Because we are committed to the empowerment of patients through information, we present a summary of all the gynaec problems that we deal with. These are intended to give a basic idea of each gynaec condition. For further questions and queries, feel free to contact us.

Abnormal bleeding may present as -
• Heavy periods
• Irregular bleeding and spotting
• Bleeding after sexual intercourse
• Continuous bleeding
• Bleeding/spotting after menopause
• Bleeding associated with pregnancy states.

Causes may be many and a proper work up and clinical approach is required in each woman to reach a proper diagnoses.

Apart from basic blood investigations, a few special investigations may be needed according to each patient's special case, like

(This is the visualization of the uterus through endoscope, which gives a definite picture of the inside of a woman's uterus)

Treatment is tailored according to each woman's age, diagnosis and her fertility status. It could be just medical management with drugs or may involve removal of polyps/ fibroids hysteroscopically. Other options could be endometrial ablation by lasers or electrocautery. In this the lining of the uterus is removed such that it cannot regrow. Complete stoppage of periods is achieved in about 35% women. About 45% experience significant reduction in menstrual flow. However upto 30% may require a hysterectomy after about 2 years.

Even if a woman needs hysterectomy it can be done without scars through the minimally invasive laparoscopic route or the vaginal route.

A uterine fibroid / myomas is the most common benign tumour of the uterus. This tumour can occur in 50% of all women and is the leading cause of hysterectomy (removal of uterus) worldwide.

(If the myoma is large or growing mainly inside the uterus (sub mucous) they could be responsible for infertility)

Causes are still unknown but family or genetic basis could be present. Women of African origin are more prone to develop them. These also have been associated with obesity.

Apart from a thorough clinical and pelvic examination, your doctor may choose the following tests to diagnose the problem and decide the treatment approach-

Treatment depends on symptoms, size and location of fibroids, age and desire to have children. Thus it has to be individualized to each patient's special needs. It may vary from just observation every six months to medical therapy which could help to shrink the fibroids temporarily and help to delay surgery to surgery. Surgery may be of two types

(At our center, almost all fibroids are removed through the laparoscopic route, which is now considered as the first choice in surgical approach.)

Urinary problems are very common in women between 20 - 80 years and may range from leaking of urine to frequent urination or urinary infections etc. Unfortunately, many women are shy or hesitant to discuss this with anyone, even their doctors. They continue to suffer in silence, which disables their social, psychological, occupational and sexual lives.

Apart from routine examinations some special investigations such as Urodynamic studies may be required to identify the exact cause.

Statistics reveal that 8 out of ten women who seek treatment get cured. Treatment options depend on the condition of the patient. Some options could be-

• Pelvic muscle rehabilitation exercise which could improve muscle tone and prevent leakage
• Some behavioral therapies and bladder training exercises (Bladder drills)
• Certain medications
• If the patient does not respond to the above, surgery is resorted to. A new minimally invasive procedure called Tension Free Vaginal Tape has long term cure rates and less post operative morbidity.
• Newer innovative approaches like certain injections applied locally under the weak area to give strength and Magnetic Enervation approach are coming up.

Pain may be severe and steady or it may be intermittent, dull and aching type or may be felt just as a pressure sensation deep within. Some women may have pain during sexual intercourse.

Adhesions are scar tissues which are formed as a result of previous surgery or inflammation. These can lead to a dragging type of pelvic pain.

Work up will depend upon the history, clinical examination etc. Apart from routine lab blood and urine tests, a pelvic ultrasound is of great help. Laparoscopy is considered as the gold standard in identification of the cause of the pain.

Treatment is directed at the identified cause and laparoscopy affords a greater advantage over open surgery because of greater magnification and better identification of pathology.

Endometriosis is a female health disorder that occurs when cells from the lining of the womb grow in other areas of the body. It often takes a long time before it is diagnosed. It is generally held that about 10% of all women during their reproductive periods are affected by this condition. Endometriosis causes scar tissues and adhesions to develop that can distort a woman's internal anatomy. In advanced stages the internal organs may fuse together causing a condition known as 'frozen pelvis'.

• May vary from no obvious discomfort to severe pain which affects the quality of life significantly. Pain may be during periods or may start even before periods.

Apart from clinical signs and symptoms, other modalities which may help are ultrasound (USG) and MRI. Again, laparoscopy is held to be the gold standard investigation for accurate diagnosis and also treatment.

Treatment may be medical or surgical. The goal of treatment could be pain relief and/or enhancement of fertility. Many medications are available and the choice depends upon your doctor's judgment according to your special case. Laparoscopic surgery is the gold standard of treatment. It is performed when medical treatment is ineffective and if other organs are being affected by the disease or for fertility enhancement. Laparoscopy helps to normalize anatomy, to remove endometriotic diseased tissue deposits by lasers or electrosurgery.