Day surgery for heavy periods

A common reason for gynaecological surgery is in the control of heavy periods. Surgical options may include both day case and overnight options.

The two major day surgical procedures for heavy periods include the insertion of a Mirena IUD or endometrial ablation.

A Mirena IUD may often be inserted in the practice rooms without needing a trip to hospital but some women prefer to have a general anaesthetic for insertion. The Mirena is a reversible contraceptive which lasts 5 years, although it can be removed at any time, with a rapid return to fertility. The Mirena reduces the heaviness of menstrual bleeding in about 75% of women with about 35% of women having no periods at all. It is well suited to women who wish to control their bleeding, while maintaining their fertility. Further information can be found at the Mirena website.

 

Endometrial ablation is a permanent method of reducing menstrual bleeding by cauterising the endometrial surface, It is a day surgery procedure which results in a permanent reduction in menstrual bleeding. It is suitable for women who have completed their family. We currently use the NovaSure endometrial ablation system which is a proven effective endometrial ablation system.

 

 

Hysterectomy

 

Hysterectomy may be perfomed for a number of gynaecological conditions. These include:

 

Any hysterectomy will require at least an overnight admission to hospital. A major consideration in recovery from hysterectomy is in the route by which the hysterectomy is perfomed. The three routes of hysterectomy are laparoscopic, vaginal and abdominal. Dr Daniels provides all three options and will discuss what is most suitable for you.

Laparoscopic hysterectomy inolves performing laparoscopic surgery to remove the uterus, with uterus eventually being delivered via the vagina. It provides easy access to also remove the ovaries and Fallopian tubes if that is required. It is suitable for women with previous gynaecological or abdominal surgery, and for women who have not had children. Dr Daniels perfoms laparoscopic hysterectomy with most women going home on the second or third day after surgery.

Vaginal hysterectomy involves performing the entire surgery via the vagina. Vaginal hysterectomy may often be combined with prolapse or incontinence surgery and is often performed on women who have previously had chldren. Women generally go home on the third or fourth day after surgery.

Abdominal hysterectomy involves an open incision on the abdomen. It is most suitable for women with a large uterus or ovary that would be difficult to remove vaginally. Women are often in hopsital for about 5 days.

An important consideration in hysterectomy is in careful care during the recovery period both at hospital or at home. Patients receive clear information prior to and after surgery to allow them to plan their work and other activities.

 

 

Permanent contraception

Some women may elect to have a surgcial procedure for permanent contraception. Dr Daniels offers two options for permanent contraception. Both are performed as day surgical procedures at Hobart Private Hospital.

Tubal ligation involves a laparoscopy and the placement of clips on the Fallopian tubes. It is permanent and has a fallure rate of 1 in 400-500 women per year. It does not affect hormone levels or periods.

Essure is a hysteroscopic sterilisation procedure in which titanium cils are inserted into the Fallopian tubes via an instrument passed into the uterus via the cervix. It requires no incisions but a test for tubal patency is required three months later to ensure effectiveness. Dr Daniels performs Essure at Hobart Private Hospital.

Incontinence surgery

 

Women with stress urinary incontinence may benefit from a midurethral tape procedure. This operation involves small incisions in the vagina and groin and the permanent placement of a sterile tape which supports the urethra during coughing, straining or other situations in which the patient may have been experiencing urinary leakage. Success rates are around 80-90%.

Dr Daniels has been performing this surgery since 2010. Women have a urinary catheter overnight after the surgery and generally go home the next morning. The Monarc brand sling is currently being used by Dr Daniels for this surgery.

 

Prolapse surgery

Women with prolapse of the uterus, bladder or bowel may require surgical treatment if conservative measures such as pelvic floor exercises or pessaries have been unsuccessful. The decision to perform prolapse surgery involves careful examination and discussion of the many surgical techniques which may be used. Women with prolapse are encouraged to make an appointment so that Dr Daniels can properly assess them and counsel them regading the risks and benefits of the many options in this area.

 

Ovarian cysts

Some women may have ovarian cysts diagnosed, often on ultrasound performed for other reasons. Depending on the patient's age and the nature of the cyst various options are available for their treatment. In most cases the cyst or ovary can be removed safely using laparoscopic techniques resulting in a rapid return to normal function.