General Gynaecology


Family planning

There are many new contraceptives on the market that cater to women’s individual preferences, medical conditions and reproductive plans. These include oral contraceptives, such as the pill, the transdermal patch, injectable contraceptives, sub-dermal implants and intra-uterine devices

Heavy or painful periods

Abnormal periods can have a major impact on a woman’s personal and professional life. There are many causes, each with their own treatment options. Some of the options include medication, Mirena® IUD and Novasure® endometrial ablation.

Preconception visits

A preconception visit with your doctor is of utmost importance. Unfortunately, many women only see a gynaecologist once they are pregnant. At this important appointment, Rubella (German Measles) and Varicella (Chicken Pox) immunity is tested and vaccines are available if necessary. Optimisation of pre-existing conditions such as diabetes, hypertension and HIV are done before falling pregnant.

Chronic medication that may harm the developing baby is reviewed and changed if necessary.

Information on prenatal vitamins, weight loss and smoking cessation are discussed. Many problems that arise in pregnancy can be avoided by identifying and managing risk factors beforehand.

Laparoscopic Surgery

Laparoscopic surgery is done by inserting a camera through the umbilicus (belly button) to treat a variety of conditions such as ovarian cysts, fibroids, endometriosis, ectopic (tubal) pregnancy and to assess whether the fallopian tubes are blocked.

A laparoscopic hysterectomy has the benefit of less post-operative pain, a shorter recovery period and a smaller scar than a conventional abdominal hysterectomy.

Vaginal hysterectomy

Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken and no longer provide enough support for the uterus. Prolapse of the uterus is usually treated by doing a vaginal hysterectomy and can be combined with other prolapse surgery for the best possible result. Post-operative pain and recovery time is noticeably reduced.

Endometriosis

Endometriosis is a condition where the tissue from the endometrial lining in the uterus grows on the outside surface of the uterus, inside the pelvis. It often causes severe period pains, painful intercourse and can also contribute to infertility. Treatment usually involves laparoscopic surgery but can sometimes be managed with medication.

Hysteroscopic surgery

During a hysteroscopy, a thin camera is inserted through the vagina into the cavity of the uterus. A hysteroscopy can diagnose the causes of abnormal bleeding and be used to remove growths such as polyps and fibroids.

Infertility workup

Infertility affects around 15% of couples. If you have been unable to conceive after more than a year, then you should consult with a gynaecologist for investigation and treatment.

The main causes of infertility in women are due to the ovaries not releasing an egg (anovulation) or due to the fallopian tubes being blocked/damaged.

Polycystic Ovarian Syndrome (PCOS) is the most common cause of anovulation. Blood tests will be done to assess your hormone levels. Various treatment options are available to assist with ovulation.

Fallopian tubes blockage can be due to endometriosis and previous surgery or infections. The fallopian tubes can be assessed during laparoscopy or by a hysterosalpingogram (HSG).

Please ask your partner to accompany you; not only to include him in the consultation process but also for possible referral for a spermiogram (testing of sperm count and quality).

STD testing

STD’s such as HIV, Syphilis and Hepatitis B can be diagnosed with a blood test. Vaginal swabs can test for Gonorrhoea, Chlamydia and Herpes. Treatment is available for both you and your partner.

Prolapse surgery

Prolapse in the vagina is often noticed as a heavy feeling or a ‘ball’ in the vagina. You will be examined to determine whether the prolapse is from the bladder, bowel, rectum or uterus. Treatments such as surgery or vaginal laser for milder cases are available.

Vulvodynia

Vulvodynia is a condition of chronic pain of the vaginal opening and/or vulva and often no cause can be found. Treatments include a low oxalate diet, medication and Botox® injections.

Termination of pregnancy

This service is available to patients for medical or personal reasons. The procedure is possible with medication alone if it is performed before 10 weeks of pregnancy. From 10 weeks onwards the procedure is usually done in theatre.

Menopause and Osteoporosis treatment

Symptoms of menopause such as hot flushes, depression, insomnia, vaginal dryness and emotional lability can be treated effectively with different types of hormone replacement. Your individual risks and benefits of hormone treatment will be discussed as well as the need for a mammogram referral.

Calcium, vitamin D supplements and lifestyle changes can prevent osteoporosis. You may be referred for a bone density scan depending on your age or other risk factors for osteoporosis.