It is usually indicated for women with:

• At least 50 % of the fibroid in the endometrial lining
• Women who are not willing to have a laparoscopic myomectomy

WHAT TO EXPECT

A hysteroscope will be inserted through the vagina and into the uterus and attached to a monitor to look at the lining of the uterus. Fluid [Normal saline] will be used to distend the cavity of the uterus so the walls can be visualized.

Instruments used for hysteroscopic myomectomy include:

• Resectoscope (the commonest instrument used),
• Hysteroscopic scissors,
• Hysteroscopic morcellation

The fibroid particles are removed from the vagina.

HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

Usually, the procedure lasts 20 – 30 minutes and then you will be discharged once you have fully recovered from the effect of anaesthesia.

It is usually indicated for women with intrauterine adhesion causes by:

• Repeated dilatation and curettage.
• A client who had myomectomy with breaching of the endometrial cavity resulting in adhesions
• A client with septic abortion resulting in adhesions
• Clients with pelvic tuberculosis

WHAT TO EXPECT

A hysteroscope will be inserted through the vagina and into the uterus and attached to a monitor to look at the lining of the uterus. Fluid [Normal saline] will be used to distend the cavity of the uterus so the walls can be visualized. Hysteroscopic scissors can be used to divide the adhesions and an IUCD or Foley catheter inserted into the cavity to separate the walls. Estrogen and progesterone are given after the procedure to improve endometrial regeneration and antibiotic given for pain.

Follow-up hysterosalpingography [HSG] or diagnostic hysteroscopy after withdrawal bleeding or 6 – 8 weeks after the procedure is recommended.

HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

Usually, the procedure lasts 20 – 30 minutes and then you will be discharged once you have fully recovered from the effect of anaesthesia.

It is usually indicated for the following conditions:

• Diagnosis of abnormal vaginal bleeding. Treatment can also be carried out at the same time.
• Confirmation of HSG report for the presence of sub-mucous fibroids, endometrial polyps, uterine septum, and uterine adhesions
• To check for the location of foreign bodies in the uterus
• Can be combined with laparoscopy for additional information

WHAT TO EXPECT

Women going for a diagnostic laparoscopy need to understand that the procedure is for diagnostic purposes and is a way of finding out problems within the uterine cavity. These problems can then be managed operatively at the same time or at a later date. A hysteroscope will be inserted through the vagina and into the uterus and attached to a monitor to look at the lining of the uterus. Fluid [Normal saline] will be used to distend the cavity of the uterus so the walls can be visualized.

HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

Usually, the procedure lasts 10 – 20 minutes and then you will be discharged once you have fully recovered from the effect of anaesthesia.

It is usually indicated for the following conditions:

• Heavy/abnormal vaginal bleeding
• Uterine fibroids in women who have completed their family’s size.
• Abnormal pap smear or endometrial hyperplasia
• Adenomyosis
• Uterine prolapse

 WHAT TO EXPECT

Women going for a hysterectomy will need to understand that they will not menstruate after the procedure. If the ovaries are removed, they will go through symptoms of menopause immediately. During the procedure, about 4 tiny incisions will be made on the abdominal wall and a telescope will be inserted into the cavity to perform the surgery. The procedure carries some potential risks which your doctor will discuss with you. These include anaesthetic risks and the risks from carrying out the procedure itself.

The uterine specimen removed will be sent for histological diagnosis to ensure that there are no cancerous lesions on the uterus or cervix.

HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent. You will be counselled to be on a soft or liquid diet for about 2 days before the procedure and given some medications to ‘empty’ your bowels. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

This is the surgical removal of fluid-filled sacs called ovarian cyst attached to one or both ovaries.

SYMPTOMS

These ovarian cysts could become large and very painful when:

• it twists on itself [tortioned ovarian cyst]
• it bleeds into the cavity [hemorrhagic ovarian cyst]
• if it ruptures and releases its contents [ruptured ovarian cyst]
• if it gets infected [infected ovarian cyst]

CAUSES

Cysts are formed in women because the ovaries grow and release eggs during ovulation. If the follicle containing the eggs does not rupture a cyst could form with fluid within it. Dermoid cysts, endometriomas, and cystadenomas could also form.

PREVENTION

Involves regular pelvic examinations or Ultrasound scan to ensure there are no large and abnormal cysts.

TREATMENT

Small cysts are managed by observation and regular ultrasound scans. A larger complicated cyst will need laparoscopic surgery to remove the cyst wall and drain the fluid. If possible the cyst is removed intact.

Kindly talk with our team if you think you have challenges concerning your ovary.

WHEN TO SEE A DOCTOR

You need to see your doctor if you have:

• Pain associated with ovarian cyst; this could be associated with fever and vomiting
• If you begin to lose weight
• If on ultrasound scan the size of the ovarian cyst is 10 cm and above.

It is usually indicated for women with proximal tubal occlusion caused by:

• Mucus plugs at the proximal end of the fallopian tube.
• Minor adhesion at the proximal tube

WHAT TO EXPECT

A hysteroscope will be inserted through the vagina and into the uterus and attached to a monitor to look at the lining of the uterus. Fluid [Normal saline] will be used to distend the cavity of the uterus so the walls can be visualized.  The occluded end of the tube is cannulated approximately 1-2 cm with a flexible tubal catheter. Methylene blue is then injected through the cannula and observed for its spillage through the fimbrial end by the surgical assistant performing the laparoscopy. If the tubes are not patent, the assistant straightens the fallopian tube as the hysteroscopic surgeon slides a guidewire with a soft, flexible tip through the initial catheter and into the isthmic area of the fallopian tube. The wire is then withdrawn and patency is evaluated again.

 HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

Usually, the procedure lasts 15 – 20 minutes and then you will be discharged once you have fully recovered from the effect of anaesthesia.

It is usually indicated for women with intrauterine adhesion causes by:

• Repeated dilatation and curettage.
• A client who had myomectomy with breaching of the endometrial cavity resulting in adhesions
• A client with septic abortion resulting in adhesions
• Clients with pelvic tuberculosis

WHAT TO EXPECT

A hysteroscope will be inserted through the vagina and into the uterus and attached to a monitor to look at the lining of the uterus. Fluid [Normal saline] will be used to distend the cavity of the uterus so the walls can be visualized.

The hysteroscopic scissors are commonly used to perform the polypectomy by cutting off the polyps. The polyps are subsequently removed from the uterine cavity through the vagina.

HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

Usually, the procedure lasts 15 – 25 minutes and then you will be discharged once you have fully recovered from the effect of anaesthesia.

It is usually indicated for women

• In whom the IUCD string is missing
• With IUCD embedded in the uterine musculature

WHAT TO EXPECT

A hysteroscope will be inserted through the vagina and into the uterus and attached to a monitor to look at the lining of the uterus. Fluid [Normal saline] will be used to distend the cavity of the uterus so the walls can be visualized.

The hysteroscopic grasper is inserted into the hysteroscope and used to grasp the IUCD.  The IUD is pulled toward the hysteroscope sheath. Pulling the IUD through the operating channel of the hysteroscope is impossible. Instead, the grasper is held closed, and both hysteroscope and the IUD are pulled out together.

HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

Usually, the procedure lasts 10 – 15 minutes and then you will be discharged once you have fully recovered from the effect of anaesthesia.

Criteria for tubal ligation include the following:

• Women above 35 years who have completed family size
• The woman has to be in a stable relationship
• She would have been counselled that there are other reversible methods of family planning

What to expect

Women going for tubal ligation need to understand that after the procedure they will not be able to achieve a pregnancy. 2 small incisions will be made on the abdomen and a telescope inserted into the abdomen.  The tubes will be ligated using energy sources or an occlusive device.

How to prepare for the procedure

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. He will ensure you are not pregnant before the procedure. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

DIAGNOSTIC LAPAROSCOPY AND DYE TEST

A laparoscopy and dye test is an operative procedure to look at your internal organs usually the fallopian tube. A blue dye is pushed through the vaginal and the fallopian tube checked to see if the fluid flowed out through the other end of the tube. Occasionally minor surgeries like adhesiolysis can be carried out during the procedure.

It is commonly used in women with fertility challenges.

It is usually indicated for the following conditions:

• A suspected case of ovarian cyst
• A suspected case of endometriosis
• Suspected tubal blockage
• Suspected uterine fibroid

WHAT TO EXPECT

Women going for laparoscopy and dye test need to understand that the procedure is for diagnostic purposes and is a way of finding out problems within the abdominal or pelvic region.  2 small incisions will be made on the abdomen and a telescope inserted into the abdomen.  The whole abdominal and pelvic cavity will be examined for any abnormal changes.

HOW TO PREPARE FOR PROCEDURE

Your doctor will counsel you before the procedure and you will need to give informed consent before the procedure. He would counsel you on the procedure and risks involved. The night before the procedure you will be told not to take any meals from midnight. The anaesthetist would review you and ask questions to assess your risk for anaesthesia. On the morning of the procedure, you can take a shower before you are wheeled into the theatre.

Usually, the procedure lasts between 10 – 20 minutes and then you will be discharged once you have fully recovered from the effect of anaesthesia.