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Dilation and curettage procedure which is commonly referred to as D&C is a minor surgical procedure where the cervix is dilated while a special instrument is used for scraping out the lining of the uterus. It is important to know what you can expect before, after and during the process so that you can stay ahead of unnecessary worries and help the process to be smooth and fruitful.
When do doctors recommend dilation and curettage process?
You may be required to undergo the dilation and curettage procedure for one of many reasons. It can be used for removal of tissues in the uterus during or after an abortion or miscarriage or to remove little pieces of placenta after delivery. This process aids in preventing infection as well as heavy bleeding. On the other hand, it can help in diagnosing and treating abnormal uterine bleeding including polyps, fibroids, hormonal imbalances and even uterine cancer. A sample of the tissues in the uterus is tested under a microscope to check if there is any abnormal cell present.
What can you expect during the dilation and curettage process?
The D&C procedure is a minor one and takes about 15 minutes even though you will have to spend about 4 to 5 hours in the healthcare facility. Before the procedure, your doctor would check complete history, and at this point, you should tell your doctor if you suspect that you are pregnant, you are sensitive to latex or any medicines or if you have a history of bleeding disorders. You will then be given anesthesia so that you don’t feel any pain or discomfort during the procedure. Before this procedure, you will have to empty your bladder.
The D&C procedure comprises two main steps, dilation, and curettage.
Dilation involves opening of the lower part of the uterus or the cervix for allowing insertion of a slender rod. This is done to soften the cervix so that it opens and allows curettage to be performed. Curettage involves scraping of the lining and removal of the uterine contents with the help of a spoon-like instrument known as a curette. This may cause some amount of cramping, and a tissue sample would be taken out for examination in the laboratory.
After the completion of the procedure, you may experience slight bleeding and cramping. In some rare cases, adhesions or scar tissues may start forming inside the uterus, and this condition is termed as Asherman’s syndrome which can cause changes in the menstrual cycle along with infertility. This problem, if arises, can be solved with the help of surgery and therefore, you should report any abnormality in your menstrual cycle to your doctor. In case you have a concern or query you can always consult an expert & get answers to your questions!
Brain mapping is a technique where the biological quantities of a human brain are represented as spatial quantities resulting in maps. As with many other medical technologies, brain mapping is fast-evolving as well. Among several uses, brain mapping is chiefly used while performing surgery on the brain.
When surgery is to be performed on the brain such as surgery for epilepsy, the surgeon would want to comprehend how the brain areas are affected by seizures. The surgical intervention is meant for removing as much as seizure focus as possible while preserving crucial functions like understanding, speech, vision, movement, and sensation.
Why is brain mapping performed?
Brain mapping is a process which helps in identification of functions of various parts of the brain. Mapping the brain by stimulating different areas of the brain areas can aid in creating a map for a particular person. The map allows the doctor in understanding what parts of the brain are responsible for performing critical functions including sensation, movement, speech and other functions.
Which functions of the brain can be mapped electrically?
Typical areas of the brain which have motor, language, visual and sensory functions are needed to be mapped. When current is applied to a single area at a time, the doctor understands which part of the brain is responsible for which function.
When the patient is not able to speak due to the current, then the area is likely to be crucial for language function. If the limbs, face or trunk of the patient stop moving as the current passes, the area that is tested is responsible for movement. On the other hand, if the individual experiences tingling, numbing, and other sensations when the current is applied, it means that a sensory region is discovered.
How is electrical brain mapping performed?
Electrical brain mapping for guiding brain surgery for epilepsy can be performed in two distinct processes: directly during the surgery or in a two-stage procedure.
In the first stage of the process, the surgeon creates an opening in the skull which helps in exposing the surface of the brain. Small electrical contacts or electrodes are placed on the brain surface even though no brain tissue is removed. As soon as the electrodes are in the right position, the scalp is closed. The electrodes not only record the seizure of the patient electrically but also allow mapping of various areas of the brain. The last stage is surgery where abnormal brain tissues are removed.
Brain mapping process during surgery:
Electrical brain mapping may also be performed during the surgery which exposes part of the brain. This is termed as intraoperative brain mapping since it occurs while performing the main operation. The process of mapping may last for an hour to several hours at a stretch.
Brain mapping is also used to diagnose neurodegenerative diseases like Alzheimer’s and Parkinson’s. In these cases, the brain map shows extreme shrinkage of the brain due to tissue loss. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
Dear doctor, One of my relative suffered due to minor brain stroke She gave birth to baby by cesarean just a week before the stroke. Is there any relation between delivery and stroke. Kindly let me know. Note She is 30 years old female.
I am suffering from slipped discs. L4 L5 S1 & L3. I am living in misery of this problem. I have been advised by doctors to opt for surgery. I am not willing to do it. Help me with a much safer and permanent solution for this dreaded problem. Regards Yogesh saaheb Divekar.
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With the modernization of all economies around the world, one health hazard that has become one of the largest perils within both developed and developing nations is the incidence of cancers of the female reproductive system, especially cervical and breast cancer.
Breast cancer is the formation of malignant tumors within the breast tissues of a woman. Usually, breast cancer affects women in the age range of 40 to 50, but there have been many reports of it occurring earlier. About 48 % percent of the Indian women having breast cancer have been reported to be under 50. This is an almost 17 percent jump compared to figures 25 years earlier.
Alarming Signs of Breast Cancer:
- The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded.
- Swelling of all or part of a breast (even if no distinct lump is felt)
- Skin irritation or dimpling
- Breast or nipple pain
- Nipple retraction (turning inward)
- Redness, scaliness, or thickening of the nipple or breast skin
- Nipple discharge (other than breast milk)
Screening Guidelines for Breast cancer:
- Mammography: US Preventive Services Task Force (USPSTF) recommends mammography once in every 2 year for females between age group 50-75 years. Women with a family history has a benefit of starting at age 40 years. After 75 years there are insufficient evidence of benefit of screening mammography.
- Breast Self Examination and annual Clinical examination: breast self examination is easy to learn and and any abnormality should be reported to the oncologist.
- For High Risk/ Genetic risk factors: screening should start by age 25 or 10 years earlier of youngest relative affected. Annual mammogram and MRI or Doppler ultrasound alternating at 6 month interval can be considered.
Some of the common treatment options for breast cancers are:
- Breast conservation surgery - This is where the tumors are removed without cutting out too much of the surrounding breast tissue.
- Mastectomy - If the cancer has spread too far then large amounts of breast tissue has to be removed along with the tumor to stop its spread any further.
- Sentinel lymph node Biopsy - it's part of both surgical procedures, it decreases morbidities of lymph node dissection first draining lymph nodes only are removed in patients with clinically negative axilla. If negative on frozen section further axillary dissection is avoided. It avoids the morbidity of complete axillary clearance.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I am a 30 years old male and since last 3 months I was having pain in right leg whenever I used to walk. My doctor advised me Lumbosacral MRI and my findings are as under: 1. Lumbar lordosis is mildly straightened. 2. Disc desiccation noted at L5-S1 noted. 3. Posterior disco osteophytes complex seen at L5-S1 level causing canal stenosis measuring 7mm and bilateral lateral recess stenosis, causing compression upon traversing S1 nerve roots and mild foramina narrowing with abutting bilateral L5 nerve roots. 4. Mild diffuse disc bulge at L4-5 level causing indentation of thecal sac with early lateral recess stenosis, however no significant neural compression seen.
Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.
Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:
- Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
- Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
- Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding. If you wish to discuss about any specific problem, you can consult a general-surgeon.
With the recent number of breast cancer cases on the rise, it is important that we should get the examination done on a regular basis as a preventive measure. Even if someone is suffering from it, it is important that we should make an effort and learn about.
If you have breast cancer then a surgery will be part of your treatment. Based on the condition, surgery will be carried out due to any of the following reasons:
1. To remove the cancerous tissues from the breast
2. To reconstruct the breast once the cancer is removed
3. To check whether the cancer has spread to the lymph nodes below the arm
4. To treat symptoms of cancer that has progressed to an advanced stage
Breast cancer surgery may be classified into two types
1. Mastectomy: Mastectomy involves removing the entire breast; tissues in the adjoining region may also be removed. A double mastectomy is a procedure where both the breasts are removed.
2. Breast-conserving surgery: In this surgery, only parts of the breast affected by cancer are removed. The area of the breast that is to be removed will depend on the severity of the cancer. Some healthy tissues may also be removed in this surgery.
Usually, if a woman is in the initial stages of cancer then she may opt for the latter as it entails removing parts of the breast. They may also undergo radiation therapy along with these surgeries.
For checking if the cancer has spread to the lymph nodes below the arm, the lymph nodes are removed from the body. Once they are removed, they are studied under a microscope to check if it has spread, if yes then the extent of their damage. This procedure is carried out along with the surgery to remove the cancer.
Once the mastectomy procedure is completed, you can opt for a breast reconstruction surgery to rebuild the area. You may opt for this procedure at the time of breast cancer removal or at a later stage. If you are considering breast reconstruction surgery then you should discuss it with your surgeon.
Surgery is sometimes not used to treat cancer, but in slowing the progression of cancer or even reducing its symptoms.It is important you talk to your surgeon before the procedure to understand the goal of the surgery.
In case you have a concern or query you can always consult an expert & get answers to your questions!