Arya Women's Hospital

Abnormal uterine bleeding, also known as AUB, is one of the most common causes requiring gynecologic evaluation. Hysteroscopy is a procedure wherein a thin camera called hysteroscope is introduced into the uterus via the vagina and this light helps in a thorough examination of the uterus. In cases where there are cysts or fibroids or even cancerous growths, this is used to get more details on the lesions. However, hysteroscopy also has a therapeutic use in that it is used to treat conditions like abnormal uterine bleeding. Read on to know more about AUB and how hysteroscopy helps in treatment. 

Causes of Abnormal Uterine Bleeding: Vaginal bleeding that occurs more often than 21 days and farther apart than 35 days is known as abnormal uterine bleeding. The bleeding is also abnormal if it lasts longer than 7 days and more than 80 mL of blood is lost during each cycle. 

Some causes include: 

1. Hormonal imbalance 
2. Cancer 
3. Uterine polyps 
4. Uterine fibroids 
5. Cervical infections 

Diagnosis/Treatment: 

When a woman has abnormal bleeding, further diagnosis is required to confirm the exact cause of the bleeding. This is where the hysteroscopy comes into the picture. Hysteroscopy, literally translates to viewing the uterus from inside directly through a camera. 

How it is done: 

Hysteroscopy is done as an outpatient procedure and normally takes about 3 to 4 hours. General or spinal anesthesia may be used depending on complexity and overall patient health. The uterus is filled with a fluid like saline or glycerin and a thin lighted instrument called the hysteroscope is inserted through the vagina, up the cervix, and into the uterus. This tube is flexible and so can be moved across the uterus to identify any areas of abnormality. It also has a camera and so can be used to take pictures of suspicious areas. 

Causes for infertility may also be detected using hysteroscopy. Small knives can also be used to remove the lesion like fibroid or polyp. These are often the cause of abnormal bleeding. Samples can also be taken for biopsy to confirm if any cancerous growth is detected.

Hysteroscopy is a safe and effective way to examine the cervical canal and uterine cavity. It is better to accompany D&C with hysteroscopy instead of going for blind dilatation and curettage, especially in women who are peri or premenopausal. Hysteroscopy is a safe procedure if done by a doctor, specialised in gynecological endoscopy and helps in both diagnosis and treatment of abnormal uterine bleeding.

In vitro fertilization (IVF) is a remarkable and complex process in which sperm and egg are united outside the body and implanted into a woman’s reproductive tract. Many treatments significantly improve the chances of getting pregnant. They include hormone treatments, fertility drugs and surgery.

Laparoscopy is one of the most common procedures for diagnosing and removing endometriosis. Instead of giving a big incision, this procedure of surgery uses lightweight instrument through a small hole or incision. There could be one or more incisions based on the number of instruments that require access inside the body. This procedure involves the use of a camera to ascertain endometriosis as well as treat it in the same sitting. This brings drastic improvement in infertility as well as pain associated with the endometriosis. If a cyst is found in the ovary, laparoscopic surgeon removes it very delicately without causing any harm to the normal ovary, as a part of the Laparoscopic Surgery for Endometriosis. 

How does the procedure go? 

Eating and drinking should be suspended before 8 hours of the laparoscopic surgery. The doctor takes a call on whether to give a general or local anesthesia. Mostly, General anaesthesia is given during such procedures. A person specialised in Gynecological Endoscopy ( Gynaec Laparoscopic Surgeon) is the best to perform such a procedure. 

How is the procedure performed? 

The abdomen is first inflated with gas with the help of a needle. It pushes the abdominal wall from the organs to give a clear visibility to a surgeon. The laparoscopic Camera is then pushed through an incision or a set of incisions to examine the internal organ. If the scar tissue or endometriosis needs to be removed, a doctor can use one of the several laparoscopic techniques such as electrocautery, excision etc. Post the surgery, the incision is closed with stitches. The whole procedure usually takes 30-60 minutes depending upon the severity of endometriosis. 

Why is laparoscopy done? 

1. If the endometriosis pain has returned after a hormone therapy 
2. If there is a growing endometriotic cyst 
3. If the scar tissue found on the pelvic wall poses a threat on fertility 
4. If the endometriosis interferes with other organs such as the bladder etc. 
5. If the pain during menses ( dysmenorrhoea) refuses to subside 

Duration of hospital stay: 
Operations such as these are usually conducted at the outpatient facility owing to their less risky nature. A patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalisation may also be required. One can successfully return to normal work within 1 week of the surgery. 

Post-surgical recovery: Once the laparoscopy is done, the next steps of treatment are decided based on the patient's age and severity of endometriosis. Few hormonal medicines are advised according to the desire for fertility etc. If a patient is over and above 35 years of age, the risk of miscarriages double. Since the quality of egg declines by the year, it makes sense to undergo infertility treatment such as the in vitro fertilization, intake of fertility drugs, insemination etc. If, however, the patient is below 35 years of age, makes sense to conceive naturally first and consult a doctor simultaneously. A routine check-up post-laparoscopic surgery on alternate six months for a year will keep any risks at bay. In case you have a concern or query you can always consult an expert & get answers to your questions!

Breast cancer is a medical condition that refers to the uncontrolled growth of cells in the breast. These cells can be like small tumours or lumps. The tumour can be malignant if it is found that the cells are growing into surrounding tissues or are spreading. It occurs mostly in women.

Breast cancers can originate from any part of the breast. Most of these cancerous growths start in the milk-carrying ducts. There are also cancerous growths in the glands that produce milk. These are known as lobular cancers. In rare cases, cancer may also start from the breast tissues. These are known as sarcomas and lymphomas.

Here are some of the ways to get prevented from the possibility of developing breast cancer:

1. Check your weight: It is important that you maintain a healthy weight. You don’t need do follow the hard and fast dieting charts or starve. But eat a balanced diet and exercise a bit to maintain a stable and healthy weight throughout. Being obese or overweight increases the chance of developing breast cancer.
2. Be Active: A sedentary lifestyle devoid of activities is something that invites diseases. It has been found that women who are physically active and exercise for at least 30 minutes a day are at a low risk of developing breast cancer.
3. Don’t avoid fruits and vegetables: It is important for you to have a balanced diet. Include lots of leafy vegetables and fruits in your diet to avoid the possibility of developing any form of cancer. Don’t drink excessive alcohol on regular basis. Remember a healthy diet is a key to a healthy life.
4. Don’t Smoke: Smoking increases the chance of developing heart diseases, stroke and 15 types of cancers. It also increases the risk for breast cancer.
5. Breastfeed your baby: It is mandatory for good health that you breastfeed your baby. Exclusive breastfeeding is best for the health of your baby as well as yours. It lowers the chances of developing breast cancer.
6. Avoid Birth Control Pills: These pills have side-effects. They increase the risk of developing breast cancer. It also increases the chances of developing heart diseases and ovarian cancer.
7. Avoid Post-Menopausal Hormones: Post-menopausal hormones have an adverse effect on the health. They increase the risk of some diseases while lowering the effects of other ones. It should be taken for a shorter period and its prolonged use must be avoided.