Department

Gynecology

Gynaecology department of Aartham Multi Super Speciality Hospital in Ahmedabad provides Gynaecology care from adolescence through post-menopause. Our care extends from preventive care to diagnostic, operative and educational care.

Dr. Sanjay Shah – M.D. (Gynaec), Surgeon is known for proven results in most complicated cases of Laparoscopy, Hysteroscopy and all Gynaec surgeries. As an endoscopy surgeon he has performed 30,000+ Laproscopic & Hysteroscopic surgeries. He is accompanied by Dr.Bela S Shah, M.B.B.S (Embryologist) as counsellor in infertility. Entire team is comprised of experienced doctors such as Dr.Aastha Mehta- M.s. (Gynaec),  Dr.HareshDoshi- M.D. (Gynaec), Dr.Falguni Parikh – M.D. (Gynaec) and Dr.Phagun Shah – M.D. (Gynaec).

Under able guidance of Dr. Sanjay Shah Aartham Hospital is emerging as the best hospital for gynaecology and IVF treatments in Ahmedabad.

Aartham Hospital for IVF operates with insurance like program in which there is a provision of about 50% refund of the treatment cost. Along with this cost benefit, there are also medical advantages such as progressive fine-tuning methodology, 3 Cycle Program. This cycle – on – cycle improvement leads to more chances of pregnancy and better outcome.

With a focus on the female reproductive system and women’s health, we provide gynaecology and endoscopy treatment using Laparoscopy, Hysteroscopy and Colposcopy to diagnose infertility, bleeding disorders, premalignant conditions of the cervix amongst many other conditions.

Hysteroscopy

Hysteroscopy is the inspection of the uterine cavity by passing the endoscope through the cervix. It allows for the diagnosis of problems in the cavity of the uterus and also serves as a method for correction for most problems (operative hysteroscopy). Common conditions that can be treated through hysteroscopy are tumours like polyps, fibroids, abnormalities like septum, etc.Since hysteroscopy is a minor surgical procedure, the patient recovers in a short span of time.

Laparoscopy

Laparoscopy involves placement of the endoscope in to the abdominal cavity, generally through the umbilicus to visualise the uterus, tubes, ovaries and the pelvis. The patency of the tubes is also checked at the same time by injecting a blue dye. Certain abnormalities like fibroids, endometriosis, adhesions etc. can also be treated at the same time (operative laparoscopy).

The biggest advantage of Laparoscopy is that it lets doctors examine the internal organs, without the need of an open surgery.

Laparoscopy can involve the removal of ovarian cysts and fibroids and in some cases, the removal of the uterus. The preparation depends directly on the type of surgery. Gynaecological Laparoscopy is a wise alternative to open surgery with a large incision. It can be performed in case of ovarian cyst removal, tubal ligation, hysterectomy, Endometriosis, ectopic pregnancy & Sling Operations.

Hysterectomy

Hysterectomy is a surgical procedure that is performed to remove the uterus.

There are various cases that require a Hysterectomy to be performed. It can be performed in cases of uterine fibroids that cause pain or are bleeding, in the case of a uterine prolapse that causes the uterus to slide from its normal position into the vaginal canal, adenomyosis, or in case of cancerous growth in the uterus, cervix, or ovaries.

Hysterectomy can be performed in two ways. Minimally Invasive Procedure or Abdominal Hysterectomy.

A patient who has recently undergone hysterectomy is told to abstain from intercourse and avoid lifting any kind of heavy object for at least 6 weeks after the surgery.

Hysterectomy the procedure does indeed help a vast majority of women overcome their main problem, be it pain or heavy periods.

Uro-gynaecology

A one-stop evaluation and treatment of women with urinary incontinence as well as pelvic floor dysfunction, including urogenital prolapse and post-hysterectomy vaginal vault prolapse. Depending on the nature of the urinary incontinence or pelvic floor dysfunction, therapeutic options including non-surgical management. Surgical management may be considered in some women with severe symptoms or when conservative treatment is ineffective.

  • Trans-vaginal Tape (TVT)
  • Trans-obturator Tape (TOT)
  • Fistula Repair
  • All kinds of pelvic floor surgeries
  • Laparoscopicrepair of Vesico-vaginal fistula
  • Latzko procedure
  • Fistulectomy with flap splitting closure
  • Fistulectomy with martius fat pad graft interposition
  • Mucosal advancement flap repair
  • Pubovaginal sling
  • Periurethral bulking injection
  • Cystoscopic botulinum toxin injection
  • Cystourethroscopy – Demonstration

Condition & treatments

Urinary Incontinence: Urinary incontinence in simple terms means a person urinates when they do not want to. Control over the urinary sphincter muscles is either lost or weakened. Urinary incontinence is a much more common problem than most people realize

Causes of Urinary Incontinence

There are many causes of urinary incontinence.

Temporary causes include

  • Urinary tract infection
  • Constipation
  • Certain medications
  • Increased dietary intake of caffeine, alcohol, artificial sweeteners and carbonated beverages

Other causes for which the treatment differs based on what causes the condition.

  • Pelvic floor muscle weakness
  • Weakness of the bladder and/or the sphincter muscles
  • Overactive or underactive bladder muscles
  • Decreases in certain hormones, especially oestrogen

Treatment of Urinary Incontinence

The treatment of urinary incontinence depends on the type of incontinence and the severity of it. The various modalities available for treatment are lifestyle changes, bladder retraining, physiotherapy or medications and surgery.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when a pelvic organ-such as your bladder-drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. Your pelvic floor muscles also hold up your pelvic organs from below. If the fascia and ligaments are torn or stretched for any reason, for example, obstetric trauma, or weakened pelvic floor muscles, then your pelvic organs (your bladder, uterus, or rectum) might not be held in their right place and they may bulge down into the vagina (birth canal). This is called prolapse.

Causes of POP

The main cause is damage to or weakening of the nerves, ligaments and muscles which support the pelvic organs as a result any of the following:

Pregnancy and childbirth (considered to be major factors leading to weakening of the vagina and its supports)

  • Aging and menopause
  • Overweight
  • Previous pelvic surgery
  • Conditions like obesity, chronic cough, chronic constipation.

Types of Prolapses

  1. Prolapse of the Anterior compartment
  2. Prolapse of the Posterior compartment
  3. Prolapse of the Apical compartment

Symptoms of Proplapse

Common symptoms reported by women are:

  • A sensation of something coming down
  • Feeling of a bulge in the vagina
  • Pressure in the vagina
  • Back pain
  • Interference with bladder/bowel functions – need to push the prolapse to help urination or bowel movement

Bladder Pain / Interstitial Cystitis

Interstitial cystitis also called painful bladder syndrome is a chronic condition associated with inflammatory changes causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe.

Symptoms of Interstitial Cystitis

  • Urgency
  • Frequency of Urination-sometimes 60 times in a single day
  • Dysuria (burning and stinging during urination)
  • Bladder pain – may intensify when bladder is filling or emptying
  • Pelvic Pain
  • Blood in urine
  • Pain with intercourse.

Gynaec Services at Aartham Multi Super Speciality Hospital in Ahmedabad

Gyneacology Service

  1. Adolescent gynecology
  2. Breast examination
  3. Contraception counseling
  4. Management of Breast Pain
  5. Management of Chronic Pelvic Pain
  6. Management of Endometrioisis
  7. Management of Menorrhagia
  8. Management of Menstural Cramps
  9. Management of Menopause
  10. Management of Ovarian Cysts
  11. Management of Polycystic Ovarian Disease (PCOD)
  12. Management of Pelvic Inflammatory Disease (PID)
  13. Management of Premenstrual Syndrome (PMS)
  14. Management of Uterine Fibroids
  15. Management of Uterine Polyps
  16. Management of Vaginal Infection
  17. Well women examination

Procedures

  1. Colposcopy
  2. Copper T-insertion
  3. Endometrial Biopsy
  4. Pap smear

Gyneacology Surgeries

  1. C- Section
  2. Exploratory Laparotomy
  3. Hysterectomy
  4. Interval Laparotomy for Ovarian Cancer
  5. Modified Radical Mastectomy
  6. Myomectomy
  7. Oophorectomy
  8. Ovarian Cyst
  9. Radical Vulvectomy
  10. Wertheim’s Hysterectomy

Sexually transmitted infection (STD) screening (for both men and women)

  1. Digital Mammography
  2. Gynaecologic and obstetric ultrasound
  3. Tubal patency test
  4. Ovarian reserve tests such as follicle stimulating hormone (FSH) levels anti-mullerian hormone levels (AMH)
  5. Annual examinations (pap testing, breast cancer screening, contraception, menopause/hormones)
  6. Endoscopy including hysteroscopy & salpingoscopy
  7. Colposcopy
  8. HPV testing & vaccination

 

Best Laproscopic Surgery in Ahmedabad

Laparoscopy: It is a type of endoscopy in which operations in the abdomen and pelvis is performed through very small incision (0.5 to 1 cm) instead of big incisions in laparotomy. It is also called as minimally invasive surgery. Uterus, fallopian tubes and ovaries can be examined as well as operated by laparoscopy.

Laparoscopy is done under general anaesthesia. Abdominal cavity is inflated with gas for better visualization of the abdominal organs. Laparoscope attached with video camera is inserted through a small incision near umbilicus and other operative instruments are inserted through one or more other small incisions. Video camera helps in getting enlarged view as well as record the procedure. After the surgery finishes, gas is removed to deflate the abdomen, and incisions closed with sutures.

 Advantages of Laparoscopy at Aartham Hospital in Ahmedabad:

  1. Short hospital stay
  2. Less pain
  3. Less bleeding
  4. Short recovery period
  5. Less wound related complications due to its smaller size
  6. Precise dissection due to better visualization of magnified field
  7. Laparoscopy Treatment

Few Gynec Laparoscopy Procedures

Diagnostic Laparoscopy: Uterus, both fallopian tubes and ovaries are examined thoroughly under direct vision to identify the pathology that can lead to infertility or other symptoms. The chromopertubation test for tubal testing can be done by inspecting the flow of blue dye from the abdominal ostium of fallopian tube while injecting the dye from below.

PCO Drilling: Polycystic ovarian syndrome is a condition associated with anovulation/oligo ovulation leading to irregular scanty menses, infertility, hirsutism and many a times obesity.

Ovarian Drilling includes performing multiple punctures targeting on the ovarian stroma with unipolar coagulation.. Decreased ovarian stroma might help in resuming ovulation or decreasing the dosage of drugs that are needed for ovulation induction.

Ovarian Cyst: It is an abnormal collection of fluid or material in ovarian substance.

Laparoscopy can be performed for drainage, removal or biopsy from such cyst. The material removed is routinely sent for Histopathological examination.

Uterine fibroids: Uterine fibroids are the benign tumor of the uterus which can cause pain during menses, excessive menstruation, infertility, and pressure symptoms on bowel or urinary tract or other abdominal structures.

Fibroids can be dissected and enucleated using laparoscopy, followed by its removal through morcellation, and suturing of dead space under laparoscopic guidance.

Ectopic Pregnancy: It is a condition in which pregnancy occurs outside the uterine cavity, mainly in the fallopian tube. This can be confirmed and treated by Laparoscopy by Linear Salpingotom ( where fallopian tube is preserved) or by salpingectomy (where the fallopian tube is removed) provided the patient is hemodynamically stable enough to receive the general anesthesia for laparoscopy.

Adhesions: Sometimes pelvic organs are abnormally adherent to each other or bowel organs leading to infection, surgery, endometriosis causing pain, or infertility. The procedure is performed using hydro dissection, scissor or laser, atraumatic forceps, and harmonic scalpel.

Hydrosalpinx: It is an abnormal dilatation of fallopian tube with clear fluid collection in cases of distal tubal block.

Neosalpingostomy or fimbrioplasty can be performed by giving linear /cruciate surgical incision on this blocked distal part and creation of new healthy opening with dissection and monopolar energy under Laparoscopic guidance.

If patient is undergoing IVF, it is advisable to remove or clip the hydrosalpinx for better results.

Endometriosis: It is a condition characterized by presence of endometrial tissue outside the endometrial cavity of uterus. During each menstrual cycle, it bleeds with the shedding of endometrial linings causing accumulation of old blood (chocolate colored fluid) in the ovarian tissue leading to chocolate cyst formation. It may lead to peritoneal scarring resulting in appearance of powder puff burns, and adhesions of pelvic organs to each other & bowel. Its presence in uterine musculature leads to adenomyosis. It is also responsible for dysmenorrhea, menorrhagia, and dyspareunia of varying severity. It may also lead to chronic pelvic pain.

These lesions can be diagnosed and treated laparoscopically by cutting or fulguration of endometrial implants. Chocolate cysts can be drained followed by cyst wall removal or fulguration of cyst wall under laparoscopic guidance. Even lesions of rectovaginal endometriosis can be treated laparoscopically under expert hands.

Total / Subtotal Laparoscopic Hysterectomy: The operation of surgical removal of uterus which is known as hysterectomy can also be performed laparoscopically. It can be performed for various indications including menorrhagia, dysmenorrhoea, Pelvic inflammatory disease, adenomyosis, uterine fibroids and other benign and malignant conditions.

Tubal Recanalisation: Abnormally blocked tubes or tubes with previous tubal ligation can be opened using microlaparoscopy known as Laparoscopic Tubal Recanalisation or Tubotubal Anastomosis


Opp. Government Polytechnic,
L-Colony, Near Panjarapole Cross Road,
Ambawadi, Ahmedabad – 380006
Gujarat

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