Comprehensive Gynaecology Treatments & Advanced Women’s Healthcare

Extensive Gynaecology Treatments

At PACE Hospitals, we provide comprehensive gynecological care for a variety of women’s health concerns, including reproductive disorders, menstrual issues, menopause, and pelvic conditions. Our specialists offer advanced diagnostics and personalized treatment plans. 

Non-Pharmacological Interventions

These approaches do not involve medication or surgery. They are used in combination with other treatments or as standalone options, depending on the condition.

Lifestyle Modifications

• Dietary Changes: A balanced diet rich in fruits, vegetables, and whole grains can help in managing conditions like polycystic ovary syndrome (PCOS), obesity, and endometriosis.
• Exercise: Regular physical activity is essential in managing conditions like obesity, PCOS, and improving overall reproductive health.
• Weight Management: Reducing weight can help manage insulin resistance in PCOS, decrease the risk of uterine fibroids, and reduce symptoms of endometriosis.
  
  

Pelvic Floor Exercises (Kegel Exercises)

These kinds of exercises strengthen the pelvic floor muscles, which can help manage incontinence, pelvic organ prolapse, and pelvic pain.

Psychological Support

• Counseling and Therapy: Cognitive behavioral therapy (CBT) or other therapeutic methods may help with stress, anxiety, and depression associated with chronic gynecological conditions like endometriosis, infertility, or menstrual disorders.
• Mindfulness and Relaxation Techniques: Techniques like yoga, meditation, and mindfulness can help reduce stress and alleviate pain.
  
  

Physiotherapy

• Pelvic Physiotherapy: This is useful for conditions like pelvic pain, pelvic organ prolapse, and incontinence, this involves techniques like manual therapy and muscle retraining.
  
  

Alternative Therapies

• Acupuncture: Used for various conditions such as menstrual cramps, endometriosis, and menopause symptoms.
• Herbal Remedies: For conditions like menstrual cramps, menopause symptoms, and vaginal infections, some women may use herbal treatments. These should be used under the guidance of a healthcare professional.

Pharmacological Management

These treatments involve the use of medications to manage or treat gynecological disorders.

Hormonal Therapy

• Oral Contraceptives (Birth Control Pills): These are used to regulate menstrual cycles and manage diseases like PCOS, endometriosis, and fibroids. These pills include synthetic hormones that regulate ovulation, minimise heavy menstrual flow, and inhibit extra tissue growth, thus alleviating symptoms such as irregular periods and pelvic pain. 
  
• Progestogens: These are a synthetic form of the hormone that plays a key role in regulating the menstrual cycle and stabilising the endometrial lining. It is commonly prescribed for conditions like endometriosis and abnormal uterine bleeding, where it helps to control bleeding, reduce pain, and regulate menstruation. 
  
• Hormone Replacement Therapy (HRT): This is used primarily for managing menopause symptoms like hot flashes, vaginal dryness, and osteoporosis. In addition to symptom relief, HRT also helps protect against bone density loss, reducing the risk of osteoporosis in post-menopausal women.

Pain Management

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These are commonly used for pain relief in conditions such as dysmenorrhea (painful periods), endometriosis, and pelvic inflammatory disease (PID). By reducing the production of prostaglandins, NSAIDs alleviate pain and reduce inflammation, offering relief from menstrual cramps, pelvic pain, and the discomfort caused by inflammation in the reproductive organs.
  
• Opioids: These are stronger pain relievers that are used when pain is severe and doesn’t respond to NSAIDs. Opioids may be prescribed for conditions like severe endometriosis or after surgical procedures like a hysterectomy. 

Anti-Androgens: This is an anti-androgen medication that blocks the effects of male hormones (androgens). It is particularly effective in treating hirsutism (excessive hair growth), a common symptom of PCOS. By reducing androgen levels, these drugs help manage unwanted facial and body hair, acne, and scalp thinning, improving the cosmetic and psychological aspects of these conditions.

Fertility Medications

• Ovulation stimulant agents: This is commonly prescribed for women with PCOS or other ovulatory disorders who struggle with infertility. They work by stimulating ovulation, encouraging the release of eggs from the ovaries, and improving the chances of conception. 
• Gonadotropin Releasing Hormone (GnRH) Analogues: These are injectable hormones used to stimulate the ovaries in women who do not respond to oral fertility medications. These hormones (FSH and LH) directly stimulate the ovaries to produce multiple eggs, which is particularly helpful in assisted reproductive techniques like in vitro fertilization (IVF).

Other Medications

• GnRH Agonists: These agents work by suppressing the production of female hormones, leading to a temporary menopause-like state. These medications are used to treat endometriosis and fibroids by reducing the estrogen-dependent growth of endometrial tissue and fibroid size. This helps reduce pain, heavy bleeding, and other symptoms associated with these conditions.
• Intrauterine devices (IUDs): These are intrauterine device that releases a hormone to help control heavy menstrual bleeding, treat endometriosis, and provide long-term contraception. It helps reduce menstrual bleeding, pelvic pain, and the growth of endometrial tissue in conditions like endometriosis, while offering a reliable form of contraception.

Minimally Invasive Procedures

Endometrial Ablation

Endometrial ablation is a minimally invasive procedure that destroys the endometrial tissue lining of the uterus to treat abnormal uterine bleeding. It can be caused by several reasons, such as hormonal changes, fibroids and polyps in the uterus. It is typically recommended for women who don't wish to become pregnant in the future. Gynaecologists don't make any incisions (cuts). Instead, they use a thin tool inserted through the vagina to reach the uterus and destroy the uterine lining.

Ovarian Cystectomy

Ovarian cystectomy is a surgical procedure for removing ovarian cysts. Ovarian cysts are fluid-filled sacs that are common and disappear on their own. This procedure may recommend when the cysts are large, causing pain and are not going away. Gynaecologists remove ovarian cysts using laparoscopic ovarian cystectomy (makes a small incision in the abdomen to send tool named a laparoscope and uses surgical instruments to remove cysts by making another small incision) and open cystectomy (laparotomy – the surgeon makes a large incision to remove the cyst).

Cervical Cerclage

Cervical cerclage is the surgical procedure performed by closing the cervix at the time of pregnancy or before the pregnancy to prevent premature birth. It is typically recommended for women with a weak or problematic cervix or those at risk of early labour. Obstetricians can stitch the cervix during this procedure to prevent preterm labour, and the stitches are removed either during delivery or after 37 weeks of pregnancy.

Cervix Cryrocautery

Cryocautery is a fast and effective method of temporarily freezing the cervix using a metal probe for 1-2 minutes. This freezing can treat mild abnormal cervical cells and excessive vaginal discharge or bleeding during sex. It promotes the growth of thicker and tougher tissue, which leads to less bleeding during sex or less production of vaginal discharge. A speculum is used to open the cervical area for clear visibility. Then the gynaecologist places a cold metal probe on the cervix for up to 1 to 2 mins. It may cause menstrual-type pain.

Dilation and Curettage (D&C)

Dilation and curettage (D&C) is a minimally invasive surgical procedure to remove tissue from the uterus. It treats conditions such as miscarriage, abnormal uterine bleeding, and leftover tissue after an abortion. During the process, the gynaecologist dilates (expands) the cervix using a laminaria stick and then uses a curette (a suction or scraping device) to remove or clean out the tissue from the uterus and send it to the lab for further evaluation to check for any abnormalities.

Uterine Fibroid Embolization

Uterine Artery Embolization, or Uterine Fibroid Embolization (UFE), is a procedure to treat or reduce the size of symptomatic uterine fibroids (shrink non-cancerous tumours in the uterus) by blocking the blood supply. Monitoring through fluoroscopy (a form of real-time x-ray), the embolic agents (agents for blocking blood flow) are delivered to the uterus to treat the fibroids. The duration of recovery and hospitalization are minimal as this procedure is not a major surgery. Uterine artery embolization is also a safe and reliable procedure for postpartum haemorrhage (blood loss by the mother during birth).

Hysteroscopic Polypectomy

Hysteroscopic polypectomy is a surgical procedure to remove the endometrial (uterine) polyps by preserving the womb (uterus). Uterine polyps are small fleshy growths that can form along the inner lining of the uterus (endometrium). These polyps are common, but rarely do they become cancerous. It is performed for endometrial biopsy and to remove the polyps. An extended thin scope attached with a light, a camera, and surgical instruments called a hysteroscopic resectoscope is inserted into the vagina and cervix into the uterus to remove the tissue. The gynaecologist utilizes an electrosurgical wire loop on the resectoscope to remove polyps or fibroids.

IUD Insertions

IUD abbreviates as intrauterine device, a minor procedure that includes insertion of T-shaped device into the uterus to prevent pregnancy by stopping sperm cells reaching and fertilising eggs. It is most effective among various forms of reversible birth control. The gynaecologist will perform a pelvic examination with the help of fingers before inserting a speculum to view the inner side of the vagina. The IUD will be placed inside the uterus with the help of special instrument and speculum will be removed after successful IUD placement.

Laparoscopic Tubal Recanalization

Tying fallopian tubes is called tubal ligation, and it is a permanent process to prevent pregnancy, but laparoscopic tubal recanalization can reverse it. The woman can become pregnant, depending on the ovaries' age and functioning. This is performed by making an incision at the abdomen, using a laparoscope to view the fallopian tubes. Then the gynaecology surgeon unties the tied fallopian tubes and reattaching them. A highly skilled professional is needed to perform this procedure.

Laparoscopic Ovarian Cystectomy

Laparoscopic ovarian cystectomy is used to remove ovarian cysts through small incisions in the abdomen. A thin tube with a camera is inserted to visualise the ovaries, and surgical tools are used to remove the cysts. This procedure has many benefits, including minimal scarring and a quicker recovery time compared to traditional surgery. It is commonly used to treat ovarian cysts that are large, persistent, or causing pain. It can also help address cysts associated with endometriosis (endometriomas) or PCOS by removing cysts while preserving ovarian function, making it a good option for women wishing to retain fertility.

Salpingo-oophorectomy

This surgical procedure is the removal of both the ovaries and fallopian tubes, performed through an abdominal or laparoscopic procedure. This surgery is needed for treating ovarian cancer, which involves removing the cancerous tissues and preventing the spread of the disease. In cases of endometriosis, where endometrial tissue affects the ovaries, removing the ovaries can alleviate pain and prevent further complications. 

Women at high genetic risk for ovarian or breast cancer may opt for this procedure as a preventive measure. Additionally, this surgery is performed in cases of chronic pelvic inflammatory disease (PID) when infections have caused irreversible damage to the ovaries and fallopian tubes.

Surgical Procedures

Hysterectomy

A hysterectomy is a surgical process involving removing the woman's womb (uterus). It is a common treatment for various reproductive system problems such as abnormal uterine bleeding, chronic pelvic pain, fibroids, ovarian cancer, cervical cancer, womb cancer or fallopian tube cancer. After the procedure, the woman cannot menstruate or become pregnant.

Myomectomy

Myomectomy is a minor surgical procedure to remove uterine fibroids from the uterus. Fibroids are benign (non-cancerous) muscle cells that grow inside or outside the uterus. During the procedure, the gynaecologist removes the fibroids while preserving healthy tissue in the uterus to enable pregnancy in the future. It is the best choice if someone wants to conceive in future. Laparoscopic Myomectomy, Abdominal myomectomy, and Hysteroscopic myomectomy are the types of myomectomies.

Caesarean Section (C-Section)

Caesarean section is also called C-Section. It is a surgical delivery of the baby by making an incision (cut) in the abdomen and uterus of the mother. It should be performed when the vaginal (normal) delivery of the mother is either unsafe or not possible and when the baby is at risk. Some conditions that may require a caesarean birth include foetal size, abnormal foetal heart rate, foetal position, placenta problems, diabetes, high blood pressure, or HIV infection in the mother.

Oophorectomy

Oophorectomy is a surgical procedure that involves removing one or both ovaries. It is also known as ovary removal surgery (ovariectomy). Removal of one ovary is called unilateral oophorectomy, while removal of both ovaries is called bilateral oophorectomy. This procedure can help prevent ovarian cancer, endometriosis, and pelvic inflammatory disease. here are different types of oophorectomy procedures, including prophylactic oophorectomy, a preventive surgery to avoid the risk of getting cancers, and salpingo-oophorectomy, which involves removing one or both ovaries and fallopian tubes. Partial oophorectomy consists in removing one or both ovaries.

Elective Abortion

Abortion is a common medical procedure for terminating a pregnancy, which can be done through medication or surgery. Over the world, one in four pregnancies ends in absorption. Elective abortion is widely practised and generally considered safe. However, late-term abortions can result in severe complications such as miscarrlage, ectopic pregnancy, and sterility.

Vulvectomy

A vulvectomy is a medical procedure typically performed to remove cancerous or precancerous cells found on the vulva (contains inner and outer labia as well as the clitoris). Patients undergoing this procedure can expect a thorough consultation with their healthcare provider to discuss the risks and benefits of the surgery, as well as any possible side effects or complications that may arise. Ultimately, vulvectomy is an essential medical intervention that can help to avoid the spread of cancerous cells and improve a patient's overall health and well-being.

External Cephalic Version
It is a procedure of turning the baby from the breech (feet) position to the down (head)position. It is done when the baby's feet (breech position) present at the opening of the uterus, making vaginal delivery difficult. This procedure is usually safe, but some risks are rarely associated, such as alteration in the baby's heartbeat, placenta tearing and preterm labour.

Pelvic Floor Repair (Colporrhaphy)

Colporrhaphy refers to surgical repair of the pelvic organ prolapse, such as prolapsed bladder or rectum. Pelvic organ prolapse occurs when the bladder, bowel, top of the vagina, or uterus slips down and bulges into the vagina from its normal position. It is a minor surgical procedure to repair and strengthen the vaginal wall after a prolapse. During this procedure, a cut is made near the vaginal entrance, after which the gynaecological surgeon repairs and restructures the weakened tissue. Laparoscopic colposuspension is a minor surgical technique that provides a safe method of reconstructing the pelvic floor without needing a large abdominal incision or other surgeries, including vaginal mesh and hysterectomy.

Episiotomy

Episiotomy is a surgical procedure where a cut (incision) is made between the vaginal opening and anus, known as the perineum, to allow the baby to come out more easily. This procedure may be done to prevent tearing of the perineal tissue. It is usually recommended when the mother is exhausted from pushing for several hours, when there is a risk to the baby's health, or when the baby's heartbeat is increasing. It may also be recommended to avoid the risk when the mother has heart disease.

Salpingectomy

A salpingectomy is the surgical removal of one or both fallopian tubes, which can be done using either traditional open surgery or minimally invasive laparoscopic surgery. This procedure is important in treating conditions like ectopic pregnancy, where the fertilized egg implants outside the uterus, typically in the fallopian tube. If the pregnancy is not viable and poses a risk to the woman’s health, removing the affected tube is necessary. This surgery is also performed to treat fallopian tube cancer and chronic pelvic infections that cause blockages or damage to the tubes. Removing the tubes can improve fertility in cases where infections or scarring have rendered the fallopian tubes nonfunctional.

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