Definition & Overview
A pelvic gynaecological surgery refers to surgical procedures performed on any of the organs in the pelvic region. Several of these procedures are now performed using minimally invasive techniques to reduce surgical risks and shorten recovery time. The procedures have relatively high success and safety ratings depending on the patient’s general condition. Some of them, however, may affect patients’ chances of becoming pregnant in the future.
Who Should Undergo and Expected Results
Pelvic gynaecological surgery can be carried out on patients who suffer from any problems that affect the organs in the pelvic region. These include but not limited to:
- Abnormal uterine bleeding
- Interstitial cystitis
- Ovarian cysts
- Pelvic congestion syndrome
- Pelvic floor muscle spasm
- Pelvic floor tension myalgia
- Pelvic organ prolapse
- Scar tissue adhesions
- Urinary prolapse
- Uterine polyps
Patients usually seek treatment and are diagnosed with the above conditions in the presence of the following symptoms:
- Chronic pelvic pain
- Abnormal bleeding
- Painful sexual intercourse
- Menstrual cramps
- Abnormal discharge
- Irregular menstruation or abnormally heavy menses
Some examples of pelvic gynaecological surgical procedures are the following:
- Pelvic radiotherapy – This is used to treat cancer that affects the pelvic region
- Hysterectomy – This procedure is used to remove the uterus usually to treat fibroid-related bleeding or to prevent future pregnancies.
- Presacral neurectomy – This is the primary surgical option for the treatment of endometriosis and pelvic inflammatory disease.
- Cystoscopy – This is a minimally invasive procedure used to examine the lining of the bladder and the urethra to check for abnormalities. It is widely used in urological diagnosis.
- Ovarian cystectomy – A cystectomy is a surgical procedure used to remove ovarian cysts or small fluid-filled sacs that form within the ovaries. These cysts are typically removed when they grow too big, are causing symptoms, or are recurrent.
- Myomectomy – This is a surgical procedure used to remove uterine fibroids. It can be performed through open abdominal surgery, laparoscopic or robotic-assisted surgery, or hysteroscopic surgery.
- Endometrial ablation – This is used to effectively reduce menstrual flow due to irregular bleeding.
While pelvic gynaecological surgery is often successful in relieving symptoms and treating the medical issue at hand, they do not rule out recurrences. For instance, a myomectomy does not guarantee against the development of new fibroids in the future.
How is the Procedure Performed?
There are now three main techniques used to perform pelvic gynaecological surgery. These include:
- Open abdominal surgery
- Robotic-assisted, such as the DaVinci Surgical System
An open pelvic surgery requires one large incision to give the surgeon access to the affected pelvic organ. These procedures are performed under general anaesthesia with patients completely asleep throughout the surgery. Although it is the primary surgical technique, the development of minimally invasive surgical techniques has reduced the need for an open pelvic surgery.
Laparoscopic procedures eliminate the need for a large incision. Instead, a number of small incisions are used to accommodate a thin hollow tube called a laparoscope. The laparoscope has a camera and a light scope attached to its end giving the surgeon visuals on the internal organs during surgery.
A robotic-assisted procedure, on the other hand, is in a way similar to a laparoscopy in that it also makes use of a laparoscope and requires around 4 to 5 small incisions instead of one large incision. However, instead of the surgeon directly controlling the special surgical tools during a laparoscopic procedure, a robotic system is used to translate the surgeon’s hand movements into the surgical instruments that have gained access to the surgical site. This type of surgery boasts improved accuracy and efficiency.
Possible Risks and Complications
Patients who undergo pelvic gynaecological surgery face a certain risk of the following complications:
- Scar tissue, which in some cases, may negatively affect the patient’s chances of conceiving
- Surgical site infection, which is the most common complication of gynaecologic surgical procedures
- Vaginal cuff cellulitis or pelvic cellulitis
- Pelvic abscess
- Injury to the blood vessels and nerves in the area
Most complications related to this type of surgery is caused by the migration of pathogenic microorganisms from the vagina to the endocervix and surgical site. Infections, for one, used to affect up to 33% of patients who undergo a vaginal hysterectomy. These can occur at the incision site, deep within it, or other nearby organs. Fortunately, the use of post-operative antibiotics has significantly reduced the rate of infection for such surgical procedures.
Meanwhile, female patients may need to undergo caesarian delivery in future childbirth as the pelvic scar may break open during the labour process.
To reduce the risk of complications, minimally invasive techniques are used when possible. These techniques are associated with much shorter hospital stay and significantly milder post-operative pain, with most patients able to return to their normal activities in just 2 weeks instead of 8 weeks. The risk of infections and scarring is also lower.
Lachiewicz MP., Moulton LJ., Jaiyeoba O. “Pelvic surgical site infections in gynecologic surgery.” Infect Dis Obstet Gynecol. 2015; 2015: 614950.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4348594/ Barber MD. “Surgical female pelvic anatomy.”
http://www.uptodate.com/contents/surgical-female-pelvic-anatomy Tizzano A., Paraiso MFR. “The evolution of pelvic surgery.” http://www.augs.org/p/cm/ld/fid=18
What is Pelvic Gynaecological Surgery: Overview, Benefits, and Expected Results
Pelvic gynaecological surgery is a medical procedure that focuses on treating various conditions affecting the female reproductive system. These surgical interventions aim to alleviate pain, correct anatomical abnormalities, and improve overall gynaecological health. In this article, we will explore the overview of pelvic gynaecological surgery, its benefits, and the expected results for patients undergoing these procedures. Whether you are considering pelvic gynaecological surgery or simply curious about the topic, this article aims to provide valuable insights.
Understanding Pelvic Gynaecological Surgery
Pelvic gynaecological surgery encompasses a wide range of surgical procedures performed by experienced gynaecologists or urogynaecologists. These surgeries target conditions related to the pelvic organs, such as the uterus, ovaries, fallopian tubes, vagina, and surrounding tissues. Some common conditions that may require pelvic gynaecological surgery include:
– Uterine fibroids: Noncancerous growths in the uterus that can cause heavy menstrual bleeding, pain, or pressure symptoms.
– Endometriosis: A condition where endometrial tissue grows outside the uterus, leading to pain, infertility, and adhesions.
– Pelvic organ prolapse: A condition where one or more pelvic organs, such as the bladder, uterus, or rectum, descend and protrude into the vaginal area.
– Ovarian cysts: Fluid-filled sacs that develop on the ovaries and may cause pain or hormonal imbalances.
– Gynaecological cancers: Surgeries may be necessary to remove cancerous tumors in the ovaries, cervix, uterus, or other pelvic organs.
Pelvic gynaecological surgeries can be performed through different techniques, including minimally invasive procedures such as laparoscopy or robotic-assisted surgery, as well as open surgeries. The choice of technique depends on the specific condition, patient factors, and the surgeon’s expertise.
Benefits of Pelvic Gynaecological Surgery
Pelvic gynaecological surgery offers several benefits for women who experience gynaecological conditions. Some of the key advantages include:
1. Alleviation of symptoms: Surgical intervention can provide relief from chronic pain, heavy bleeding, discomfort during intercourse, urinary or bowel problems, and other debilitating symptoms associated with gynaecological conditions.
2. Improved quality of life: By addressing the underlying cause of the condition, pelvic gynaecological surgery aims to improve a woman’s overall quality of life, allowing her to engage in daily activities without the limitations imposed by her gynaecological condition.
3. Fertility preservation: In cases where fertility preservation is desired, surgical interventions can treat conditions like endometriosis, ovarian cysts, or uterine fibroids, which may hinder conception or cause infertility.
4. Prevention of complications: Pelvic gynaecological surgeries can prevent or manage potential complications that arise from untreated conditions. For instance, pelvic organ prolapse surgery can prevent the worsening of prolapse symptoms and associated urinary or bowel problems.
5. Resolution of gynaecological cancers: In cases where gynaecological cancers are diagnosed, surgical removal of tumors is often a crucial step in the comprehensive treatment plan, potentially increasing survival rates and improving outcomes.
Expected Results from Pelvic Gynaecological Surgery
The expected results of pelvic gynaecological surgery can vary depending on the specific condition being treated and the individual patient’s circumstances. However, here are some general outcomes that patients may experience:
1. Symptom relief: Pelvic gynaecological surgery often provides significant relief from symptoms such as pain, heavy bleeding, urinary or bowel dysfunction, and discomfort during sexual intercourse. Patients can expect an improvement in their overall gynaecological health and a reduction in the impact of these symptoms on their daily lives.
2. Restoration of normal function: Surgery can help restore normal anatomy and function of the pelvic organs, allowing women to regain control over their bladder and bowel functions, improve their sexual experiences, and resume their normal active lifestyle.
3. Increased fertility potential: For women struggling with infertility due to gynaecological conditions like endometriosis or fibroids, surgical treatment can improve fertility potential by removing obstacles to conception and enhancing reproductive function.
4. Cancer eradication: When pelvic gynaecological surgery is performed to remove cancerous tumors, the expected result is the eradication or control of the cancer, increasing the chances of long-term survival, remission, or improved quality of life.
It’s important to note that pelvic gynaecological surgery, like any medical procedure, carries certain risks and potential complications. Prior to surgery, patients should have a detailed discussion with their healthcare provider to understand the expected benefits, potential risks, and postoperative recovery process.
In summary, pelvic gynaecological surgery plays a vital role in addressing various gynaecological conditions affecting women. These surgical interventions offer numerous benefits, including symptom relief, improved quality of life, fertility preservation, prevention of complications, and effective treatment of gynaecological cancers. While the expected results may vary depending on the specific condition and individual patient factors, pelvic gynaecological surgery aims to provide significant relief from symptoms, restore normal function, and potentially enhance fertility. It is essential for patients to consult with their healthcare providers to determine if pelvic gynaecological surgery is the right option for them and discuss the expected outcomes and potential risks associated with the procedure.