Treatments

A hysterectomy is an operation to remove a woman's uterus. A woman may have a hysterectomy for different reasons, including: Uterine fibroids that cause pain, bleeding, or other problems Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal Cancer of the uterus, cervix, or ovaries Endometriosis Abnormal vaginal bleeding Chronic pelvic pain Adenomyosis, or a thickening of the uterus Hysterectomy for noncancerous reasons is usually considered only after all other treatment approaches have been tried without success. Types of Hysterectomy Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is important to clarify if the cervix and/or ovaries are removed: In a supracervial or subtotal hysterectomy, a surgeon removes only the upper part of the uterus, keeping the cervix in place. A total hysterectomy removes the whole uterus and cervix. In a radical hysterectomy, a surgeon removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. Radical hysterectomy is generally only done when cancer is present. The ovaries may also be removed -- a procedure called oophorectomy -- or may be left in place. When the tubes are removed that procedure is called salpingectomy. So, when the entire uterus, both tubes, and both ovaries are removed, the entire procedure is called a hysterectomy and bilateral salpingectomy-oophorectomy. Surgical Techniques for Hysterectomy Surgeons use different approaches for hysterectomy, depending on the surgeon’s experience, the reason for the hysterectomy, and a woman's overall health. The hysterectomy technique will partly determine healing time and the kind of scar, if any, that remains after the operation. There are two approaches to surgery - a traditional or open surgery and surgery using a minimally invasive procedure or MIP. Open Surgery Hysterectomy An abdominal hysterectomy is an open surgery. This is the most common approach to hysterectomy, accounting for about 54% for all benign disease. To perform an abdominal hysterectomy, a surgeon makes a 5- to 7-inch incision, either up-and-down or side-to-side, across the belly. The surgeon then removes the uterus through this incision. Following an abdominal hysterectomy, a woman will usually spend 2-3 days in the hospital. There is also, after healing, a visible scar at the location of the incision. Abdominal hysterectomy. Most women go home 2-3 days after this surgery, but complete recovery takes from six to eight weeks. During this time, you need to rest at home. You should not be doing housework until you talk with your doctor about restrictions. There should be no lifting for the first two weeks. Walking is encouraged, but not heavy lifting. After 6 weeks, you can get back to your regular activities, including having sex. Vaginal or laparoscopic assisted vaginal hysterectomy (LAVH). A vaginal hysterectomy is less surgically invasive than an abdominal procedure, and recovery can be as short as two weeks. Most women come home the same day or the next. Walking is encouraged, but not heavy lifting. You will need to abstain from sex for at least 6 weeks. Laparoscopic supracervical hysterectomy (LSH). This procedure is the least invasive and can have a recovery period as short as six days to two weeks. Walking is encouraged, but not heavy lifting.

If you have an anal fissure that hasn’t healed with self-help measures and medical treatments, we may suggest you a procedure to treat it. An anal fissure is a small tear or ulcer (open sore) in your skin around the opening of your anus. There are several different types of procedures available, including injections with botulinum toxin, removal of the fissure (excision or fissurectomy) and sphincterotomy. We may suggest you have a procedure called a fissurectomy alongside Botox injections. This involves cutting away the damaged skin from around your anal fissure, along with any ‘sentinel’ skin tags (lumps of skin associated with the fissure).

Intrauterine insemination (IUI) is a simple procedure that puts sperm directly inside your uterus, which helps healthy sperm get closer to your egg. IUI stands for in intrauterine insemination. It’s also sometimes called donor insemination, alternative insemination, or artificial insemination. IUI works by putting sperm cells directly into your uterus around the time you’re ovulating, helping the sperm get closer to your egg. This cuts down on the time and distance sperm has to travel, making it easier to fertilize your egg. Before having the insemination procedure, you may take fertility medicines that stimulate ovulation. Semen is collected from your partner or a donor. It goes through a process called “sperm washing” that collects a concentrated amount of healthy sperm from the semen. Then doctor puts the sperm right into your uterus. Pregnancy happens if sperm fertilizes your egg, and the fertilized egg implants in the lining of your uterus. IUI is a simple and low-tech procedure, and it can be less expensive than other types of fertility treatments. It increases your chances of pregnancy. Before IUI, you may take fertility medicines that help make your eggs mature and ready to be fertilized. Your doctor will do the insemination procedure during ovulation (when your ovaries release an egg). Sometimes you’ll be given hormones that trigger ovulation. They’ll figure out exactly when you’re ovulating and ready for the procedure to maximize your chances of getting pregnant. Your partner or donor collects a semen sample at home or in the doctor’s office. The sperm are prepared for insemination through a process called “sperm washing” that pulls out a concentrated amount of healthy sperm. Sperm washing also helps get rid of chemicals in the semen that can cause reactions in your uterus and make it harder to get pregnant. If you’re using donor sperm from a sperm bank, the sperm bank generally sends the doctor's office sperm that’s already “washed” and ready for IUI. During the IUI procedure, the doctor slides a thin, flexible tube through your cervix into your uterus. They use a small syringe to insert the sperm through the tube directly into your uterus. Pregnancy happens if sperm fertilizes an egg, and the fertilized egg implants in the lining of your uterus. The insemination procedure is done at Sukhayu Hospital, and it only takes about 5-10 minutes. It’s pretty quick, and you don’t need anesthesia. IUI is usually not painful, but some people have mild cramping.

Male circumcision is an operation to remove the foreskin that covers the tip of the penis. The functions of the foreskin include protecting the head of the penis and contributing to sexual sensations. While recent research suggests that circumcision may bring some medical benefits, some doctors believe these are too small to justify surgery. A medical circumcision is a circumcision performed to treat a disease, such as pathological phimosis (lichen sclerosis), recurrent balanitis or recurrent urinary tract infections. A request circumcision is a circumcision performed for non-medical reasons, such as parental preference, religious reasons or to potentially prevent disease at some future time.There are different methods of circumcision. Either local or general anaesthesia should always be used. The procedure involves numbing the area with local anaesthetic creams or injection. A bell-shaped instrument is inserted under the foreskin to separate it from the penis. The foreskin is then removed using scissors or a scalpel. Alternatively, circumcision can be performed as a formal surgical procedure, using dissolving sutures or tissue glue.

You’ve had painful attacks caused by gallstones. To treat the problem, your doctor advised to remove your gallbladder? This surgery is called cholecystectomy. Removing the gallbladder can relieve pain. It will also prevent future attacks. You can live a healthy life without your gallbladder. You may also be able to go back to eating foods you enjoyed before your gallbladder problems started. There are 2 methods for removing the gallbladder. We will choose which method is best for you: Laparoscopic cholecystectomy. This is most common. During surgery, 2 to 4 small incisions are made. A thin tube with a camera is used. This is called a laparoscope. The scope is put through one of the incisions. It sends images to a video screen. Surgical tools are put through other incisions. The gallbladder is removed using the scope and these tools. Open cholecystectomy. One larger incision is made. The surgeon sees and works through this incision. Open surgery is most often used when scarring or other factors make it a better choice for you. In some cases, safety requires a change from laparoscopic to open surgery during the procedure.

Appendicitis means inflammation of the appendix. When the appendix is inflamed it causes pain and makes you feel unwell. What are the benefits of surgery? You will no longer get appendicitis. Surgery should prevent you from having serious complications that appendicitis can cause. Are there any alternatives to surgery? Antibiotics can be used to treat inflammation or an abscess, but only if you are well enough. If an abscess continues or if you become unwell even with antibiotics, you will need an operation. What does the operation involve? An appendicectomy is usually performed under a spinal anaesthetic. The operation usually takes between half an hour and an hour. We will remove the appendix either by using the laparoscopic (keyhole) technique or by an open cut in the abdomen.

A hydrocele is a sac of fluid that forms around a testicle. It occurs when fluid builds up in the layer of tissue that covers the testicle. It may be caused by an infection or by injury to the testicle. But the cause is often not known. A large hydrocele can cause pain or swelling in the scrotum. Hydrocelectomy is surgery to remove the hydrocele. The procedure takes about 30 minutes. You will likely go home on the same day.

Hernia repair surgery is the world’s most common surgical procedure. Hernia surgery can help to relieve pain, return the hernia abdominal organs to their correct place and, strengthen the weak muscle area. A hernia operation usually takes around an hour as a day case procedure. It can be performed by: • Open surgery – under local or general anaesthetic, an incision usually around 2.5 to 3 inches is made to your skin near your hernia and your surgeon will push your hernia back into your abdomen. The incision is then either stitched closed or much more commonly a mesh is placed over the hole and fixed using fine stitches. The mesh acts like a scaffold and your own tissue will grow through the mesh to reinforce the weakened area without putting tension on the surrounding tissues. • Keyhole (laparoscopic) surgery – under general anaesthetic, several smaller incisions are made to allow surgeon to use a less invasive technique using various special instruments including a tiny telescopic camera to repair your hernia. A mesh may then be used to strengthen your abdominal wall. If hernia surgery is recommended, we will advise on the most appropriate type of surgery based on the location and severity of your hernia.