1. What are the causes of excessive
bleeding during menstrual cycle?
Dysfunctional uterine bleeding
Foreign body in uterine cavity
Genital cancers of as uterus & cervix
2. How to diagnose these
Colposcopy & Cervical biopsy
3. How to treat?
Medical Only for benign
conditions ( Non cancerous)
II) TABC Thermal Balloon Ablation of Endometrium.
III) TCRE Trans cervical Resection of Endometrium.
V) Radical Hysterectomy malignant (Malignant or Causes)
4. What is Hysterectomy?
Removal of uterus (womb)
5. What are various types of Hysterectomy?
1. Laparoscopic removal of uterus (Laparoscopic Hysterectomy)
a) Total Laparoscopic Hysterectomy (TLH)
b) Laparoscopic Assisted Vaginal Hysterectomy (LAVH)
2. Total Abdominal Hysterectomy
3. NDVH-Non descent Vaginal Hysterectomy
4. Vaginal Hysterectomy
6. What are the indications of hysterectomy?
3. Heavy uterus bleeding.
4. Cancers of uterus and cervix.
7. What is laparoscopic Hysterectomy?
The separation of uterus through multiple ports (key holes) in
the abdominal wall & removal of uterus through the birth canal
8. What are the benefits of laparoscopic surgery?
i) Quick recovery time.
ii) Less painful Post surgery.
iii) Cosmetically better.
iv) Less blood loss during surgery.
9. What are the other procedures which can be done laparoscopically?
i) Ovarian cysts.
ii) Ectopic pregnancy Pregnancy in tubes or outside uterus.
a) Ovarian drilling
b) Tubal cannulation
10. Is this operation painful?
No, as a comfortable anaesthesia is given to do the Operation.
Preferably, it is done under general anaesthesia.
11. When can I go back to normal work?
Varying on the type of surgery & condition of the patient. Doctor
will advice you on how soon you can return to work.
12. Does it require hospitalization?
It depends on the type of surgery. Some surgeries may be require
an overnight stay.
13. How much pain, does one feel post-surgery?
It depends on a patients tolerance level. In pain medications are
prescribed for the post-surgery patients.
14. When can I get back to routine exercises?
This again depends on the type of surgery performed. All patients
are suggested to start a slow walking routine on the second day of
post-surgery day. She keeps on increasing the exercises depending
on her convalescence.
15. Is it must to get treatment of fibroid uterus?
No, all patients diagnosed to be having fibroid uterus need not
be treated. A symptom less patient whose fibroid is a
coincidental finding while investigating for something else
should be left untouched. Only fibroids causing symptoms like:
a) excessive bleeding
c) Pressure symptoms
d) Sudden enlargement
e) Appearance of degenerative changes
f) It becomes painful
g) Cancerous changes which are mostly sarcomatous.
h) Very big fibroids causing abdominal distension need to be
16. What is the treatment of fibroid uterus?
There is no permanent medical treatment of fibroids.
Surgical treatment is HYSTERECTOMY i.e. removal of uterus and
MYOMECTOMY i.e. removal of fibroids only.
1) When should I contact a doctor for not able to conceive after
When after one year of cohabitation i.e. living together after
marriage if a couple doesnt conceive should report to a doctor
for investigation or report earlier if the female partner has
irregular menstrual cycle.
2) What is infertility?
Infertility is not able to conceive which may be because of many
Factors from both partners
Blockage in the ducts that carry sperm
Physical problems with the testicles
Lifestyle or environmental factor
a) Addiction of smoking
b) Excessive drinking
c) More stress
d) Working in hot places
e) Wearing tight clothes
a) Congenital Abnormality
I. Small Uterus ( Hypo-plastic Uterus )
II. Septum of Uterus
III. Double Uterus
b) Synechiae Uterus
c) Polyp of Endometrial Cavity
d) Fibroid Uterus
e) Tuberculous Endometritis
f) Foreign body
c) Blocked Tubes
d) Ovarian Cysts
a) Thyroid Diseases
b) Ovarian Hormonal imbalance
c) Hypothalamic Factors
b) Adhesions in Pouch of Douglas' (POD)
c) Previous abdominal surgery
3) What all tests / investigations are required for infertile
A) Investigations for the male partner
a) Semen examinations
b) Testicular biopsy if azoospermic (FNAC OR INCISION BIOPSY)
c) Male hormonal study
d) Routine blood investigations.
B) Investigation for the female partner
a) Routine blood investigations
b) Female hormonal study
c) Follicular study
d) HSG/ SSG
e) PCR for tuberculous endometritis.
4) Is a female partner alone getting investigated is enough?
No as already mentioned infertility can be from both partners.
So investigation for both the partners is mandatory.
5) What is HSG?
HSG stands for HYSTEROSALPINGOGRAPHY. It is a test to know the
patency of the fallopian tubes. It is done by injecting a dye in
the uterus through cervix by inserting a cannula under screening
and taking X-RAYS. In normal patent tubes the dye should freely
move from uterus to fallopian tubes and should be seen in the
peritoneal cavity i.e. abdomen. If we dont see the dye in the
tubes then it shows that tubes are blocked.
6) What is SSG?
SSG stands for SONOSALPINGOGRAPHY, which is done by putting a
dye/saline through the cervix and the movement of the dye
through the tube is visualised under ultrasound.
6) What is Hysteroscopy and Laparoscopy?
Hysteroscopy is visualising the endometrial cavity with an
endoscope which helps to find out the factors of the uterus
effecting the implantation of the embryo. The various common
factors are foreign body, polyp, myoma in the cavity, septum of
the uterus or tubercular endometritis.
Laparoscopy is visualization of the abdominal cavity i.e.
peritoneal cavity with an endoscope. It helps to find out:
A) Shape, size and position of uterus.
B) Size position and texture of the ovary.
C) Any pathology associated with the fallopian tubes.
D) Any adhesions surrounding female genitalia.
E) Any nodes or masses.
7) What is ectopic pregnancy?
Pregnancy which is outside uterus is ectopic pregnancy. The
various common sites are:
A) Fallopian tubes
C) Broad ligament
D) In the abdomen