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    Gynecologic Surgery

    Surgery relating to female reproductive system is called gynecological surgery. Women in many different stages of life and for many different reasons require gynecologic surgical procedures. Many gynecology problems can be relieved or helped by surgery.It is usually performed by gynecologists. There are a wide range of surgical procedures that have been developed to treat the various conditions that affect the female reproductive organs. These are minimally invasive surgeries with faster recovery, minimal pain, smaller incisions and shorter hospital stay.

    Some common reasons for gynecology surgery:

    Prolapsed uterus: Uterus has moved out of its normal position and down into the vagina. A prolapsed uterus may cause pain, infections or problems passing urine or having bowel movements.

    Bladder or bowel problems: If the sides of the vagina become weak, the bladder and rectum can bulge into the vagina. Problems with the bladder (called cystocele) may cause pressure, pain, difficulty passing urine, incontinence or a frequent urge to urinate. Problems with the rectum (called rectocele) may cause pressure, pain, constipation or difficulty having bowel movements.

    Fibroids: Fibroids are growths from the muscle of the uterus. The hormone estrogen makes them grow larger. They can grow on the inside or outside of the uterus. Fibroids are rarely caused by cancer. For many women, fibroids do not cause problems and don’t need treatment. In some women, fibroids can cause pain and heavy bleeding.

    Endometriosis: Tissues similar to uterine tissues grow outside the uterus. During the period these patches bleed, but the blood cannot flow to the outside of your body. This can cause pain and scarring. Your periods may become heavy or irregular.

    There are many types of gynecology surgery. Some women need more than one type of surgery done at the same time. Few are, Colposcopy, Cryosurgery, LEEP (Loop Electrosurgical Excision Procedure), Hysteroscopy, Pelvic Laproscopy and D & C (Dilation & Curettage)

    Colposcopy

    Colposcopy is a medical diagnostic procedure employed to examine an illuminated, magnified view of the cervix and the tissues of the vagina and vulva. The colposcope magnifies, or enlarges, the image of the outer portion of the cervix. The instrument, colposcope provides an enlarged view of the areas, helping the colposcopist to visually distinguish normal from abnormal tissue and take biopsies for further pathological examination.

    Conditions:

    • Many premalignant lesions and malignant lesions can be detected with this examination.
    • The main goal of colposcopy is to detect precancerous lesions early and treating them and thereby preventing cervical cancer.
    • Colposcopic examination further investigates a cytological abnormality on the pap smears of patients. After a colposcopy decisions can be made about your ongoing treatment.
    • Other indications for colposcopy are HIV infection, changes in normal appearance of cervix or for the forensic examination.
    It functions as a lighted binocular microscope to magnify the view of the cervix, vagina, and vulvar surface.Low power may be used to obtain a general impression of the surface architecture. Medium and high powers are used to evaluate the vagina and cervix. The higher powers give the idea of certain vascular patterns that may indicate the presence of more advanced pre-cancerous or cancerous lesions. Various light filters are available to highlight different aspects of the surface of the cervix. After a complete examination, the colposcopist determines the areas with the highest degree of visible abnormality and may obtain biopsies from these areas using a long biopsy instrument. Adequate follow-up is critical to the success of this procedure.

    Procedure:

    During the colposcopy, the gynecologist focuses on the areas of the cervix where light does not pass through. Abnormal cervical changes are seen as white areas, the whiter the area, the worse the cervical dysplasia. Abnormal vascular changes are also apparent through the colposcope. A tissue sample or biopsy is taken from the whitest abnormal areas and sent to the lab for further evaluation.

    A special instrument called a speculum is inserted into your vagina. This will hold the walls of your vagina slightly apart so that the cervix is visible. The colposcope does not go into your vagina, but is positioned between the legs to allow the doctor to examine the cervix. The colposcope is like a microscope with a light on the end, at the opening of the vagina and the doctor will then look through the colposcope to carefully examine the cervix. In this way, the doctor can see the location and pattern of any abnormal cells. The examination usually starts with a repeat Pap smear. The first smear is taken from the outside of the cervix using a spatula. The second is taken from the canal of the cervix using a special brush. After taking the Pap smear, the specialist will dab the cervix with very mild acetic acid (vinegar) solution. This will help to identify any abnormal cells.

    Complications: Significant complications from a colposcopy are not common, but may include bleeding, infection at the biopsy site or endometrium, and failure to identify the lesion.
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