The ovaries are mainly made up of 3 kinds of cells.... Most ovarian tumors are epithelial cell tumors. Germ cell tumors start from the cells that produce the eggs (ova). Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.

Types:

The ovaries are made up of three types of cells. Each cell can develop into a different type of tumor:

-Epithelial tumors form in the layer of tissue on the outside of the ovaries. About 90 percent of ovarian cancers are epithelial tumors
-Stromal tumors grow in the hormone-producing cells. Seven percent of ovarian cancers are stromal tumors.
-Germ cell tumors develop in the egg-producing cells. Germ cell tumors are rare.

Causes:

Ovarian cancer happens when cells divide and multiply in an unregulated way. However, exactly why this happens is not clear.

The following risk factors are linked to a higher chance of developing the disease:

*Family history:
Women with close relatives who have had ovarian or breast cancer have a higher risk of developing ovarian cancer, compared with other women. Genetic screening can determine whether somebody carries certain genes that are associated with an increased risk.

*Age:
Most cases of ovarian cancer occur after menopause, and especially in women aged over 63 years. It is rare before the age of 40 years.

*Reproductive history:
Women who have had one or more full-term pregnancies, especially before the age of 26 years, have a lower risk. The more pregnancies they have, the lower the risk.

*Breastfeeding may also decrease the risk.

-Birth control:
Using the contraceptive pill for at least 3 to 6 months appears to reduce the risk. The longer the pill is used, the lower the risk appears to be. Using an injectible contraceptive hormone, depot medroxyprogesterone acetate (DMPA or Depo-Provera CI), especially for 3 years or more, reduces the risk further.

-Infertility or fertility treatment:
Fertility drugs have been linked to a higher risk of ovarian cancer, especially in women who used them for more than one year without becoming pregnant. Those who are infertile may also have a higher risk than those who are not, possible due to not carrying a pregnancy.

-Breast cancer:
Women who have received a diagnosis of breast cancer have a higher chance of being diagnosed with ovarian cancer.

For this reason, women who are diagnosed with breast cancer and who test positive for the BRCA1 or BRCA2 gene may opt to have an oophorectomy as preventive therapy.

Symptoms:

It s easy to overlook the early symptoms of ovarian cancer because they re similar to other common illnesses or they tend to come and go. The early symptoms include:

-abdominal bloating, pressure, and pain
-abnormal fullness after eating
-difficulty eating
-an increase in urination
-an increased urge to urinate

*Ovarian cancer can also cause other symptoms, such as:

-fatigue
-indigestion
-heartburn
-constipation
-back pain
-menstrual irregularities
-painful intercourse
-dermatomyositis (a rare inflammatory disease that can cause skin rash, muscle weakness, and inflamed muscles)

These symptoms may occur for any number of reasons. They aren t necessarily due to ovarian cancer. Many women have some of these problems at one time or another. These types of symptoms are often temporary and respond to simple treatments in most cases.

Again, cancers are best treated when detected early. Please consult with your doctor if you experience new and unusual symptoms.

The symptoms will persist if they re due to ovarian cancer. Symptoms usually become more severe as the tumor grows. By this time, the cancer has usually spread outside of the ovaries, making it much harder to treat effectively.

Diagnosis:

A doctor will carry out a pelvic examination and check for any palpable abnormalities in the uterus or ovaries. They will also check the patient's medical history and family history.

The following tests are used to help diagnose ovarian cancer:

-Blood tests: Checking for elevated levels of a marker called CA-125.

-Imaging tests: Transvaginal ultrasound, MRI, or a CT scan might be used.

-Laparoscopy: A laparoscope, a thin viewing tube with a camera at the end, is inserted through a small incision in the lower abdomen. This will allow the doctor to see the ovaries and, if necessary, to take a tissue sample

-Colonoscopy: If there is constipation or bleeding from the rectum, a colonoscopy may be needed, to examine the large intestine, or colon.

-Abdominal fluid aspiration: If the patient's abdomen is swollen, there may be a buildup of fluid, which can be examined by using a fine needle to remove some fluid through the abdomen.

-Biopsy: The usual way to diagnose ovarian cancer is to remove the tumor or part of the tumor to examine for the presence of cancer cells.

Role of Homeopathy In Ovarian:

Treatment of ovarian cancer has to be multi-way therapy. Its not either Homeopathy or conventional treatment. The best long-term results are achieved by combination therapy depending on age, stage of ovarian cancer and general health condition of patient. While conventional treatments like chemotherapy or radiation therapy helps in faster removal of cancer, Homeopathy Treatment for ovarian cancer can help in:

-Regression of ovarian cancer
-Prevention of recurrence of ovarian cancer,
-Removing side-effects of chemo and radiation therapy,
-Relieving cancer pains
-Improving general quality of life and hence, a better reaction to other treatments.

The speciality Homeopathic treatment for ovarian cancer, developed at Welling Clinics can be very helpful for those suffering from ovarian cancer.

Diet and non-diet:

There is no proven evidence regarding the cause of PCOD though gynaecologists are of the opinion that some females possess a predisposition to this disease, and it may run hereditarily in the family. You can alleviate your PCOD symptoms to a considerable extent by regulating your diet properly.

Have loads of fruits and green leafy vegetables and try to abstain from dairy products as many experts believe that dairy products are a direct cause of an increase in insulin levels, which can aggravate skin troubles along with other PCOD symptoms. Avoiding red meat and eating lean meat instead will help the condition and reduce the chances of infertility. It is always recommended to avoid hydrogenated and saturated fats, which are normally found in animal and dairy-based food. Try to put a stop to cheese, cottage cheese, clarified butter, pork, lamb, beef, etc. and certain baked products like cookies, cakes and fudges as they will trigger a rise in your blood sugar and cholesterol levels.

What Is Ovarian Cancer?

Like most things in life, the uterus also has both good and bad sides to it. It is a symbol of womanhood and also carries the developing baby. The bad side is that it brings with it (and its appendages) many problems including dysfunctional uterine bleeding, endometriosis, fibroids, pelvic inflammatory disease, uterovaginal prolapse, adenomyosis, a pelvic pain of unknown origin, cancer of the uterine cavity and other obstetric complications.

Hysterectomy is one of the most commonly performed procedures and ensures complete relief from these symptoms. There are however, multiple procedures, which can be used to manage these conditions without having to resort to removal of the uterus. This can help in preventing complications from hysterectomy including prolonged recovery, infertility in women of childbearing age and loss of womanhood.

Read on to know some of the emerging conservative alternatives to hysterectomy:

Myomectomy: Where there are fibroids, which are in the smooth muscles of the uterus and show symptoms like pain and discomfort. In these, it is advisable to go for a myomectomy. This removes only the fibroid, leaving the uterus in place. It can be done in one of the 3 ways traditional surgical process through an incision; laparoscopically through minute incisions; and then through vagina. In all these, only the fibroid is removed and sent for biopsy to confirm it is benign. It is less invasive, requires less recovery time and helps retain the uterus.

Uterine endometrial ablation: In cases of dysfunctional uterine bleeding or menorrhagia with no fibroids, the lining of the uterus could require removal. In these women, thermal balloon ablation, cryoablation, and radiofrequency ablation can be used. A small amount of extreme heat or cold or radio frequency waves are used to remove the uterine lining, thereby managing symptoms.

Uterine artery embolization: In women with fibroids, the feeding arteries could be cauterised to ensure blood supply is stopped so that fibroid growth is stopped. With very promising success rates, this is gaining popularity as a conservative method.

Laparoscopy and endometriosis excision: In endometriosis, where the uterine tissue is growing in areas outside the uterus, it could be removed laparoscopically after identifying the area of growth on ultrasound and laparoscopy.

Vaginal pessary: In women with uterine prolapse, the uterus drops from its normal position, pushing against the vaginal walls. This can be due to vaginal childbirth, age, smoking and obesity. Vaginal pessary is where a removable device is placed into the vagina to prevent it from falling down. It is a temporary solution, but very useful in holding the uterus in place and relieve symptoms partially or completely.

In all these, medical management (painkillers and hormone replacement), stress and weight management, quitting smoking, reducing alcohol are also essential.

Hysterectomy - Know the Emerging Conservative Alternatives to it?

A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen. 
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have. 
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewelry.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38  C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Surgery For Womb Removal - What You Need To Be Aware Of?

Vaginal cysts are closed packets of fluid, air or pus which develop along the vaginal lining. Vaginal cysts are of many types, and they are usually caused by accumulation of fluids, childbirth-related injuries or non-malignant tumors in the vagina. Usually these cysts do not yield many symptoms, but may cause a little discomfort.

Treatment might not be needed in case of cysts which are tiny. However, larger cysts would definitely warrant medical attention.

Types of Cysts-

The commonly occurring cysts are:

Gartner s Duct Cysts: This duct forms around a woman s reproductive canal during pregnancy and it disappears post childbirth. If the duct remains even after the delivery, it may lead to fluid accumulation, thus resulting in a cyst.

Vaginal Inclusion Cysts: Any injury to the vaginal walls, especially during childbirth or surgery, can lead to vaginal inclusion cysts.

Bartholin s Cyst: Bartholin s gland is situated near the vaginal opening. A flap of skin covering this gland may lead to accumulation of fluid. This fluid accumulation usually leads to a cyst which is called a Bartholin s cyst.

Treatment-

Usually, cysts in the vagina do not require any treatment. Most of the cysts do not grow in size and thus do not cause major problems. A biopsy of the cyst may require in order to rule out chances of cancer. A common treatment for vaginal cysts would be to sit inside a bathtub filled with warm water so that the cyst is allowed to soak in the water. If there are symptoms of infection in the vagina, then antibiotics are required.

If the size of the cyst is large and filled with fluids, then a catheter needs to be inserted into it to drain out the cyst. Usually, the catheter is kept in place for a few weeks before it is removed. A surgical procedure called marsupialization is used in some cases, wherein an incision is made around the affected area and into the cyst in order to drain out its contents.

Surgery to remove the entire cyst may also be recommended to prevent its recurrence.

Vaginal Cysts - Types and Treatment

The liver has a significant role to play in metabolism and digestion. The failure of a liver can lead to significant health issues. There are some causes for liver failure, which cannot be treated with medications. In these people, a transplant, which is replacing the diseased or injured liver with another liver, is the only definitive treatment option.

Some conditions which can require a liver transplant are:

Severe cirrhosis with a life expectancy of less than a year
Severe liver failure
Non-alcoholic steatohepatitis (NASH)
Liver cancer
Chronic hepatitis C
Biliary atresia in children
Types of transplant:

Living donor transplant: In some patients, partial liver can be removed from a close family member and transplanted into the affected individual. The liver is known for its regeneration ability, and over time, will grow in the recipient.
Cadaveric transplant: Immediately after death, a liver can be removed and transplanted.
While the concept of a transplant sounds quite convincing and appealing for those with a severe liver disease, it is also important to note that not all would qualify for a liver transplant. The conditions which would disqualify a recipient are discussed below:

Significant heart disease: Those with severe coronary artery disease, valvular disease, cardiomyopathy, aortic stenosis, and cardiomyopathy are not candidates for a liver transplant.
Severe lung disease: Those with poor lung perfusion do not qualify for a liver transplant.
Advanced age: Greater the age, lesser the survival rates. So, people aged more than 70 are usually not considered for a transplant.
Obesity: A person with a BMI of more than 35 is often not a good candidate for a transplant. The overall health should be managed in these people.
Malnutrition: On the other extreme, severely malnourished individuals are also not considered for a transplant.
HIV infection: A person who is HIV-infected does not qualify for a liver transplant.
Substance abuse: Anyone who is actively abusing alcohol and/or substances is definitely removed from the list for a transplant.
Metastasis: If a patient is looking for a liver transplant due to hepatic cancer, it is essential that the cancer is contained. If it has spread to various parts, then containing it would be difficult, and a transplant may not succeed.
Multisystem organ failure: Other than heart and lungs, even people with poor renal function are not ideal candidates for a liver transplant.
A detailed liver recipient evaluation assessing the severity of liver disease, chances of survival, and overall health are done before a person is listed for liver transplant. This evaluation ensures a better success rate with the transplant.

Common Surgical Complications That One Should Be Prepared For?

The kidneys are primarily responsible for filtering blood and removing waste from the body. They also regulate the fluid and electrolyte balance. If the kidneys stop functioning, a patient may need to undergo dialysis or have a renal transplant. Many patients prefer undergoing a transplant as it offers a better quality of life in the long run.

A kidney transplant can be described as a procedure to replace one s own kidneys with a donor's kidney. In case of kidney transplant, there are two types of donors. The human body can function with one healthy kidney and hence family members and friends of the patient may choose to donate a kidney. Else, a kidney may be sourced from recently deceased donors who have chosen to donate their organs after death. In both cases, it is important that the donor kidney match the patient s blood and tissue type.

A renal transplant surgery usually takes about 3 hours. The donor kidney is placed in the abdominal cavity and connected to the patient s arteries, veins and bladder. Usually, the donor kidney begins functioning immediately. The patient s own damaged or diseased kidneys may not be removed unless there is a severe infection, cancer or a diagnosis of large polycystic kidneys.

The patient will need to be hospitalized for a few days after the surgery. In some cases, dialysis may be needed if the kidneys are unable to produce urine. In addition diuretics and other medication may be needed to remove excess water and salt from the body. Medication will also be prescribed to suppress the immune system so that the patient s body does not reject the donor kidney. These medications typically need to be taken for the rest of the patient s life.

A renal transplant is considered a relatively safe procedure. Less than 20 out of 100 people reject a donor kidney. However, there are a few other risks involved. These include:
  Bleeding
  Severe infection
  Failure of the donor kidney
  Reaction to anesthesia
  Increased risk of infections due to suppressed immune system

Kidney transplant is not advised for people suffering from diseases such as cancer or any significant lung or heart disease. If the patient is suffering from an infection, he or she may be advised to wait until the infection subsides before undergoing a renal transplant. A renal transplant may seem to be an expensive procedure but in the long run, this can work out to be more budget friendly than dialysis.

Renal Transplant - What Should You Know About It?

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