Laparoscopic Surgery (key-hole surgery) involves the direct visualization of abdominal and pelvic organs via a small 5-10 mm fibre optic lens (with a built-in light source) into the abdominal cavity. Entry to the abdominal cavity is achieved by making a small incision at the navel, inserting a multi-purpose access port, and passing the fibre optic lens through the port into the abdomen. Additional access ports may be placed in strategic places along the abdominal wall to facilitate the passage of multiple specialized surgical instruments.
Procedures traditionally performed through "open" incisions are now routinely handled through laparoscopic interventions. These include diagnostic procedures, destruction of endometriosis lesions, hysterectomies, surgeries for subfertility, removal or drainage of ovarian cysts, removal of ovaries and/or fallopian tubes, bilateral tubal ligation, and evacuation of ectopic (tubal) pregnancies.
Laparoscopic surgery enables the gynaecologist to perform intra-abdominal/pelvic surgery without a need for large surgical incisions. Post-operative pain is substantially reduced and post-operative recovery time is minimized.
Our gynaecologist Dr. Seng, has been performing laparoscopic surgery for the past 10 years including ovarian cyst removal, hysterectomies, fibroid removal, and fertility surgery. Contact us for a consultation to learn more about your options.
Vaginismus
Vaginismus is a condition marked by involuntary spasms of the vaginal muscles, brought on by the fear of vaginal penetration. Any attempts at intercourse, tampon use, or even a routine gynaecological exam are not just painful, but virtually impossible. Main symptoms of vaginismus include:
- Tightened and/or severe spasm of vaginal muscles during intercourse
- Pain with attempted intercourse
- Fear and anxiety develops even with the thought of penetration
Treatments for vaginismus can be effective, especially for the less severe forms of vaginismus.
Kegels and Dilation: Women who can tolerate some form of penetration and have minimal anxiety can try using a series of Kegels and dilators.
Hypnotherapy: This works by reducing patients’ anxiety towards penetration. It may also be helpful in patients with a history of childhood abuse.
Sex Therapy: This addresses methods to achieve more intimate relationships, including intercourse. Although sex therapy may not work in more severe cases, this is a useful post-procedure to help patients overcome their continued fear of penile penetration and libido issues.
Psychotherapy: Cognitive behaviour therapy (CBT) is designed to help patients overcome the anxiety of penetration. Less severe cases of vaginismus respond to this form of treatment.
Physical Therapy: Manual stretching is helpful in moderate cases of vaginismus. Dilators are often also recommended as part of the treatment. This may be combined with Biofeedback to help women lessen pelvic floor tension.
Biofeedback: This teaches patients how to lessen pelvic floor tension. It can be valuable in patients with mild vaginismus, as it requires a probe in the pelvic area.
Antidepressants and anti-anxiety medication: These medications may help, but some patients experience an altered state of mind.
Vestibulectomy: This is a procedure whereby a cuff of the vaginal mucosa is removed surgically. It is performed for patients with more severe cases and appears to give good results. However, this is a major surgical procedure and requires six weeks of healing. Some patients continue to have pain in the scar tissue.