with age. If you have a laparoscopic procedure to remove the cyst, your recovery time will be shorter and there will be less scarring. If you have a laparoscopic procedure, you may even have the procedure done as an outpatient or spend only a day in the hospital. If you need an open surgery in which there is a larger incision you can expect to stay in the hospital longer.
Preparation before the procedure:
- You will be asked questions about your health history and allergies you may have to medication.
- You will have your blood drawn and tested. You may have a variety of other tests, too. These can include CT scan, ultrasound, chest x-ray or electrocardiogram.
- Your vital signs including your blood pressure, temperature and respiration will be taken
- You will need to remove glasses, contact lenses, dentures, hearing aids, jewelry and hair ornaments
- An anesthesthetist will talk to you about anesthesthetic procedures and options.
How is it done?
An intravenous canula (IV) will be inserted in your arm to give you fluids and medication. Your vital signs will be monitored throughout the procedure.
If a laparoscopic procedure is being done, the surgeon will use a laparoscope, a slender illuminated optical or fiber-optic instrument that is inserted through a very small incision in the abdominal wall. The surgeon will either remove just the cyst or the entire ovary. Fluid may be drained from the cyst and tissue may be sent to the lab for examination.
Depending on the situation, such as the presence of cancer, both ovaries may need to be removed.
If you are having an open procedure an incision will be made in your abdomen. Your abdomen will be opened and the cyst will be removed.
What equipment is used?
A laparoscope may be used. Other tools such as microscissors, a laser or an electrocautery may be used as well.
How will it feel?
You will not feel any pain while the cyst is being removed. You may feel some soreness in your abdomen if you have a laparoscopic procedure. There will be more discomfort with an open procedure. Pain medication will be given to help with this.
What are the risks and benefits?
- Anesthesthetic risks include allergic reactions to medication and problems breathing.
- Surgical risks always include bleeding and infection
- The ovarian cyst may recur
- There may be the possibility that a planned laparoscopic procedure shifts to an open procedure during surgery
Who interpretes results and how will I get them?
We will let you and your family know how it went. A report will be prepared for the physician who referred you for the surgery.
After the procedure
You will spend one to three hours in the surgery recovery area. After you are discharged you should avoid strenuous exercise or weight lifting for two weeks if you had a laparoscopic procedure and six weeks if you had open surgery.
For the first several days you should move and keep your legs raised to avoid getting a blood clot.
We will let you know when it is safe to have sexual activity or to use tampons.
What are fibroids?
Uterine fibroids are tumors or growths, made up of muscle cells and other tissues that grow within the wall of the uterus (or womb). Although fibroids are sometimes called tumors, they are almost always benign (not cancerous). The medical term for fibroids is uterine leiomyomata (you-ter-in lie-oh-my-oh-mah-tah). Fibroids can grow as a single growth or in clusters (or groups). Their size can vary from small, like an apple seed (or less than one inch), to even larger than a grapefruit, or eight inches across or more.
Why should women know about fibroids?
Uterine fibroids are the most common, benign tumors in women of childbearing age, but no one knows exactly what causes them. They can be frustrating to live with when they cause symptoms. Not all women with fibroids have symptoms, but some have pain and heavy menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination.
What are the symptoms of fibroids?
Most fibroids do not cause any symptoms, but some women with fibroids can have:
- heavy bleeding or painful periods
- bleeding between periods
- feeling of fullness in the pelvic area (lower abdomen)
- urinating often
- pain during sex
- lower back pain
- reproductive problems, such as infertility, having more than one miscarriage, or having early onset of labor during pregnancy
Where can fibroids grow?
Doctors put fibroids into three groups based on where they grow, such as just underneath the lining of the uterus, in between the muscles of the uterus, or on the outside of the uterus. Most fibroids grow within the wall of the uterus. Some fibroids grow on stalks (called peduncles) that grow out from the surface of the uterus, or into the cavity of the uterus.
What causes fibroids?
No one knows for sure what causes fibroids. Researchers have some theories, but most likely, fibroids are the result of many factors interacting with each other. These factors could be hormonal (affected by estrogen levels), genetic (running in families), environmental, or a combination of all three. Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink. For the most part, fibroids stop growing or shrink after menopause. But, this is not true for all women with fibroids.
Can fibroids turn into cancer?
Fibroids are almost always benign, or not cancerous, and they rarely turn into cancer (less than 0.1 percent of cases). Having fibroids does not increase a woman's chances of getting cancer of the uterus.
How do I know for sure that I have fibroids?
A Doctor may find that you have fibroids when you see him for a regular pelvic examination. Often, a doctor will describe how small or how large the fibroids are by comparing their size, to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 8 weeks pregnant.
Your doctor can do imaging tests, or tests that create a "picture" of the inside of your body without surgery, in order to confirm that you have fibroids. These tests might include:
- ultrasound - uses sounds waves to produce the picture.
- magnetic resonance imaging or MRI - uses magnets and radio waves to produce the picture.
- CAT scan or CT - makes many pictures of the body from different angles to provide a more complete image.
What is the treatment for fibroids?
Talk with the doctor about the best way to treat your fibroids. He will consider a number of things before helping you choose a treatment. Some of these things include:
- whether or not you are having symptoms from the fibroids
- if you might want to become pregnant
- the size of the fibroids
- the location of the fibroids
- your age
If you have fibroids, but do not have any symptoms, you may not need any treatment.
If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options:
- Myomectomy - Surgery to remove fibroids without taking out the healthy tissue of the uterus. There are many ways a surgeon can perform this procedure. It can be open surgery (with an abdominal incision) or by Keyhole surgery. The type, size, and location of the fibroids will determine what type of procedure will be done. Talk with your doctor about the different types of this surgery.
- Hysterectomy - Surgery to remove the uterus. This surgery is the only sure way to cure uterine fibroids. This surgery is used when a woman's fibroids are large, or if she has heavy bleeding, and is either near or past menopause and does not want anymore children.