Q. What are fibroids? Who can get them?

Ans. Fibroids are non cancerous growth in the womb (uterus). Any woman can get fibroids but they are more common in women of reproductive age group and in certain populations like Africans.

Q. What are the symptoms of fibroids?

Ans. Fibroids can be completely asymptomatic and detected incidentally. The various symptoms caused by fibroids are:

1. Menstrual Symptoms- like heavy periods, irregular periods, bleeding in between periods; painful periods 2. Pressure Symptoms- if the fibroid presses on the urinary bladder it can lead to more frequent urination, if it presses on the ureter it can lead to non functioning kidney on that side. 3. Infertility- It can lead to problems when a couple is trying to conceive. It can lead’ to rruscarnages, and also problems during pregnancy and delivery. 4. Very rarely (less than 1 cases) fibroid can turn malignant i.e. leimyosarcoma.

Q. Why is the Laparoscopic approach better than the Open approach?

Ans. The Laparoscopic (keyhole) approach has several advantages for the patient like- less hospital stay, less painful, quicker return to daily activities, lesser blood loss during surgery, better conception rates for infertile women, more cosmetic. Overall laparoscopic surgery is a better surgery as the magnification offered by the equipment makes it a much more superior surgery. The only pre requisite that the patient must check on is the experience and expertise of the operating surgeon as this has a long learning curve.

Q. What is the treatment of fibroids?

Ans . The treatment of each patient is individualized and several factors have to be considered like the age of the patient, the desire for more children, the symptoms with which the patient has presented and the size of the fibroid. Also not all fibroids need treatment; some small asymptomatic ones can be left alone. Medical (temporary) and Surgical options are available for the patient. Incase a woman is desirous of more children, the fibroid can be removed and the uterus stitched back in that area, the procedure is called Myomectomy. This procedure is best carried out laparoscopically (keyhole). Incase a woman has completed her family the uterus can be removed, this is also best done laparoscopically (Total Laparoscopic Hysterectomy). Another option available is UAE (uterine artery embolisation), but this has its own risks and benefits and after this procedure also patient may still need a Hysterectomy.

Q. I am a 36 year old working lady who has an active sexual life. Me and my husband have had a great sexual life so far, but lately, the act has become painful. I am afraid that I might have caught an infection. Could you suggest any remedy for this? – Shradha, Pune

Ans . Pain during sexual intercourse (DYSPARENUNIA) is caused by a number of reasons and as you have rightly pointed out; vaginal infection is the most cornmon cause. This can easily be treated by vaginal tablets, but to give the correct treatment your doctor will have to do an internal examination to assess the type of infection also. While doing an internal examination the doctor will be able to rule out other causes of Dysparenunia like endometriosis (presence of inner lining of womb at other sites of pelvis), fibroids, ovarian cysts, retroverted uterus, uterine prolapse and local vaginal causes like vaginal dryness (especially in perimenopausal women). Also, lack of lubrication during intercourse, and vaginismus (spasm of the vaginal muscle) .can lead to problems with intercourse and need psychological treatment with partners, they are advised a number of bond building activities before indulging in intercourse. Besides, there are some other causes like Urinary Tract Infection, when treated helps in returning to normal sexual activity.

Q. Are ovarian cysts very dangerous? Also, can anyone get them or are they contracted via intercourse only? Timira, Mumbai

Ans . Ovarian cysts are extremely common during the reproductive years of a woman. These cysts can be physiological (normally present) or pathological. They are insignificant and are called as functional cysts if they are clear and less than 5 cms in size. But, if the cysts are large or bilateral (present on both ovaries), if they have any solid areas in them or septa (walls) in them, or are associated with ascites (fluid in the pelvis), they may then be indicative of a serious pathology and even cancer! During reproductive years (and even in pregnancy) dermoids (Teratomas) are very cornmon and can be associated with complications like Torsion (twisting of the ovary on itself), leading to acute abdominal pain. Additionally, any ovarian cyst can be associated with rupture of the cyst leading to acute pain or haemorrhage (bleeding into the cyst), which can also lead to acute pain. Lastly, endometriotic cysts (chocolate cysts) deserve a special mention. Endometriosis is a condition, which is associated with infertility, painful periods and painful intercourse. Hence, all cysts need to be treated carefully under guidance of your gynaecologist.

Q. I am 31year old married for 7 years and eager to conceive. My husband is 32 years old we live together and have no sexual problems but, I have never got pregnant we have been trying to conceive since the first month of our marriage, now there is a lot of family pressure on me to have a baby. My doctor says that my husband is normal and his Semen Analysis is also normal but she says that my tubes are blocked. This was diagnosed on HSG done 2 months back. She says that I have to go for IVF, but I cannot afford IVF is there any way out?

Ans . Infertility is a very common problem now days, if the male partner is normal then 50 of your problem are overcome already. As far as you are concerned we have to check your entire genital system namely your uterus, tubes and ovaries. Ovulation (egg release) has to be checked and this can easily be done by certain hormonal tests from your blood samples. But to check your uterus and tubes a hysteroscopy (looking inside the uterus) and Laparoscopy have to be done. Any tubal block found at that time can be opened during the same surgery and any other problems found can also be tackled at the same time. This Surgery is very cost effective and done in Day Care and is minimally invasive.

Q. I am a 25 year old lady and have a six year old child. My problem is that I have very heavy bleeding during my periods and I also pass a lot of clots. Also I feel a lump in my abdomen the doctor did an ultrasound and says I have fibroids in my uterus one of them in 9cms and there are several ofthem from 2 to 6cms in size, she says that my uterus is as large as a 22wks size pregnant uterus and says that since the uterus is this large these fibroids will have to be removed by a large cut on my abdomen and I may even lose my uterus. As I want to have atleast 1 more child can I do something?

Ans . You need to undergo a surgery known as Laparoscopic Myomectomy this procedure is now completely standardized and we at Sunrise have a new World Record {by Dr. Hafeez Rahman }of removing the largest fibroid in the world which was of 4kgs weight and equivalent to 9months (36Wks) of pregnancy ,so today any size of fibrod can be removed laparoscopically in expert hands. Also with the old methods of surgery since there used to be a lot of blood loss during Myomectomy patients had a chance of losing their uterus hut, today we have a large armamentarium of agents to control bleeding at Myomectomy and the uterus does not have to be removed .But in the future after Myomectomy we would advise you to undergo a caesarean section at term to deliver your 2nd baby.

Q. I am 42 years old and my problem is that I leak urine whenever I cough or laugh or do any exercise, so much so that I have to wear pads. This is interfering with my sex life and causing a lot of problems between my husband and me. I have met the Doctor and she says I have stress incontinence, will yoga or meditation help to calm me and decrease my stress?

Ans. Stress incontinence is not related to any mental stress ,this incontinence results from weakening of the supports of the urethra {the tube connecting the urinary bladder to the outside} and the urine then leaks when the abdominal pressure rises like during coughing etc. Today we have several minimally invasive methods to handle this problem.like a TVT, orTOT tape these tapes support the urethra in its mid portion and thence prevent any leak. The tape insertion is usually done under short general anesthesia and the patient can go back home the same day. This procedure helps in improving the quality of life for the patient drastically ,and since it is such a simple procedure we advise this procedure to save the patient from embarrassing moments.

Q. I am 29 yrs old married for 4yrs and eager to conceive during my investigations for infertility i was found to have a 15cms size fibroid in my uterus on ultrasound, my doctor recommended an open surgery for removal of the fibroid as he says that the fibroid is very large, also he says that I may even end up in losing my uterus if there is excessive bleeding during the surgery plz help?

Ans. Today any size of fibroid can be removed by a laparoscopic myomectomy our team [Sunrise team headed by Dr Rahman] has removed the largest fibroid in the world weighing 4kgs.Also since many modalities are now available to control bleeding during laparoscopic surgery we reassure patients that their uterus will not be removed during their surgery.

Q. I am 46yrs old with excessive bleeding during periods I was diagnosed with adenomyosis 2 yrs ago and Mirena was inserted but as I have no relief I have been advised to undergo a hysterectomy. I have heard that women have increased hair growth on their face, hot flushes, decreased sex drive etc after hysterectomy. What should I do?

Ans . Total laparoscopic hysterectomy is a completely standardized procedure which can be performed as a’Day care surgery’ with minimal discomfort, minimal blood loss and minimal pain.You can return to office one week after this procedure.The post surgery symptoms like hot flushes described by you can only occur if the ovaries are removed during surgery.As a rule we do not remove healthy ovaries at any age during hysterectomy unless the woman has a family history of ovarian cancer.

Q. Where is your hospital located?

Ans. Sunrise Hospital is located at F-1, Kalindi Colony, New Delhi-110065

Q. What is Laparoscopy/Key-hole surgery?

Ans. As the name suggests ‘Laparo’ means abdomen ‘scopy’ means vision. The surgeon visualizes inner parts of the patients body through the laparoscope put through the small incision on the abdomen. The magnified (up to 20 times larger) vision of the interior parts through the small incision (5-10mm) is quite different from the traditional open surgery. Due to the small incision inflicted on the patients, it is also known as Minimally Invasive Surgery (MIS), Band-aid surgery and key-hole surgery.

Q. What are the advantages of laparoscopic surgery for patients?

Ans.

  • It is performed through tiny incision, hence less pain
  • It reduces blood loss, compared to traditional open surgery
  • Rapid recovery after surgery
  • Needs shorter hospital stay
  • Excellent cosmetic result
  • Early return to normal and routine activities
Q. What is laparoscopic surgery used for?

All kind of gynecological disorders like uterus removal, endometriosis, fibroids, pelvic repairs etc

  • Infertility treatment
  • Hernia repair, appendicitis, cholecystectomy
  • Bariatric (Anti obesity) surgery
  • Cancer surgery
Q. Why do doctors prefer laparoscopy?
  • Laparoscopy enables doctors for better diagnosis with high precision
  • Reduced level of rate of infections and adhesions etc
  • Enhances quality of surgery
  • Patient satisfaction
  • Effective for infertility treatment
  • Cancer surgery
Q. What is obesity? Do you have any special treatment for weight reduction?

Obesity is a condition in which excess body fat has accumulated to such an extent that health may be negatively affected. It is commonly defined as a body mass index (BMI) of 30 KG/M2 or higher. BMI > 25 over weight BMI > 30 obese BMI > 40 Morbidity obese

Yes. We do have special treatment for weight reduction surgeries. We perform Bariatric (weight loss) surgery through laparoscopic procedure. Compared to open surgery, laparoscopic surgery for treating obesity is highly effective simple and safe.

Q. What is your OP timings ?

General OP timings: Morning : 9 a.m. to 1 p.m. Evening : 2 to 5 p.m.

However, you may contact our appointments desk for exact timings of the specified department

Q. What are the contact numbers for emergency and appointment system?

For appointments: 9810157410

For emergency: 9810157410

Q. What are the special facilities available at Sunrise?

State-of-the-art operation theatres with laminar flow & HEPA filters