Gynecology

 Physicians that specialize in women's health and more specifically in the female reproductive system are referred to as gynecologists.

Gynecologists focus on a wide range of problems, including obstetrics, or pregnancy and delivery, menstrual and fertility problems (IVF and fertility medical category), sexually transmitted infections (STIs), and hormonal disorders among others.

A lot of women in the United States prefer to visit a well-woman clinic instead of a family doctor for problems that have to do with general health. The gynecologist can then refer the patient to another expert.

A qualified gynecologist should have at least 8 years of training and should be certified by a body such as the American Board of Gynecologist (ABOG) and registered by a professional organization such as the American College of Obstetrician and Gynecologist (ACOG).

1. Tubal ligation

Tubal ligation is also referred to as having your tubes tied or tubal sterilization. It is a type of permanent birth control. Tubal ligation involves cutting of the fallopian tubes, tied or blocked in order to permanently prevent pregnancy.

The ideal behind tubal ligation is to prevent an egg from traveling from the ovaries through the fallopian tubes and blocks sperms from traveling up the fallopian tubes to the egg. The menstrual cycle is not affected by this procedure.

Tubal ligation can be performed at any time, including after delivery, or in combination with another abdominal operation, such as a C-section. Majority of tubal ligation procedures are irreversible. In the event that an attempt on reversal is initiated, it requires major surgery and most of the times it doesn’t seem to be effective.

 

Why is tubal ligation done?

In women, one of the most widely used surgical sterilization procedures is tubal ligation. Tubal ligation permanently prevents pregnancy, for this reason; there is no need for any types of birth control. However, care must be taken as it does not protect against sexually transmitted infections.

There is a reduced risk of ovarian ligation with tubal ligation most especially if the fallopian tubes are removed.

Tubal ligation is not suitable for all. Your doctor or health care professional will ensure that you have a better understanding of the risks and benefits of the procedure.

Your doctor may also talk about other options, such as long-acting reversible contraceptives, such as an intrauterine device (IUD) or birth control device embedded in your arm. Another lasting possibility is hysteroscopic sterilization, where your doctor puts a small coil or other inserts into the fallopian tubes. The insert causes the formation of scar tissue and seals off the tubes.

One of the safest and effective methods of permanent birth control is tubal ligation. But it is not suitable for everyone. Less than one in hundred women are pregnant the first year after the procedure. The younger you are at the time the surgery is done, the more likely it is to fail.

In the event that you conceive immediately after a tubal ligation, there is a risk of having an ectopic pregnancy. This is an indication that the fertilized egg implants outside the uterus, usually in a fallopian tube. Ectopic pregnancy requires urgent treatment. If you find out that you are pregnant at any time after tuber ligation, it is important to get in touch with your doctor immediately. Always remember that tubal ligation is reversible but the reversal procedure is complicated and may not work.

2. Tubal Ligation Reversal

This is a procedure that is used for restoring fertility after a woman has had a tubal ligation. Tubal ligation is a procedure that cuts or blocks the fallopian tube in other to prevent pregnancy. On the other hand, tubal ligation can be referred to as “having your tubes tied.”

Tubal ligation reversal procedure involves reconnection of the blocked segment of the fallopian tubes with the remainder of the fallopian tubes. This allows the movement of the egg again through the tubes and the sperm to move up the fallopian tubes so that it can attach itself to an egg.

Why is it done?

A tubal ligation reversal can allow a woman to get pregnant absent the need for additional medical assistance.

A tubal ligation reversal is not suitable for all. Your doctor will consider a number of factors in order to determine if tubal ligation reversal will probably work, such as:

  • Your age and body mass index
  • The type of tube ligation
  • The extent of damage to your fallopian tubes
  • Remaining tubal length
  • Other factors of fertility, such as sperm and egg quality

There are many factors that determine the success of a tubal ligation reversal. It is more likely that the procedure will be a success if you still have a large portion of a healthy fallopian tube remaining. 

The use of clips or rings also determines the success of tubal ligation reversal instead of segments of the fallopian tubes was burned to close them off (electrocautery). Some sterilization types, such as Essure or Adiana systems, are not considered reversible.

The success rates after a tubal ligation reversal can differ widely as it depends on factors such as maternal age and the type of tubal ligation procedure that is originally performed. Although it is difficult to predict the chances of pregnancy after this procedure, younger women - especially those 35 or under tend to have a greater rate of success. In cases where tubal ligation reversal is unsuccessful, in vitro fertilization (IVF) may be an alternative to help you become pregnant.

3. Myomectomy

This is a surgery that is done in order to remove fibroids while preserving the uterus. Myomectomy is the best option for treating women with symptoms of fibroids who want to have children in the future.

Myomectomy is very effective, but the chance of fibroids re-growth is possible. The younger are and the more fibroids you have at the moment of myomectomy, the more likely you will develop new fibroids in the future. Women who are approaching menopause are most likely to have recurrent fibroid problems after myomectomy.

A Myomectomy can be done in various ways. Depending on the size, number and position of your fibroids, you may be eligible for abdominal myomectomy, laparoscopic myomectomy or hysteroscopic myomectomy.

If you have fibroids that are causing symptoms that are troublesome or disrupt your daily life, myomectomy may be recommended by your doctor. If you need surgery, the reasons for choosing myomectomy instead of hysterectomy for the uterine fibroids are:

  • You intend to have children
  • Your doctor suspects that uterine fibroids interfere with your fertility.
  • You want to keep your uterus

 

Myomectomy results may include:

1. Elimination of symptoms. After myomectomy, a lot of women feel relieved from disturbing signs and symptoms, such as excessive menstrual bleeding and pelvic pain and pressure.

 

2. Improved fertility. Removal of submucosal fibroids by hysteroscopic myomectomy can improve fertility and pregnancy outcomes. After myomectomy, exercise patient for at least three months before you attempt conception this is done so that the uterus can have enough time to heal.

Tiny tumors (seedlings) that your doctor does not recognize during surgery may eventually develop and cause symptoms. New fibroids can also develop which may or may not require treatment. Women with a single fibroid are less likely to be treated for additional fibroids often referred to as recurrence rates than women with multiple fibroids.

4. Vulvectomy

Vulvectomy is a procedure performed in the operating room under anesthesia during which the surgeon removes all or some of the vulva. This procedure is most commonly associated with the treatment of vulvar cancer.

There are many types of vulvectomy and include:

  • Skinning vulvectomy
  • Simple vulvectomy
  • Modified Radical vulvectomy
  • Radical vulvectomy

 

A drain can be installed to remove surplus fluid from the surgical area; they are temporary and will be removed at your doctor’s office. Your doctor will teach how to take care of the drains and, if necessary, a home care nurse can help you. There can be a need for skin graft at some vulvectomy sites; this can be carried out by a gynecologic oncologist or plastic surgeon. For women who have undergone extensive vulvectomy, reconstructive surgery is an option.

5. Ovarian Cyst Removal

Ovarian Cyst RemovalOvarian cysts are sacs which are filled with fluid that can develop in or on your ovaries. Majority of ovarian cysts are harmless and disappear on their own. But you may need surgery to remove the cyst if it causes you pain or discomfort or if it can be carcinogenic.

The name of the surgical procedure that is used to remove ovarian cysts is laparoscopy (a type of keyhole surgery), but open surgery may be required if the cysts are large.

How you get prepared for the operation will be explained to you by your surgeon. In the event that you are a smoker, for example, you will be asked to stop. Smoking increases the risk of getting an infection after surgery, which can slow down the recovery. It can also result in complications.

Ovarian cysts are usually removed by keyhole surgery as a day-case procedure. That means you can go home the same day of the surgery. The operation is performed under general anesthesia. If you have general anesthesia, you will certainly sleep during surgery. You will be asked to follow the instructions as you will need to fast. That means you do not eat or drink about six hours before surgery. It is important to follow the advice of your anesthesiologist.

You may have to put on compressed socks in order to prevent blood clots forming in the veins in your legs.

Your surgeon will talk to you about what will happen before, during and after your procedure, including the pain you feel. If you are not sure of something, do not be scared to ask. It is important that you feel fully informed to be happy that you have agreed to continue with the procedure. There may be a need for you to append your signature to a consent form this is done to show that you have agreed to go ahead with the surgery.  

As mentioned above, gynecology is a branch of medicine that deals with the health of the female reproductive systems including the vagina, uterus, and ovaries and the breasts. Gynecology can also be referred to as "the science of women". The name given to physicians that specializes in women’s health and more specifically in the female reproductive system is gynecologists.

Gynecologists deal with a wide range of problems such as obstetrics, or pregnancy and delivery, menstrual and fertility problems, sexually transmitted infections (STIs), and hormonal disorders among others. Ovarian cyst removal, vulvectomy, myomectomy, tubal ligation, tubal ligation reversal are some of the procedures performed by gynecologists.