Most women will develop ovarian cysts during their lifetime and the majority of them will be physiological and hence resolve spontaneously. Despite that there are some cysts that will not disappear if not treated ( ie endometriomas, dermoids etc). Moreover in postmenopausal women cysts may have suspicious features and hence both these categories require surgery to remove the cyst. Most cysts today can be removed via key hole surgery “laparoscopy”. Benefits of laparoscopy include minimal hospital stay, fast return to everyday activities and a better cosmetic result.
The main advantages of laparoscopic surgery is that it avoids large open wounds or incisions hence decreasing blood loss, pain and discomfort. Also, during laparoscopic surgery, the instruments used are finer and therefore less likely to cause tissue trauma, and less analgesia used.
Below you can find some of the relevant procedures.
Fibroids are almost always benign growth’s arising fro the muscle layer of the uterus. Depending on their location and size they can cause different symptoms like pain, heavy or irregular menstrual bleeding, infertility or pressure symptoms. For fibroids that are not suitable fro hysteroscopic resection laparoscopy or laparotomy is necessary in order to remove them.
Endometriosis refers to the presence of endometrial tissue outside the endometrial cavity. It is present in approximately 10% of women globally . Typically endometriosis is associated with painful periods, dyspaurenia ( painful sex ) and infertility. If medical management of endometriosis has failed or if the woman wants a definitive answer regarding her symptoms then laparoscopy is required for diagnosis and treatment.
This means the removal of the ovaries and or fallopian tubes for a variety of reasons. This can also be achieved in the vast majority of cases via laparoscopy.
Previous abdominal surgery, chlamydial infections etc can cause the formation of intraabdominal adhesions. In most cases these are asymptomatic but in some cases they can cause symptoms like localised pain. In these cases adhesions can be treated by laparoscopic adhesiolysis.
Total Hysterectomy means the surgical removal of the uterus, cervix and both fallopian tubes and ovaries. It may be required for the management of fibroids, resistant pelvic pain and/or mennorhagia, severe premenstrual tension syndrome, endometrial hyperplasia with atypia, endometrial cancer and many others. It is considered major gynaecological surgery but with the use of laparoscopy it can be achieved in less than an hour and with minimal scaring.
Ectopic pregnancy is defined as a pregnancy that implants outside the uterus and most commonly in the fallopian tube. It is a potentially life threatening condition that occurs in approximately 1% of pregnancies. With the correct and timely use of ultrasonography the vast majority of ectopic pregnancies is diagnosed and treated with no problems. Treatment can be conservative, medical or surgical
Pelvic pain is a common condition, if its occasional and sporadic it does not cause significant problems but when its chronic it can have a huge impact on a woman’s quality of life. Pelvic pain has many different causes and some of them are of gynaecological origin. If a diagnosis of resistant chronic pain is made then laparoscopy may be needed for diagnosis and treatment.
Infertility affects approximately 1:10 couples globally. Laparoscopy is not considered a routine investigation but in some cases may be necessary for diagnosis and treatment ( for example a combination of tubal patency checking and adhesiolysis and or treatment of endometriosis).
There are many different options available to women today in terms of contraception. Most of these are non invasive and reversible. Tubal ligation or clip sterilisation is considered a safe but permanent form of contraception. Due to that it should be considered only after mature thought and only for women who have completed their family.
Women after the menopause ( and sometimes after childbirth) often complain about incontinence symptoms or prolapse. These if mild can be managed conservatively but in some cases surgical intervention by a urogynaecologist is warranted.