Hysteroscopy and curettage
Hysteroscopy involves a telescopic examination of the uterine cavity to identify and treat intra uterine abnormalities. It can be diagnostic or operative. Diagnostic hysteroscopy and curettage is a procedure to try and obtain both a visual and histologic assessment of the uterine cavity and endometrium. Operative hysteroscopy is used to resect lesions, divide adhesions or ablate the uterine cavity when necessary.
Abdominal hysterectomy is a definitive procedure for removing a uterus when it is considered safer to perform this operation through an abdominal incision.
The majority of women who require an abdominal hysterectomy have heavy or painful menstrual bleeding, which has failed conservative treatment.
An enlarged uterus causing pressure pain, degeneration of fibroids and uterine carcinoma are other reasons for performing an abdominal hysterectomy.
Vaginal Hysterectomy is primarily a gynaecological operation for the treatment of women who have symptomatic uterine prolapse and women with abnormal uterine bleeding. It can only be performed if there is enough uterine descent down the vagina to allow for surgical access. In such cases it is the operation of choice.
Vaginal repair and urethral slings
Vaginal repair is performed for women with symptomatic vaginal prolapse. Vaginal prolapse is often associated with dragging pelvic discomfort, urinary incontinence, constipation and faecal or flatal incontinence. Urethral slings are performed for women who have urinary stress incontinence but may not have overt signs of anterior vaginal prolapse. Some women with urinary stress incontinence can have a vaginal repair, sub urethral sling or both procedures performed at the same time.
A laparoscopy is an examination of the pelvis through a telescopic lens inserted through keyhole surgical incisions in the abdomen. It is used to make a diagnosis or to treat a surgical problem. Some patients may have high risks because of their weight, medical history, or complexity of the planned surgery. These patients may not be suitable for laparoscopic surgery at all. A patients risks need to be discussed and referral to a laparoscopic sub specialist should be considered if necessary.