Menorrhagia refers to very heavy and prolonged menstrual bleeding or periods in women. The bleeding is abnormal in nature, and if this continues for a long time, a hysterectomy surgery needs to be carried out to solve the problem.

Bleeding during the night time and passage of large blood clots during menstruation are other symptoms of Menorrhagia.

Causes:

The various possible causes of this kind of heavy menstrual bleeding are:

Hormonal imbalance, specifically of estrogen and progesterone is a common cause, which is more likely in adolescents and in women nearing menopause. Dysfunction in the ovaries also causes hormonal imbalance.

Non-cancerous tumors or fibroids may also be responsible for menorrhagia.

Women suffering from a miscarriage or ectopic pregnancy are likely to experience heavy menstrual bleeding.

Using blood thinners may lead to menorrhagia.

An intrauterine device used for birth control measures can cause disturbance and may lead to heavy menstruation.

A condition known as adenomyosis, where the glands in the uterus lining get embedded in the walls of the uterus, also causes menorrhagia.

Pelvic inflammatory diseases, infection in the uterus or fallopian tubes are other common causes.

Heavy bleeding may occur in patients with ovarian or cervical cancer.

Diseases of the kidney, liver or thyroid diseases may also cause menorrhagia.

Diagnostic Tests:

Several tests and methods are carried out for the diagnosis of menorrhagia. They are:

A general physical examination.

Bleeding diary of the woman.

Blood tests to detect anemia or thyroid.

Pap Smear for the evaluation of cervical inflammation, infections or cancer

Ultrasound for evaluation of pelvic organs like uterus, ovaries and pelvis.

Hysteroscopy, where a camera is inserted into the uterus to observe the linings.

Sonohysterography, where a fluid gets instilled into the uterus along with an ultrasound test.

Treatment:

Certain drugs are used to treat menorrhagia. They include:

Iron supplements for treating anemia.

NSAIDS or non-steroidal anti-inflammatories for treating and reducing blood loss.

Tranexamic acid is used for reducing menstrual bleeding.

Several oral contraceptives are used for regulation of the menstrual cycle. Oral progesterone corrects hormonal imbalance and reduces bleeding.

Surgical procedures for treatment of menorrhagia include:

Hysteroscopy, dilation and curettage, where uterus lining is scraped and evaluated.

Uterine artery embolization treats menorrhagia with fibroids.

Focused ultrasound ablation enables the killing of the fibroid tissue.

Myomectomy, endometrial ablation and endometrial resection are other surgical techniques.

Hysterectomy surgery is the penultimate solution, where the uterus, cervix or ovaries are completely removed.

Menorrhagia is characterized by abnormally heavy menstrual bleeding in women. This is quite unhealthy and proper measures must be taken for curing the heavy bleeding.

Menorrhagia (Heavy Menstrual Periods) - A Common Indication For Hysterectomy

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

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

The kidneys are two small organs located in the abdomen. The main function performed by these organs is filtering of the blood. Kidneys help remove waste from the blood which they turn into urine so that it may be excreted from the body. In doing this they also help regulate blood pressure, maintain the production of red blood cells, and sustain the electrolyte balance. When the kidneys do not function properly, the results could be fatal. 

Hence, it is important to be able to recognize the early signs and symptoms of Kidney failure.

Tiredness: A decrease in kidney functioning can cause toxins to build up in the body and blood. This can make a person feel more tired than usual and keep them from concentrating on simple tasks. Kidney failure is also associated with anemia which can also contribute to fatigue.
Trouble sleeping: Chronic kidney disease has been linked to obesity and sleep apnea. Both these conditions can make it difficult for a person to fall asleep and stay asleep. The buildup of toxins in the blood can also contribute to insomnia.
Dry skin: The skin is one of the first organs to show signs of internal organ failure. Thus, when the kidneys stop functioning as well as they are supposed to, the skin turns dry and itchy. This is because the production of red blood cells is reduced and the amount of minerals or nutrients in the body is unbalanced.
Increased urge to urinate: An increased urge to urinate frequently especially at night could be a sign of kidney disease. This may also be a sign of a urinary infection.
Blood in the urine: Urine should ideally be clear and pale yellow in color. Seeing blood mixed with urine should never be ignored. This is a sign that the kidneys have been damaged and blood is leaking into the urine. It could also be a sign of kidney stones, an infection, or a tumor in the kidney.
Foamy urine: Excessive foam in the urine that does not go away even after flushing could be a sign of protein in the urine. This foam may look similar to a beaten egg white as it is produced by albumin; the same protein present in eggs.
Swollen ankles: Swollen ankles are a sign of sodium retention. This is caused by the improper filtration of blood by the kidneys. The patient may also notice his or her feet getting swollen.

Kidney Failure - Recognising The Early Signs!

A hernia occurs when a weakened area of muscle in the abdominal wall gives way and the internal organ/tissue bulges out through this weakened are or  defect'. This can happen in many different areas of the abdomen. A hernia that develops in the groin region is called "inguinal hernia". It may be very painful especially if a part of the intestine gets trapped in the bulge.

The only treatment option is surgical repair as the weakened area "defect" needs to be repaired and will likely need reinforcement by a prosthetic material called a "mesh". Doctors may resort to Open Surgery or Laparoscopic Inguinal Hernia Repair depending on his/her evaluation of the patient. 

Who is a candidate for Laparoscopic surgery?

Laparoscopic surgery is the preferred treatment option for most people with inguinal hernia. Special situations in which laparoscopic surgery is much superior to open are

  Failure of a previous open surgical repair. Laparoscopic surgery is performed from "behind" the hernia and abdominal wall in comparison to open surgery which is performed from "the front". So, in case of failure of the open surgery, laparoscopic surgery is done through a fresh, non-scarred area and is technically safer and easier than doing an open surgery once again.

  If there are hernias on both sides and both need to be repaired at the same time, laparoscopy has a great advantage as both the hernias can be tackled and repaired through the same three tiny cuts, and two separate large incisions need not be made. 

Who is Not a Candidate for Laparoscopic Surgery?

The person is not a candidate for Laparoscopic Surgery if he has:

  Some patients who have undergone previous Abdominal Surgery or prostate surgery may not be suitable candidates for laparoscopic inguinal hernia surgery.

  Some underlying medical conditions, that make him unfit for general anaesthesia, as usually laparoscopic surgery can only be done under general anaesthesia.

How Laparoscopic Inguinal Hernia Is Carried Out?

In a Laparoscopic Intervention, two to three small incisions are made in the lower abdominal area. The laparoscope is passed through one of these incisions and the surgical instruments are inserted through the other incisions. The abdominal cavity is inflated using Carbon Dioxide to help the surgeon visualize the lower abdominal area clearly. Using the laparoscope, the surgeon visualizes the Hernia and uses long instruments to operate on it. She covers the hernia with a mesh and may fix the mesh to abdominal muscles using either stitches or stapler-like instruments.

Benefits of Laparoscopic Surgery

1. Two or three tiny cuts (5-10 mm in size), hence there is less pain after laparoscopic surgery

2. Better cosmetic results

3. Quicker recovery

4. Early return to daily activities like walking, working, etc

5. Shorter hospital stay 

Role of Laparoscopic Surgeon In comparison to many other minimally invasive surgeries:

Laparoscopic Inguinal Hernia Repair is more demanding in terms of technical capability of the surgeon. In general, Laparoscopic Inguinal Hernia Repair is more difficult to carry out in obese people than others. However, if the doctor is well trained and technically advanced with long experience, he can carry out such minimally invasive surgeries smoothly irrespective of the BMI of the patient. Everybody is not a candidate for Laparoscopic Inguinal Hernia Repair.

It is the doctor who decides if a particular patient is suitable for such surgery or not. However, the conclusive factor in any such repair is the experience and expertise of the doctor. This is why there are not many Laparoscopic Surgeons who carry out Laparoscopic Inguinal Hernia Repairs. Owing to the complexity of this procedure, it is important to get it done from an expert surgeon only.

Laparoscopic Inguinal Hernia Repair !

This surgery involves the removal of Gallbladder, which is a pear-shaped organ that lies right beneath the right side of the liver. The main function of the gallbladder is to collect and concentrate bile, which is a digestive juice produced by liver after eating, aiding digestion. The most common disorder of the digestive system is presence of Gallstones, which are the stones made up of a mixture consisting of cholesterol, bile pigment and calcium salts.

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.
Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

    The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
    A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
    Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
    Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
    In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.

Complications after gallbladder surgery:
This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:
There are three main types of gallstones. They are
1. Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
2. Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
3. Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.

Medical factors to consider before cholecystectomy:
The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:
Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week. 

Gallstone Surgery - Things You Should Know About It 

Don't wait any longer, manage your Robotic Surgeon online with a Lybrate doctor today

Consult for Robotic Surgeon - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES