Posted by sivanesan_admin in on February 13th, 2023
Although gynaecological conditions are very common, affecting up to 95% of all women at least once or twice in their lifetime, this does not mean you have to suffer from their impact on your physical, mental and emotional health.
Dr Siva has many surgical and medical intervention options at his disposal, designed to relieve, and in many cases cure, symptoms of a wide range of gynaecological conditions, with advances in medicines, technologies and surgical techniques delivering better outcomes with few side effects and faster recovery times.
These are some of the main gynaecological conditions we treat. This list is not exhaustive, so if you have another gynaecological condition you might need help with, please get in touch with Dr Siva’s rooms. If it’s a gynaecological condition you need help with that we don’t treat, we can always refer you to a trusted colleague with the appropriate level of expertise.
Dr Siva’s specialised areas of interest and treatmentment expertise include:
When irregular periods or painful and heavy periods (menorrhagia) are negatively affecting your quality of life and ability to work, study, parent or socialise, it’s time to seek professional help from an experienced gynaecologist.
Whether you have medical or surgical treatment will depend on the cause and extent of your menstrual disorder. Treatments may include:
Up to 40% of women have these benign (non-cancerous) growths of the muscle of your uterus without any symptoms at all. Sometimes fibroids are only detected during a routine gynaecological check up.
Larger fibroids or fibroids growing on a particular part of your uterus, can present one or more of the following symptoms:
Fibroid treatment will depend on the size and severity of your fibroids, with treatment options including:
Ovarian cysts are a fluid-filled (occasionally solid) sac that grows within your ovary. Ovarian cysts are very common, usually benign (non-cancerous) and do not usually cause any symptoms.
While most ovarian cysts occur naturally and go away in a few months without needing any treatment, larger ovarian cysts will need treatment.
This progressive and chronic condition occurs when cells similar to those that line your uterus are found in other parts of the body, causing the surrounding tissue to become irritated and develop scar tissue and adhesions. When endometriosis affects the womb, it is called Adenomyosis.
Pelvic organ prolapse (POP) occurs when the connective tissue in your pelvic floor becomes weaker, allowing one or more of the pelvic organs (the bladder, uterus, bowel and/or rectum) to slip down. This causes the top of your vagina to weaken, fall into your vaginal canal and sometimes even bulge out.
Pelvic organ prolapse symptoms include:
Please feel free to get in touch with Dr Siva’s rooms via email ipswichgyn@gmail.com or call (07) 3816 9189
for any further questions about our appointments, fees or anything else.
Posted by sivanesan_admin in on December 11th, 2022
As a highly experienced specialist gynaecologist located in Ipswich, Queensland, Dr Siva provides professional diagnosis, management and treatment of a wide range of general gynaecological conditions in a caring and compassionate manner.
You’ll receive the most up-to-date information and the best treatment for your gynaecological condition, using the most advanced technologies and surgical procedures.
Many gynaecological conditions can be treated medically and don’t require surgery. If surgery is required for your general gynaecological condition, the majority of procedures can be performed using laparoscopic (keyhole) surgery, which allows you to recover more quickly with fewer side effects than open abdominal surgery.
From his consulting rooms in Northwest Medical Centre, Everton Park & Lower Cameron House, Ipswich, Dr Siva provides general gynaecological services and performs minor gynaecological procedures for women of all ages from Ipswich, Brisbane, Springfield, Brookwater, Toowoomba and beyond.
All other surgical procedures, including laparoscopic keyhole surgery, are performed in North West Private Hospital, Brisbane and St. Andrew’s Ipswich Private Hospital, Brisbane.
Please feel free to get in touch with Dr Siva’s rooms via email ipswichgyn@gmail.com or call (07) 3816 9189
for any further questions about our appointments, fees or anything else.
Posted by sivanesan_admin in on December 11th, 2022
Dr Siva has a special interest and many years of expertise in pelvic organ prolapse, including vaginal prolapse and uterine prolapse. He provides wide ranging assessment and treatment and surgery for all kinds of vaginal prolapse and pelvic organ prolapse, including surgery for recurrent vaginal wall prolapse and vaginal vault prolapse surgery.
Dr Siva also performs fertility preserving procedures for women who wish to retain their uterus (including Sacrocolpopexy and Manchester Operation), as well as providing options for conservative, non-surgical management of prolapse.
Pelvic organ prolapse (POP) – also known as vaginal prolapse or prolapse – occurs when the connective tissue in your pelvic floor becomes weaker.
As the structure of your vaginal walls lose tone, one or more of the pelvic organs (the bladder, uterus, bowel and/or rectum) may slip down, causing the top of your vagina to weaken, fall into your vaginal canal and sometimes even bulge out.
Cystocele (anterior prolapse) is the most common kind of prolapse and is a prolapse of the bladder into the vagina
Vaginal vault prolapse (vault prolapse) is prolapse of the vaginal wall.
Uterine prolapse (uterovaginal prolapse) occurs when the uterus slips down into or protrudes out of the vagina.
Enterocele (small bowel prolapse) occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge.
Rectocele (rectum prolapse or posterior prolapse) occurs when the end of the large intestine (rectum) pushes against and moves the back wall of the vagina.
Pregnancy, labour, and childbirth (especially multiple vaginal deliveries) are the most common causes of prolapse, however menopause, age, obesity, uterine fibroids, genetic factors and respiratory conditions with a chronic cough can also cause prolapse.
Symptoms of prolapse may include a feeling of a vaginal bulge, a vaginal lump, fullness or something coming down or out the vagina, lower back pain, difficulty emptying the bowel or bladder or problems with sexual intercourse.
Some women do not have any symptoms at all and only discover they have a prolapse during a routine gynaecological exam.
These are the four stages of pelvic organ prolapse:
Where possible, Dr Siva will provide you with options for conservative management of prolapse, including pelvic floor exercises, seeing a pelvic floor physiotherapist or vaginal pessary insertion.
Surgery for pelvic organ prolapse/vaginal prolapse is usually only recommended if your prolapse is symptomatic.
Dr Siva will assess whether you might require surgery or whether one of the conservative management options will be sufficient to treat your prolapse.
The right type of surgery for you will depend on your type of prolapse, the level of prolapse and your overall health and medical history.
Colporrhaphy (vaginal wall repair) – is a reconstructive surgery for patients with stage one or stage two prolapses who have not had other prolapse surgery.
Dr Siva performs this procedure through your vagina, making small incisions in your vagina before using stitches to repair or strengthen the tissue that supports the vagina. You will either have a spinal anaesthetic or a general anaesthetic for this procedure.
Hysterectomy – is usually only recommended for women with stage three or four uterine prolapse.
A hysterectomy can either be done entirely through your vagina with no cuts to your stomach, with a few small cuts to your stomach (laparoscopic or ‘keyhole’ hysterectomy) or with one long cut across your stomach (abdominal hysterectomy).
You will require a general anaesthetic and you will no longer be able to become pregnant after a hysterectomy.
Sacrocolpopexy – is a procedure where a piece of mesh is attached to your tailbone (sacrum) to give your vagina and/or uterus permanent support. It can either be performed as keyhole surgery or with one longer cut to your stomach (laparotomy) under a general anaesthetic.
Sacrocolpopexy is usually recommended for women with a stage three or stage four prolapse or for women who have already had a hysterectomy. It is also used as a uterus preserving prolapse surgery for younger women with a prolapsed uterus who don’t want to have a hysterectomy.
Colpocleisis – stitches a section of your vagina closed to prevent pelvic organs from moving into it. This operation has a very high success rate and it is performed vaginally without any incisions to your stomach.
Colpocleisis is a procedure usually reserved for older women because after this operation you can no longer have penetrative sex.
Manchester Operation – is a fertility preserving procedure which is associated with less blood loss and a faster recovery, when compared to vaginal hysterectomy.
A vaginal pessary is a soft removable plastic or silicone device that is inserted into your vagina to help support areas that are affected by pelvic organ prolapse, such as your vaginal walls and uterus.
Dr Siva will measure and fit the right size and type of pessary for you in his rooms. Ring pessaries can be removed and reinserted by you daily for cleaning or before sexual intercourse, while other types of pessaries will need to be removed and cleaned by Dr Siva in his rooms every 3 to 6 months.
It all depends on the type of prolapse surgery you are having. Most vaginal prolapse surgeries require just one or two nights stay in the hospital.
To reduce the risk of blood clots occurring in your legs you are encouraged to mobilise as soon as possible, usually the day after surgery. Spend some time each day going for a walk, slowly increasing as you feel comfortable. It is safe to go up and down stairs after prolapse surgery.
You will probably need extra help at home for the first 2 weeks as it’s important not to lift or bend too much at this stage.
Between 4 – 6 weeks post op you can start to move more, do gentle exercises and walk outside your home, slowly increasing your movement as you feel comfortable. At this stage you can:
You may have a vaginal pack in your vagina after your vaginal prolapse surgery. A vaginal pack is a gauze pack placed in your vagina to prevent bleeding. Your vaginal pack will be removed within 24 hours of your surgery, before you are discharged from the hospital.
It is normal to experience some mild vaginal bleeding in the first week after surgery. If your bleeding is heavier than a period, itchy or if it is offensive smelling, please get in touch with Dr Siva as this may indicate a blood clot or an infection that you might need treatment for.
To prevent constipation, make sure you eat a well balanced diet with plenty of fibre and try to drink 2-3 litres of fluids a day. We also recommend regular stool softeners after surgery for about 2 weeks. If you experience ongoing constipation a laxative may help or you might need to get in touch with your GP or Dr Siva’s rooms.
It all depends on the type of vaginal prolapse surgery you have. Abdominal open surgery has a longer recovery time and it can take 4 – 6 weeks to fully heal. Keyhole (laparoscopic surgery) surgery has a shorter recovery time of approximately 1 – 2 weeks to recover. Vaginal surgery could take any time from 6 – 12 weeks duration.
Do not place tampons or anything else in your vagina until after your post op visit with Dr Siva, which is usually 6 weeks after surgery..
You can resume driving once you can easily turn in your seat without discomfort and can safely perform an emergency stop – usually about 4 weeks after surgery. We highly recommend you see your GP prior to getting the clearance for driving.
The amount of time you need to take off work will depend on the type of vaginal prolapse surgery you have had.
You will probably need to take 6 – 12 weeks off work after vaginal prolapse surgery. This duration does depend on multiple factors. Please discuss this with Dr Siva prior to your hospital discharge.
Sexual intercourse can be resumed once you’ve healed completely and have no bleeding or discharge), which is usually after 12 weeks, however you may require additional lubrication and experience some discomfort .
Please feel free to get in touch with Dr Siva’s rooms via email ipswichgyn@gmail.com or call (07) 3816 9189
for any further questions about our appointments, fees or anything else.
Posted by sivanesan_admin in on December 11th, 2022
Advanced laparoscopic surgery is also known as keyhole surgery or minimally invasive surgery because the entire surgery can be done without cutting open your abdomen.
Laparoscopic surgery is performed using a laparoscope, which is a thin and long tube approximately 5-10 mm wide with a camera attached to the tip. During surgery, a laparoscope is inserted into a small incision made in your abdomen, with the camera allowing the surgeon to watch the insides of your abdomen on a screen so they can either diagnose a gynaecological condition or perform surgery.
Because laparoscopic keyhole surgery avoids the need for a more invasive abdominal open surgery, it reduces scarring, the chance of infection, post-operative pain and your overall recovery time.
When laparoscopic surgery is performed for diagnosis, two incisions are made, whereas for operative laparoscopies, three or four incisions may be required. Scarring from these incisions, if any, is minimal and barely visible.
Dr Siva has a special interest in Advanced Laparoscopic Surgery and is an accredited Level 5 advanced laparoscopic surgeon, one of the highest levels of complexity for laparoscopic surgery.
Dr Siva uses Level 5 advanced Laparoscopic Surgery for diagnosis and treatment of complex gynaecological conditions such as:
These Advanced Laparoscopic Surgeries are all carried out in St Andrew’s Ipswich Private Hospital, Queensland.
Total Laparoscopic Hysterectomy (also known as TLH) is a surgical procedure for the removal of your uterus (womb) and sometimes also your cervix, which is the lower part of your uterus near your vagina.
Total Laparoscopic Hysterectomy is the route of choice rather than abdominal abdominal hysterectomy because a Total Laparoscopic Hysterectomy is associated with less pain, less blood loss and a faster recovery because your uterus is separated from the inside of the body and removed through your vagina.
Dr Siva performs Total Laparoscopic Hysterectomy to treat:
Most hysterectomy cases can be performed laparoscopically and Dr Siva performs Total Laparoscopic Hysterectomy at the St Andrew’s Ipswich Private Hospital, Queensland.
SILS is a special form of laparoscopy that uses a single incision in the thinnest part of the abdomen – the belly button – through which all the instruments required for the operation are placed.
The main advantages of SILS are the improved cosmetic appearance after surgery by avoiding several scars near the bikini line, a reduction in pain following surgery and the possibility of a slightly faster recovery than with traditional laparoscopic techniques.
Dr Siva performs Single Incision Laparoscopic Surgery (SILS) for a wide range of gynaecological procedures including:
The majority of laparoscopic surgery cases are day surgery cases, however total laparoscopic hysterectomy is usually an overnight stay.
Laparoscopic surgery can take anywhere between 60-90 minutes, depending on the type of laparoscopic surgery you are having and any complications, such a the number of and size of adhesions.
A total laparoscopic hysterectomy usually takes around 90 minutes.
You may experience some vaginal bleeding for anywhere between a couple of days to up to one month after surgery. If this bleeding becomes heavy or you experience an unusual discharge, please contact Dr Siva’s rooms as this may indicate an infection.
Your next normal menstrual cycle may not occur until four to six weeks after surgery and you may experience heavier bleeding and more discomfort than usual.
Immediately after the surgery, you may feel sleepy and nauseous, with pain at the site of the incisions – you will be given pain-relieving medication for this. You may also experience a sensation of bloating in the abdomen or pain in the shoulder tips from the carbon dioxide gas used during a laparoscopy.
For the first 24 hours after you return home, have a responsible adult stay with you, rest quietly and don’t do any heavy lifting, housework, cooking or drink alcohol. Don’t drive, operate machinery or sign any important or legal documents.
Cuts on your abdomen will be closed by stitches or glue. Glue will dissolve by itself, while stitches may either dissolve or need to be removed in Dr Siva’s room five to seven days after surgery.
Your cuts will be covered with a dressing that can be removed 24 hours after your surgery, which is when you can also have a wash or shower.
If you have any stitches in your vagina they will dissolve themselves and you might see a stitch, or part of a stitch, coming away after a few days or weeks. This is normal and nothing to worry about.
Until you’ve had the sign off from Dr Siva at your post surgical review, don’t resume sexual intercourse, swimming, bathing or use tampons.
You will be permitted to resume sexual intercourse, swimming and bathing once your wound has fully healed, which is usually six weeks after surgery.
Avoid all vigorous activities for the first few weeks after your operation and avoid exercises such as sit-ups or lifting heavy objects until after your post surgical review.
Depending on the type of laparoscopic surgery, you should be able to return to driving and/or work 1-2 weeks after your procedure.
Please feel free to get in touch with Dr Siva’s rooms via email ipswichgyn@gmail.com or call (07) 3816 9189
for any further questions about our appointments, fees or anything else.
Posted by sivanesan_admin in on December 11th, 2022
A colposcopy is a relatively minor and simple procedure, similar to a cervical screening test or a pap smear, that usually only takes 5-10 minutes. Dr Siva performs colposcopy in his rooms at St. Andrew’s Ipswich Private Hospital.
If your cervical screening test delivers an abnormal result, such as human papillomavirus (HPV) or cervical cell changes, your GP may refer you to Dr Siva for a colposcopy appointment.
Your GP might also refer you to Dr Siva for a colposcopy if you have unusual or unexplained bleeding or an abnormal lump or growth on your cervix or vagina.
A colposcopy is the primary tests for diagnosing and presenting cervical cancer, vulvar and vaginal cancers and it is used to investigate, diagnose and prevent conditions such as:
Dr Siva is accredited to perform colposcopy to manage abnormal cervical screening test results such as low grade squamous epithelial lessons (LSIL) and high grade squamous epithelial lesions (HSIL).
The cervical screening test looks and feels like a pap smear, however it has now replaced the pap smear. While the pap smear was used to search for changes in the cells of the cervix (the entrance to the uterus from the vagina), the cervical screening test instead looks for evidence of the human papillomavirus (HPV), which can lead to these cell changes in the cervix.
If your cervical screening test results are normal, you’ll only need to have a cervical screening test done every 5 years, however if it shows changes to the cells in your cervix, you’ll need to have the test done every year and you’ll be referred to your gynaecologist for a colposcopy to further evaluate these changes.
A colposcopy looks and feels the same as a cervical screening test, however it is only performed if you have an abnormal cervical screening test result and it is performed by your gynaecologist using a colposcope.
A colposcopy is a speculum examination performed on a special gynaecological chair in your gynaecologist’s rooms. You will lie on your back, with your legs might be raised and supported in stirrups while your gynaecologist inserts a speculum to open your vagina.
During a colposcopy, your gynaecologist will use a colposcope, which is a special magnifying instrument that looks like a pair of binoculars with a bright light, allowing your gynaecologist a greatly magnified view of the surface of your vagina and cervix. The colposcope does not enter your body.
Fluid is applied to your cervix to highlight any cell changes that can only be seen when looked at with the colposcope. If there are changes to your cervix and the area requires further investigation, a tiny piece of tissue a few mm in length is taken and sent to a laboratory for a biopsy.
Results of your biopsy will usually be back within a week and observation or treatment of any cell changes will then be planned. Treatment, if required, will usually involve a large loop excision of the transformation zone (LLETZ) procedure to remove any abnormal cells.
LLETZ stands for large loop excision of the transformation zone, a common and highly effective treatment to remove cell changes (abnormal cells) in your cervix. During a LLETZ procedure an electrical wire (diathermy) is used to shave abnormal cells off your cervix, leaving only the healthy tissue.
The LLETZ procedure is successful in over 90% of cases to stop any cell changes developing into cervical cancer, meaning no further treatment is needed.
LLETZ is a simple and safe surgical procedure that only takes about 15-30 minutes. Dr Siva performs LLETZ in an operating theatre under general or local anaesthetic as a day case, meaning there is usually no overnight hospital stay required.
During the LLETZ procedure you lie on your back on an examination couch as a clean speculum is inserted into your vagina, similar to a cervical screening test. If you are not having a general anaesthetic, a local anaesthetic will be injected into your cervix to make it numb.
As the LLETZ loop shaves off the area of your cervix that has cell changes you might notice a slight burning smell and hear a noise like a soft vacuum cleaner. After the loop has removed the tissue, another small instrument is used to seal the cut.
Any cells and tissue that have been removed are now sent to a lab to be biopsied, checking what kind of cell changes you have and whether all cell changes have been completely removed.
After your LLETZ treatment, you will be contacted with your biopsy results after 7-10 days. For most patients, following the LLETZ procedure, you would need a CST with your GP in 12 months time.
To find out more about colposcopy or the LLETZ procedure, get in touch with Dr Siva’s rooms.
A colposcopy can take anywhere between about 5 – 15 minutes, depending on whether a tissue sample has to be taken or not. Allow approximately 30 minutes in total for your colposcopy appointment.
Although a colposcopy can feel awkward and uncomfortable, it is relatively painless. You might feel slight pressure when the speculum enters your vagina, a slight burning or stinging when the solution comes into contact with your cervix or a slight pinching or cramping sensation if a tissue sample has to be taken.
A colposcopy procedure is usually done when you are not menstruating, however you should discuss this with Dr Siva.
For 24 to 48 hours beforehand, you should not:.
If you didn’t need a tissue sample and a biopsy, you should be able to resume normal activities right away.
After a biopsy, you might experience cramps, some spotting, vaginal discharge or bleeding for up to 5 or 6 days. Avoid heavy exercise, swimming, bathing (showering is fine) for 2 days. It is normal to have a little spotting for 2-5 days after a colposcopy, especially if you have also had a biopsy.
Avoid penetrative sex or using tampons for at least a week after a biopsy to minimise the risk of infection.
You will not need a general anaesthetic or a hospital stay for a colposcopy, however a local anaesthetic may be required if Dr Siva needs to biopsy a particularly sensitive area.
Dr Siva performs all of his colposcopies in his rooms, located at St. Andrew’s Ipswich Private Hospital.
Yes it does. It takes approximately four- to six weeks for new healthy tissue to grow on your cervix to replace the removed abnormal tissue.
Dr Siva’s rooms will contact you with the results of your biopsy and arrange a follow up appointment for further treatment, if required.
While some spotting is to be expected, please contact Dr Siva if:
Your cervix should heal itself anywhere from three to six weeks. Any vaginal discharge and bleeding will stop as soon as your cervix is healed.
Some cramping pain, like a period, is to be expected for up to 4 weeks after treatment. Although the pain varies from person to person, it should not be too severe and over-the-counter pain relief medication usually helps.
After the anaesthetic has worn off, you may experience pain, vaginal bleeding and changes to vaginal discharge for up to 4 weeks. Bleeding can vary from slight to as much as a light period.
For one to two weeks you should avoid heavy exercise and for the first 3-4 weeks you should avoid intercourse, swimming, bathing, douching and using tampons.
Please feel free to get in touch with Dr Siva’s rooms via email ipswichgyn@gmail.com or call (07) 3816 9189
for any further questions about our appointments, fees or anything else.