Gynaecology is a specialised area of medicine encompassing the female reproductive system that consists of – the vagina, ovaries, uterus and even breasts. Most gynaecologists are also experts in obstetrics, an area of medicine that involves the study of childbirth and pregnancy.
We specialise in a range of conditions from cervical cancer to simple screenings and infections. There are a variety of procedures that we are happy to perform to ease your discomfort and improve your self-esteem, especially as surgery for aesthetic reasons aren’t supported by the NHS.
Here at North Downs Hospital in Surrey we are experts in gynaecology and the respective diagnostic and treatment processes. We offer a range of services from major surgery to non-surgical alternatives best suited to your individual treatment plan.
Gynaecological Surgeries Available
Anterior Repair for an Anterior Vaginal Wall Prolapse
An anterior repair is used when an anterior prolapse occurs- when the bladder protrudes into the front wall of the vagina.
Symptoms of an anterior prolapse include applied weight on the pelvis and vagina, pain during sexual intercourse, recurrent infections of the bladder and a feeling of a full bladder after urination. In major cases of the condition the bladder may bulge through the vaginal opening causing great discomfort.
Non-surgical solutions entail using a vaginal pessary for support or partaking in pelvic-floor exercises.
The surgery involves making an incision on the anterior wall of the vagina allowing surgeons to reposition the urethra and bladder into their original positions. Supporting tissues will also be stitched to provide additional support to the organs. The procedure is normally completed under general anaesthetic and lasts for half an hour.
Endometriosis Treatment (Endometrial Ablation)
Endometriosis is a condition in which cells that make up the endometrial lining migrate to other areas of the body. Like the cells within the womb they breakdown every month – in the womb this causes a period and the blood created is expelled. However, cells located elsewhere do not have a place to be released.
This condition is particularly painful and many women suffer from it chronically. It causes heavy periods, fertility problems and fatigue.
An endometrial ablation improves a woman’s pain and in most cases lightens her periods. It involves the use of microwave energy to remove the lining of the womb. In general it takes around 20 minutes and is performed under local or general anaesthetic.
Hysterectomy – Abdominal
A hysterectomy is an operation that involves the removal of the womb. Once the uterus (womb) has been removed you will no longer be fertile.
Hysterectomies are usually performed to treat heavy periods, tumours or cancer of the ovaries, uterus and cervix.
The operation involves the gynaecologist making an incision on your abdomen and at the top of your vagina. In most cases your uterus will be removed along with your cervix. An abdominal hysterectomy is normally performed when the uterus is large, for the treatment of endometriosis and when cancer affecting the cervix, ovaries and uterus is likely.
The procedure is normally carried out under general anaesthetic and normally takes around an hour.
Hysterectomy – Vaginal
A vaginal hysterectomy in some cases may involve the removal of the ovaries alongside the removal of the uterus and cervix.
The vaginal hysterectomy is not used when there is an indication of cancer being present. It has a faster healing time then an abdominal hysterectomy but poses a greater risk to surrounding organs.
The procedure is usually exercised in the removal of fibroids and when endometriosis is not present.
The surgery normally lasts for 45 minutes using general anaesthetic. It involves an incision on the top of the cervix and the beginning of the vagina. The operation is entirely done through the vagina so no abdominal cuts are made.
A hysteroscopy allow surgeons to gain an insight of the inside of the uterus via inspection. The procedure involves the insertion of a hysteroscope through the cervix into the womb. Gas or fluid can be used to inflate the womb to allow for a better assessment to take place.
Normally a hysteroscopy takes place for diagnostic purposes e.g. if you are suffering from heavy periods, unusual vaginal discharge or fertility problems. However, a hysteroscopy can also be used to treat irregular growths inside the womb such as non-cancerous growths (fibroids) or polyps. It can also be used to treat scar tissue.
The procedure normally lasts from 10-30 minutes provisional to the amount of tissue or diagnosis that needs to be done.
Laparoscopy & Dye Test
A laparoscopy and dye test is used as an exploratory procedure in order to examine the cause of infertility.
The surgeon will make an incision on the top of your abdomen and then inflate it with carbon dioxide gas to improve the surgeon’s view. A laparoscope (small tube with a camera) is then inserted and the uterus and surrounding organs are assessed.
A blue dye will then be injected into the uterus in order to pass through the fallopian tubes – if there is an issue the dye will start to pool.
The operation is normally performed under general anaesthetic and takes around 15 minutes.
Ovarian Cyst Removal (Laparotomy & Laparoscopy)
An ovarian cyst is a sac filled with liquid that forms on an ovary. They are particularly common and normally do not cause any discomfort – in most cases they are harmless.
The cysts can start to prove painful if they rupture, prevent blood from entering the ovaries or are particularly big. These then lead to the following symptoms:
- Stomach bloating
- Infertility (difficulty in conceiving)
- Pain during sexual intercourse
- Sharp pelvic pain
- A constant need to pass urine
Most cysts can be treated surgically via laparoscopy - a type of minimally invasive surgery where a laparoscope is inserted (small microscope) into your abdomen in order to inspect and remove the cyst. This type of procedure leads to less scarring and a quicker recovery time.
Another way to treat an ovarian cyst is through a laparotomy, a surgery used for diagnosis or preparation for major surgery. The surgeon makes an incision into the abdomen and inspects the cyst – a biopsy or the entire cyst may be removed and then sent to a lab for analysis. This procedure is normally used if the cyst is particularly large.
Removal of Ovaries (Oophorectomy)
An oophorectomy is a surgery that involves the removal of the ovaries. The ovaries are a part of the reproductive system that releases eggs for fertilisation and produces female sex hormones.
The removal of the ovaries may be necessary in the treatment or prevention of ovarian cancer. A prophylactic oophorectomy is an operation to remove the ovaries in healthy women in the aid to prevent cancer if they are in the high-risk category.
This procedure for benign reasons is normally performed via laparoscopy and in complex cases is performed through a laparotomy.
There are many types of oophorectomy, all which are dependent on the severity of your condition, in some cases a bilateral oophorectomy is needed (the full removal of both ovaries) or only a portion of your ovary may be removed. You may also require the removal of your fallopian tubes.
The procedure is normally done under general anaesthetic and is often performed through the same incisions as an abdominal hysterectomy.
Female Laparoscopic Sterilisation
Female sterilisation is a form of contraception. Contraception prevents a woman from becoming pregnant by either preventing the sperm reaching the egg or preventing egg production.
It is a permanent form of contraception and can be extremely difficult to reverse, it is normally recommended for women who do not want children or do not want any more children.
The surgeon will insert a laparoscope into your abdomen in order to inspect your reproductive organs. The most common type of sterilisation involves the clipping of the fallopian tubes. In certain situations the surgeon may insert a piece of metal that causes the body to form scar tissue over it – causing a blockage to the fallopian tube.
The procedure takes approximately 20 minutes and is usually performed under general anaesthetic.
Hormone Replacement Treatment of Menopause (HRT Therapy)
Menopause is officially classified as the end of menstruation, where eggs stop becoming released. It is caused by an alteration of the body’s sex hormones - oestrogen starts to decrease which then prevents ovulation from taking place. (The production of an egg each month by the ovaries)
Symptoms of the menopause include:
- Emotional changes – such as mood swings
- Dryness of the vagina
- Hot flushes – which can include blushing, sweating and palpitations.
- Perfuse Sweating at Night
The aim of hormone replacement therapy (HRT) is to balance female hormone levels preventing the symptoms of menopause from occurring. It restores the oestrogen and level in your body, it is usually taken with progesterone as taking oestrogen on its own may increase the risk of contracting endometrial cancer. However, if you have had a hysterectomy, in most cases, it is safe to take on its own.
HRT can be taken in a variety of forms through tablets, implants placed into your skin under local anaesthetic and via gels or patches.
Treatment for Miscarriage (ERPC or SMM)
An ERPC is formally known as an Evacuation of Retained Products of Conception, which can also be known as a surgical management of miscarriage (SMM). A miscarriage is classed as a loss of pregnancy during the first 23 weeks.
Here at North Downs Hospital we provide full support both emotionally and physically when it comes to treating your miscarriage and are on hand to guide you through the treatment process.
There are a variety of options available to you if you have suffered from a miscarriage including both surgical and non-surgical solutions for the removal of pregnancy tissue.
It is normally recommended for you to wait 7-14 days for the tissue to pass naturally. However, if you are suffering from complications (excessive bleeding, potential infection) or feel more comfortable with a surgical solution an operation is available to you.
The operation is normally completed under local or general anaesthetic but the choice should be offered to you if you qualify for both.
You can also take medication if the tissue has not passed naturally and you do not like the idea of surgery.
At North Downs Hospital we offer you the best in terms of medical advice and aftercare for full emotional and physical support through your miscarriage.
Urinary Incontinence Treatment – Tension Free Vaginal Tape Insertion (TVT)
Stress incontinence is when urine involuntarily passes from your bladder when you place strain or pressure on it. Activities such as exercise, coughing and laughing have been known to trigger it.
Major causes of stress incontinence are weaknesses in the pelvic-floor muscles and the urinary sphincter.
The procedure involves the use of a synthetic mesh that acts as “tape”. During the surgery the tape will be passed around the urethra forming a sling support. Two small cuts are made to your abdomen and vagina to allow surgeons to pass the mesh through.
The tension free vaginal tape insertion normally is performed under general anaesthetic and lasts for an hour.
Here at North Downs Hospital we pride ourselves in our specialist gynaecologists and their expertise. We offer a range of non-surgical and surgical solutions to long-standing problems and conditions. Our experts are on hand to discuss your queries and to organise an effective treatment plan.