Gynaecology

Gynaecology or gynecology literally means "the science of women", but in medicine this is the specialty of diseases of the female reproductive system (uterus, vagina, and ovaries). Almost all modern gynaecologists are also obstetricians;

History

In the United States, J. Marion Sims is considered the father of American gynaecology. While Sims was lionized in his day, his actions are now condemned as racist and sexist by most medical ethicists and commentators.

Therapies

Occasionally gynaecologists will use drugs such as clomiphene (which stimulates ovulation) and most famously hormonal contraceptives (which are also used for dysmenorrhoea). Surgery, however, is the mainstay of gynaecological therapy. For historical reasons gynaecologists are not usually considered "surgeons"—this has always been the source of some controversy—though modern advancements in both fields have blurred many of the once rigid lines of distinction. The rise of sub-specialties within gynaecology which are primarily surgical in nature (for example urogynaecology and gynaecological oncology) have strengthened the reputations of gynaecologists as surgical practitioners and many surgeons and surgical societies have come to view gynaecologists as comrades of sorts. As proof of this changing attitude gynaecologists are now eligible for fellowship in both the American and Royal Colleges of Surgeons and many newer surgical textbooks include chapters on (at least basic) gynaecological surgery.

Some of the more common operations that gynaecologists perform include:

1. Termination of pregnancy
2. Dilation and curettage (removal of the uterine contents for various reasons including miscarriage and menorrhagia; procedurally very similar to the above);
3. Hysterectomy (removal of the uterus);
4. Oophorectomy (removal of the ovaries);
5. Tubal ligation;
6. Exploratory laparoscopy or laparotomy (used to diagnose and treat sources of pelvic and abdominal pain dysmenorrhea vaginal bleeding etc.)

7. Colposuspension ("tightening" of the ligaments around the vagina a common therapy for incontinence and discomfort in older women);
8. Large Loop Excision of the Transition Zone (LLETZ) where the surface of the cervix containing pre-cancerous cells identified on Pap smear are removed).

HYSTERECTOMY – SURGERY to remove your uterus

Introduction:

Hysterectomy – the surgical removal of your uterus. It can means survival if you have uterine cancer or if you are a woman with intolerant pelvic pain from endometriosis or heavy irregular periods, a hysterectomy often means relief from troublesome symptoms.

Uterine prolapse

Persistent vaginal bleeding

Chronic pelvic pain.

Preparation for this surgery

Hysterectomy is an inpatient procedure, it means you are admitted to hospital to have it done. How long you will be in the hospital depends on what type of hysterectomy you have and what your doctor recommends.

Types of hysterectomy

To perform a hysterectomy a surgeon detaches your uterus from the blood vessels and connective tissue that support it as well as from the vagina. Depending on your situation, surgery may involve the removal of additional organs and tissue.

1) Partial hysterectomy

2) Total hysterectomy

3) Hysterectomy and bilateral salpingo – oophorectomy.

4) Radical hysterectomy

During the day of surgery

The first thing you will do when you arrive at the hospital is check in. family and friends can stay with you until you leave for surgery.

The surgery itself can take from one and half to three hours depending on the reason your hysterectomy, which will influence whether you are having a vaginal hysterectomy. The surgeon may close the wound with stables which will be removed prior to discourage from the hospital.

Post operative care

Immediately after surgery you will be checked to the recovery room where you will stay for one to two hours.

The recovery room one nurse will come and take your blood pressure, temperature and pulse every one hour.

Check your bowel, bladder and lung function daily.

Check your incision daily.

How long you will be in the hospital depends on what type of hysterectomy you have and what your doctor recommends.