Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. Usually the treatment is done in the second trimester of pregnancy, for a woman who had either one or more late miscarriages in the past.
The treatment consists of a strong suture being inserted into and around the cervix early in the pregnancy, usually between weeks 12 to 14, and then removed towards the end of the pregnancy when the greatest risk of miscarriage has passed.
In women with a prior spontaneous preterm birth and who are pregnant with one baby, and have shortening of the cervical length less than 25 mm, a cerclage prevents a preterm birth and reduces death and illness in the baby.There is no evidence that cerclage is effective in a multiple gestation pregnancy for preventing preterm births and reducing perinatal deaths or neonatal morbidity.
An endometrial ablation is a procedure your doctor might consider if you bleed between your menstrual periods, have a heavy flow, or have periods that last a long time. If medicine doesn’t help, your doctor might suggest endometrial ablation. It can curb the bleeding or stop it totally.
Heavy menstrual bleeding can have many causes. Changing hormones might be the reason. Or it could be fibroids and polyps growing in your uterus.
Endometrial ablation removes the endometrium, which is the lining of the uterus. In most cases, this stops you from having periods. If it doesn’t completely stop your periods, your flow should at least return to normal or be very light.
Hymenotomy is a medical procedure involving the surgical removal or opening of the hymen. It is often performed on patients with an imperforate or septate hymen, or other situations where the hymen is unusually thick or rigid such as Microperforte Hymen. In the case of a person with a hymen without any opening, an opening may be created in order to facilitate menstruation. In situations where the opening is extremely small or the band(s) of a septate hymen limit access to the vaginal opening, the individual may elect for hymenotomy to allow for comfortable sexual penetration of their vagina, or to relieve pain or discomfort that occurs when inserting/removing tampons. Sexual intercourse would not normally be adversely affected by a hymenotomy.
Unlike hysterectomy wherein the surgeon can make the incision either in the abdomen or the vagina to access the uterus, hysterotomy is performed exclusively via the abdomen. The incision is generally smaller when compared to the one used in hysterectomy. Both procedures can be performed under general anaesthesia.
Hysterotomy is the widely preferred technique for open foetal surgery. It is also the operation of choice if the uterus needs to be operated on during pregnancy or if a woman decides to abort the foetus after the first trimester. If the procedure is to be performed for delayed abortion, it is done the same way as caesarean section.
Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before. Myomectomy is the preferred fibroid treatment for women who want to become pregnant. After myomectomy, your chances of pregnancy may be improved but are not guaranteed.
Before myomectomy, shrinking fibroids with gonadotropin-releasing hormone analogue (GnRH-a) therapy may reduce blood loss from the surgery. GnRH-a therapy lowers the amount of estrogen your body makes. If you have bleeding from a fibroid, GnRH-a therapy can also improve anemia before surgery by stopping uterine bleeding for several months.
Vulvectomy refers to a gynaecological procedure in which the vulva is partly or completely removed. The procedure is usually performed as a last resort in certain cases of cancer, vulvar dysplasia, vulvar intraepithelial neoplasia, or female genital mutilation. Although there may be severe pain in the groin area after the procedure, for a number of weeks, sexual function is generally still possible but limited.
simple vulvectomy can be either complete (more than 80% of the vulvar area) or partial (less than 80% of vulvar area). It removes the skin and superficial subcutaneous tissues. a radical vulvectomy is the same with regard to complete or partial, however, includes removal of skin and deep subcutaneous tissue. An inguinofemoral lymphadenectomy may be performed along with a radical vulvectomy (whether partial or complete) on one or both sides if spread of a cancer is suspected.
Simple partial vulvectomy is the least severe, only removing the affected portion of the vulva.’Skinning vulvectomy’ involves the removal of the top layer of vulvar skin (the external female genital organs, including the clitoris, vaginal lips and the opening of the vagina). In this case skin grafts from other parts of the body may be needed to cover the area. There are two types of Skinning Vulvectomy, the ‘partial skinning vulvectomy’ and the ‘total skinning vulvectomy’. The objective of the first one is the preservation of the cosmetic and functional integrity of the vulva in younger and sexually active patients, in whom a steady increase in the incidence of vulvar intraepithelial neoplasia has been observed in the last decade. Meanwhile, the objective of the total skinning vulvectomy is to remove the entire vulva with total skin graft replacement in patients with an entire vulvar cancer involvement. ‘Modified radical vulvectomy’ involves the removal of vulva containing cancer and some of the normal tissue around it.
HOD And Consultant – ObGyn
Gynecologist,Obstetrician,Reproductive Endocrinologist (Infertility)
MBBS, DNB – Obstetrics & Gynecology
Manipal Hospital
Years Of Experience : 37
Chairperson Obstetrics, Gynaecology & ART
Obs & Gyanecology
MBBS, DNB – Obstetrics & Gynecology
Artemis Hospital
Years Of Experience : 22
Senior Consultant
Obs & Gyanecology
MBBS, MD – Obstetrics & Gynaecology
Fortis Hospital
Years Of Experience : 26
