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:
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.
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.
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:
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.