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What is Endometriosis?

Endometriosis?
Endometriosis?

What is Endometriosis?

Endometriosis is a disorder in which the endometrium (the tissue that lines the inside of the uterus or womb) develops outside of the uterus or womb.
Endometriosis most commonly affects the lower abdomen and pelvis, however, it can appear anywhere in the body.
As a result, the normal tissue surrounding the endometriosis implants becomes irritated, swells, and has scars.
During their reproductive years, almost 10% of women suffer from this illness.

Most common symptoms are:

  • Menstrual cramps that are too severe.
  • Menstrual flow that is abnormal or excessive.
  • Urination is painful during menstruation.
  • Intercourse discomfort.
  • Menstrual cramps cause painful bowel motions.

It’s important to note that a woman’s pain level isn’t always proportionate to the severity of her illness.
Some women with severe endometriosis experience no symptoms, while others with a milder form of the disease may experience significant pain or other symptoms.

Fertility and Endometriosis

Endometriosis affects between 20 and 40% of infertile women. Endometriosis is hypothesized to disrupt fertility in two ways: first, by distorting the fallopian tubes, preventing them from picking up the egg after ovulation, and second, by causing inflammation that can affect the function of the ovary, egg, fallopian tubes, or uterus. For additional care and support, consult a fertility professional.

Endometriosis risk factors

These variables greatly enhance your chances of developing this condition:

  • Family tree.
  • Late pregnancy.
  • Women who have an uncommon uterus.
  • There are no kids.
  • Menstrual cycles that continue for more than seven days.
  • Menstrual cycles are short.

Diagnosis of Endometriosis

If you are experiencing painful periods, do not be afraid to seek medical attention.
A gynecologist will review your medical history, perform a pelvic examination, and order any necessary, additional tests. Here are a few basic techniques to relieve endometriosis pain:

  • Rest, relax, and meditate.
  • Take warm baths.
  • Prevent constipation.
  • Get frequent exercise.
  • Apply a hot water bottle or a heating pad to your abdomen.
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Laparoscopic Myomectomy

Laparoscopic Myomectomy
Laparoscopic Myomectomy

Laparoscopic Myomectomy

Laparoscopic Myomectomy is the surgical removal of uterine fibroids while leaving the uterus intact. It is the primary treatment option for patients who still want to conceive or prefer not to have a hysterectomy through a minimally invasive procedure in which small incisions are made in the abdomen over the fibroid’s location. A camera and surgical instruments are inserted through these incisions to visualize and act on the uterus.

The symptoms of uterine fibroids differ depending on their size, location in the uterus, and type. They are most commonly found in menstruating women between the ages of 30 and 50.
There is no link between birth control pills or hormone replacement therapy used to treat menopause and uterine fibroids. When compared to women with normal blood pressure, certain medical conditions, such as high blood pressure, may increase the risk of uterine fibroids by 24%.

Symptoms

The most common symptom of uterine fibroids is 

  • A heavier-than-normal period that lasts longer than usual.
  • Even if you are menstruating, you may be palpable or even visible if it is large, resembling an early pregnancy.
  • You may experience urinary incontinence or frequent urination, particularly when lying flat.
  • You may be constipated or feel abdominal pressure.
  • Fullness in the abdomen caused by a rapidly growing fibroid that may become malignant (Cancerous)
  • Infertility.
  • Easy miscarriage.

Diagnosis

  • External and internal physical examination.
  • Transvaginal or abdominal ultrasound.
  • Magnetic resonance imaging (MRI) or computed tomography (CT) (MRI).
  • Hysteroscopy.
  • Laparoscopy.
  • Hysterosalpingography.

Treatment

  • If the fibroid is small, the doctor may recommend monitoring it or treating it with medication, followed by an ultrasound, and assessing any vaginal bleeding associated with the growth. Your doctor may also perform an anemia test on you. Your obstetrician/gynecologist (OB/GYN) will most likely see you every three to six months.
  • If the fibroid causes excessive bleeding, medication to reduce blood loss may be prescribed.
  • Myomectomy.
  • The uterus is removed during a hysterectomy (only in severe cases where the patient no longer wishes to have children).
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What is Urogynecology ?

Urogynecology service
Urogynecology service

What is Urogynecology ?

Urogynecology is a branch of gynecology that deals with the diagnosis and treatment of conditions related to the female pelvic organs, including the bladder, uterus, and rectum. This field of medicine focuses on the evaluation and management of pelvic floor disorders, such as urinary incontinence, pelvic organ prolapse, and fecal incontinence.

Urinary incontinence is a common problem that affects millions of women worldwide. It is characterized by the involuntary leakage of urine, which can occur during physical activities such as coughing, sneezing, or exercising. This condition can be caused by a variety of factors, including pregnancy, childbirth, menopause, and aging. Urogynecologists specialize in the diagnosis and treatment of urinary incontinence, offering a range of treatment options such as medication, pelvic floor exercises, and surgery.

Pelvic organ prolapse is another condition that is commonly treated by urogynecologists. It occurs when the pelvic organs, such as the bladder, uterus, or rectum, descend into the vaginal canal. This can cause discomfort, pain, and difficulty with urination or bowel movements. Urogynecologists can diagnose pelvic organ prolapse through a physical examination and imaging tests. Treatment options for pelvic organ prolapse may include pelvic floor exercises, pessaries, or surgery.

Fecal incontinence is a condition that involves the involuntary leakage of fecal matter. This can be caused by a variety of factors, including childbirth, nerve damage, or inflammatory bowel disease. Urogynecologists can diagnose and treat fecal incontinence, offering a range of treatment options such as medication, biofeedback, or surgery.

Urogynecologists also specialize in the treatment of other pelvic floor disorders, such as pelvic pain and sexual dysfunction.
They work closely with other healthcare professionals, such as physical therapists, to provide comprehensive care for their patients.

In conclusion, urogynecology is a subspecialty of gynecology that deals with the diagnosis and treatment of conditions related to the female pelvic organs.
Urogynecologists offer a range of treatment options for conditions such as urinary incontinence, pelvic organ prolapse, and fecal incontinence, and work closely with other healthcare professionals to provide comprehensive care for their patients. If you are experiencing symptoms related to a pelvic floor disorder, it is important to consult with a urogynecologist to receive a proper diagnosis and treatment plan.

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Cosmetic Gynecology Surgery(Female Cosmetic Genital Surgery)

Female Cosmetic Genital Surgery
Female Cosmetic Genital Surgery

Cosmetic Gynecology Surgery(Female Cosmetic Genital Surgery)

Cosmetic Gynecology-Changing Your Perception of a Beautiful Person

With increased awareness of female genitalia, cosmetic gynecology has emerged as a new subspecialty of gynecology, significantly reshaping the perception of an attractive personality.

Cosmetic gynecology, according to the gynecologists, refers to the enhancement and correction of genital structures such as the labia minora, labia majora, mons pubis, clitoral head, vulva, vagina, perineum, hymen, and abdomen.

A woman’s internal and external genital structures may suffer as a result of aging, childbearing, or hormonal imbalance, which can have an impact on her appearance and sexual function. However, the advent of cosmetic gynecology has made it possible for women to not only enjoy their sexual activities more, but also rejuvenate their genitals for a more aesthetically pleasing appearance.

Gynecological Cosmetic Procedures

According to some studies, the attractive appearance of a woman’s genitalia is the key to her self-confidence and sexuality. If you want to make a beautiful change in your life, you should go to a gynecology clinic, where skilled and experienced gynecologists are known to provide a wide range of cosmetic treatments with the utmost care and attention. Among the best cosmetic gynecological procedures are

  1. Ovarian Rejuvenation Therapy/Platelet-Rich Plasma (PRP)
    Ovarian rejuvenation therapy uses a patient’s own PRP (Platelet-Rich Plasma) to improve ovarian reserve quality while treating perimenopause and infertility.
    PRP basically infuses the ovaries with growth factors and other components that speed up tissue healing, thereby improving ovarian function.
    Ovarian rejuvenation is the process of stimulating the ovaries to induce follicle growth and the production of eggs for fertilization.
  2. Rejuvenation of the Vaginal Canal (Non-surgical)
    Vaginal rejuvenation is a non-surgical procedure that uses radio-frequency or CO2 lasers to tighten lax lips while also treating mild urinary incontinence and vaginal dryness.
  3. Reconstruction of the Vaginal Canal (Surgical)
    Vaginal reconstruction is a surgical procedure that tightens up the vagina that has become loose due to a variety of factors such as age or childbearing. This treatment has the ability to repair or tighten vaginal tissues.
  4. G spot Augmentation
    G spot augmentation or G shot can be performed to tighten its tissues and enhance sexual pleasure because the G spot is well known for its erogenous function.
  5. Labiaplasty
    Labiaplasty is a popular surgical procedure that improves the appearance of the vaginal lips (labia minora and labia majora) by changing their size and shape.

You can undergo any of the cosmetic procedures mentioned above to reshape your personality and boost your self-confidence.

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Gynec Laparoscopic Surgery(minimally invasive surgery (MIS))

gynec laparoscopic surgery
gynec laparoscopic surgery

Gynec Laparoscopic Surgery(minimally invasive surgery (MIS))

Laparoscopic gynecologic surgery is an alternative to open surgery. It looks inside your pelvic area with a laparoscope. Open surgery generally requires a large incision.

A laparoscope is a small, illuminated telescope. It allows your doctor to see inside your body. Endometriosis and fibroids can be detected using diagnostic laparoscopy. It can also be used as a form of treatment. Your doctor can perform a variety of surgeries using miniaturized instruments. These are a few examples:

  1. Removal of an ovarian cyst
  2. Tubal ligation, a surgical contraception method
  3. Hysterectomy

In general, laparoscopy heals faster than open surgery. It also results in smaller scars. This procedure may be performed by a gynecologist, general surgeon, or another type of specialist.

The Benefits of Gynecologic Laparoscopy
Laparoscopy can be used for both diagnosis and treatment. Sometimes a diagnostic procedure leads to treatment.

Some of the reasons for diagnostic laparoscopy include:

  • Unidentified pelvic pain
  • A history of pelvic infection
  • Unexplained infertility

Laparoscopy may be used to diagnose the following conditions:

  • Uterine fibroids
  • Endometriosis
  • Cysts or tumors in the ovaries
  • Infertility
  • Inflammation of the pelvis
  • Cancers of the reproductive system

How laparoscopic surgery is performed?

Laparoscopy is almost always performed while under general anesthesia. This means that you will be unconscious during the procedure. You may, however, be able to return home the same day.
Once you’ve fallen asleep, a small tube called a catheter will be inserted into your bladder to collect your urine. A small needle will be used to inject carbon dioxide gas into your abdomen. The gas keeps the abdominal wall away from your organs, reducing the possibility of injury.
Your surgeon will insert the laparoscope, which transmits images to a screen, through a small cut in your navel. This allows your doctor to see your organs clearly.
What happens next is determined by the procedure. Your doctor may examine you and then make a diagnosis. Other incisions will be made if surgery is required. These holes will be used to insert instruments. The surgery is then carried out with the laparoscope as a guide.
All instruments are removed once the procedure is completed. Stitches are used to close incisions, and you are then bandaged and sent to recovery.

Recovery after laparoscopy

After the procedure, nurses will check your vital signs. You’ll be in the recovery room until the anesthesia wears off. You will not be allowed to leave until you can urinate on your own. The urinary difficulty is a possible side effect of catheter use.

The amount of time it takes to recover varies. It is determined by the procedure used. You may be able to leave the hospital a few hours after surgery. You may also be required to spend one or more nights in the hospital.

Your belly button may be tender after surgery. Your stomach may have bruises. The gas inside you can cause pain in your chest, middle, and shoulders. There’s also a chance you’ll feel sick the rest of the day. Before you leave, your doctor will give you instructions on how to deal with any potential side effects. To prevent infection, your doctor may prescribe pain relievers or antibiotics.

Depending on the procedure, you may be advised to rest for several days or weeks. Returning to normal activities may take a month or more.
Serious complications from laparoscopy are uncommon. You should, however, contact your doctor if you have:

  • Severe abdominal pain
  • Prolonged nausea and vomiting
  • Fever of 101°F or higher
  • Pus or significant bleeding at the site of your incision
  • Pain during urination or bowel movements

The outcomes of these procedures are usually positive. This technology enables the surgeon to easily see and diagnose a wide range of problems. In addition, recovery time is reduced when compared to open surgery.

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Menopause(Climacteric)

Menopause(Climacteric)
Menopause(Climacteric)

Menopause(Climacteric)

Menopause, also known as the climacteric, is the period in a woman’s life when her menstrual periods stop and she is no longer able to bear children.
Menopause is typically experienced between the ages of 47 and 54. Menopause is commonly defined by medical professionals as the absence of menstrual bleeding for a year.
It can also be defined by a decrease in ovary hormone production.

Menopause is not considered to have occurred in those who have had their uterus removed but still have functioning ovaries.
A woman’s periods typically become irregular in the years preceding menopause, which means that periods may be longer or shorter in duration, or the amount of flow may be lighter or heavier.
During this time, women frequently experience hot flashes, which can last anywhere from 30 seconds to ten minutes and can be accompanied by shivering, sweating, and skin reddening.

Other symptoms may include difficulty sleeping and mood swings. The severity of symptoms varies from woman to woman.
Menopause is considered “early menopause” when it occurs before the age of 45, and “premature ovarian insufficiency” when occurs before the age of 40.
Menopause is typically a natural transition.

Other causes include ovary removal surgery and certain types of chemotherapy.
Menopause occurs physiologically as a result of a decrease in the ovaries’ production of the hormones estrogen and progesterone.
Menopause can be confirmed by measuring hormone levels in the blood or urine, which is usually not necessary.
Menopause is the inverse of menarche, which is when a girl’s period begins.

The primary indications for menopause treatment are symptoms and bone loss prevention. Mild symptoms may benefit from treatment.
When it comes to hot flashes, it’s common advice to avoid smoking, caffeine, and alcohol.
Menopausal hormone therapy is the most effective treatment for menopausal symptoms (MHT).

When should you see a doctor?
Maintain regular doctor visits for preventive health care and any medical concerns. Maintain these appointments both during and after menopause.
As you get older, preventive health care may include recommended health screening tests like colonoscopy, mammography, and triglyceride screening.
Your doctor may also recommend additional tests and exams, such as thyroid testing if your history suggests it, as well as breast and pelvic exams.
If you experience bleeding after menopause, always seek medical attention.

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Ovarian Cysts During Pregnancy

Ovarian cysts during pregnancy
Ovarian cysts during pregnancy

Ovarian Cysts During Pregnancy

A pregnancy ovarian cyst is usually not a reason to be worried. Most ovarian cysts are painless and disappear on their own. Ovarian cysts do not usually cause symptoms, though they can be painful if they rupture. If a cyst twists or causes the ovary to twist (a condition known as ovarian torsion), you will require immediate surgery. While it is rarely necessary, an ovarian cyst can be safely removed during pregnancy.


What exactly is an ovarian cyst?

A fluid- or tissue-filled sac or pouch in or on the ovary is known as an ovarian cyst.
Ovarian cysts are typically painless and disappear on their own. They can range in size from half an inch to four inches, and they usually appear during or after menopause.
Approximately 7% of women worldwide have an ovarian cyst at some point in their lives.

Ovarian cysts are classified into several types:
1) Functional cyst:- It is the most common type of cyst, which is related to ovulation. They don’t cause cancer. Follicular cysts and corpus luteum cysts are examples of functional cysts.
2) Endometrioma cyst:- It can develop in women who have endometriosis (a condition where the tissue that normally lines the uterus grows outside the uterus, often on the ovaries).
3) Teratoma cysts:- (also known as dermoid cysts) contain a variety of bodily tissues, including skin and hair tissue. Teratoma cysts can exist in the body from birth and grow during a woman’s reproductive years.
It’s uncommon, but these can develop into cancer.
4) Cystadenoma cysts are benign growths on the ovary’s outer surface (non-cancerous). They can grow to be quite large and sturdy.

Polycystic ovary syndrome occurs when the ovaries produce a large number of small cysts (PCOS). PCOS can impair fertility and lead to diabetes later in life.

What causes a pregnancy ovarian cyst?

A corpus luteum cyst is the most common type of ovarian cyst during pregnancy. The follicle that released the egg fills with fluid and remains on the ovary rather than shrinking.
These cysts usually disappear on their own by the middle of the second trimester, but they can remain on the ovary and, if large or causing symptoms, may need to be removed.

Symptoms of ovarian cysts:
Ovarian cysts rarely cause any symptoms. Your doctor or nurse may discover one during a routine pelvic exam or ultrasound.
It can be painful if an ovarian cyst grows large, bleeds, ruptures, twists, or causes the ovary to twist.
Other symptoms of an ovarian cyst include:
1) Bloating
2) Pressure in the abdomen
3) Pain associated with bowel movements

What will I do if I suspect I have ovarian torsion?

Ovarian torsion is typically characterized by intermittent lower abdominal pain on one side. It may also result in:
-Nausea
-Vomiting
-Fever of low severity
Torsion of the ovaries is a medical emergency. If you suspect you have ovarian torsion, go to the emergency room right away.

Treatments for ovarian cysts
Ovarian cysts are usually not treated. They leave on their own. Unless:

You have a ruptured ovarian cyst. In this case, you will almost certainly require pain medication. Your body will usually absorb the ruptured cyst, but your healthcare provider will advise you to rest and watch for signs of infection.
You suffer from ovarian torsion (the cyst causes the ovary to twist). This is a medical emergency that will necessitate surgery.
If the cyst is large or causing symptoms, it should be removed. Rest and possibly surgery may be recommended by your caregiver.

What happens if I have an ovarian cyst while pregnant?

Ovarian cysts rarely cause problems during pregnancy, but if they continue to grow, they may rupture,
twist, or cause the ovary to twist (this twisting is called ovarian torsion). A growing cyst may cause complications during childbirth,
especially if it is a large mass obstructing the abdomen or pelvis.

Is it safe to have an ovarian cyst removed while pregnant?
An ovarian cyst can be safely removed during pregnancy if necessary, though your caregiver will most likely avoid removal unless you are in pain or the cyst is bleeding.
If surgery is required, you may be able to have minimally invasive laparoscopic surgery through small incisions. However, in some cases, routine abdominal surgery is required.

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Case Study

Bad Obstetric History(BOH)

Case Study
Case Study

Bad Obstetric History(BOH)

Patient Brief:

The patient came at 6 weeks of pregnancy. She had a history of 3 miscarriages and one IUD (Intrauterine device) at 6 months of pregnancy. The patient was diagnosed with LA positive.

Challenges:

The challenges, in this case, were to manage the Recurrent loss of a pregnancy, Intrauterine death, and prevent a baby with low weight.

Treatment:

If you are suffering from a BOH problem, Gold Rush Hospital in Kharadi is well-equipped to provide you with the best care and treatment you need.  In this case, Dr. Kirti Khewalkar recommended doppler sonography for the fetus every 3 weeks after 16 weeks of pregnancy.

At Gold Rush Hospital, we want to help you have a healthy pregnancy under the guidance of our experts. We also offer periodic counseling sessions to help with mental wellness and emotional well-being during pregnancy, as well as reduce fears and anxiety about childbirth and parenting. With our team of qualified experts, you can be confident that you’re in good hands at Gold Rush Hospital.

Result:

The patient was delivered at 34 weeks due to a PV leak. The mother was healthy and stable post-delivery. The baby did not require any respiratory support and developed physiological jaundice treated with phototherapy. The baby is also well now.

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Case Study

G3 A2-Came at 8 weeks of pregnancy with ITP

G3 A2-Came at 8 weeks of pregnancy with ITP
G3 A2-Came at 8 weeks of pregnancy with ITP

G3 A2-Came at 8 weeks of pregnancy with ITP

Patient Brief:

The patient came to the clinic at 8 weeks of pregnancy with ITP (idiopathic thrombocytopenic purpura). The patient’s platelet count was 6000/cmm in the first trimester, which is considered a high risk for serious bleeding. The following platelet counts were monitored during the pregnancy: -At 28 weeks, the platelet count was stable at 70000/cmm. -After 28 weeks, the platelet count started dropping more.

Challenges:

The challenges, in this case, were to manage a high-risk pregnancy, control high blood pressure, and prevent spontaneous bleeding, which could be severe and pose a risk to both the baby and the mother.

Treatment:

If you’re pregnant and have been diagnosed with a critical condition, Gold Rush Hospital in Kharadi is well-equipped to provide you with the care and treatment you need. Dr. Kirti Khewalkar recommended that this patient be kept under strict monitoring for platelet count and regular obstetric ultrasonography. The patient started taking steroids for thrombocytopenia after 3 months of pregnancy.

 At Gold Rush Hospital, we want to help you have a healthy pregnancy by following a strict diet plan and exercise routine under the guidance of our experts. We also offer periodic counseling sessions to help with mental wellness and emotional wellbeing during pregnancy, as well as reduce fears and anxiety about childbirth and parenting. With our team of qualified experts, you can be confident that you’re in good hands at Gold Rush Hospital.

Result:

We delivered the patient at 32 weeks for thrombocytopenia with a platelet count of 17000/cmm. The mother was stable post-delivery and the baby required NICU care but recovered in 10 days. We’re happy to see smiles on the faces of the patient and her relatives as it was a life-saving case for both mother and child.

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In Vitro Fertilization (IVF)

ivf consult
ivf consult

In Vitro Fertilization (IVF)

IVF may be an alternative if you’ve been having trouble getting pregnant and therapies like fertility drugs or IUI haven’t worked.
What you should know about in vitro fertilization is provided here.
While many couples succeed in getting pregnant after a few months of trying, some struggle with infertility and have more challenges.
Fortunately, there are numerous alternatives available for hopeful parents seeking fertility treatments,
including intrauterine insemination (IUI), surgery, and drugs like Clomid (clomiphene) and Femara (letrozole).

What is in vitro fertilization (IVF)?
In vitro fertilization takes place in a lab and involves the fertilization of eggs by sperm outside of the body. After that, one (or more) of those fertilized eggs is put into the uterus in the hopes that it will implant and lead to a pregnancy,
which will then bear fruit in the form of a child nine months later.
In 1978, the first IVF baby was born, and an estimated 8 million more have since done so globally (born via in vitro fertilization and other reproductive technologies).

How does IVF function?
Your doctor may advise trying a variety of reproductive therapies before resorting to IVF.
However, IVF may be the most effective method for conceiving for women who have severe fallopian tube obstructions,
ovulation problems, a reduced ovarian reserve, poor egg quality, or endometriosis.

What is the success rate for IVF?
The probability that an IVF procedure will result in pregnancy relies on a number of variables, including:

-Your age
Your chance of having a successful IVF cycle increases with age, especially if you’re under 35.
This is because fewer eggs are produced as you become older because your ovaries are less likely to respond favorably to hormone-stimulating medications.

Additionally, as you age, the quality of your eggs normally declines (though there are exceptions), which could make it more difficult for them to implant in your uterus.

-Your ovarian reserve
The more high-quality fertile eggs you still have in your ovaries, the stronger your ovarian reserve, and the more successful IVF will be.

-Your fallopian tubes
The better your fallopian tube health, the more successful your IVF will be.
Women with a fluid-filled blockage in one or both fallopian tubes (called a hydrosalpinx) have lower success rates,
even though in vitro fertilization bypasses the fallopian tubes altogether.

-Your lifestyle

The likelihood of IVF success decreases when your lifestyle becomes less healthy (for example, if you smoke or are overweight or obese).

Remember that the success rates at various fertility clinics vary.
You can evaluate the success rate of your potential clinic before enrolling for your treatments thanks to the Society for Assisted Reproductive Technology (SART) and the Centers for Disease Control and Prevention (CDC),
which track pregnancy and live birth rates by clinics and publish their findings online.

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