Mr Faraj provides the following treatment:
1.Heavy and painful periods:
Non surgical treatment:
This is suitable for women trying to avoid surgery for various reasons.
It includes different types of medications that try to helps with blood clotting and also affect the Prostaglandin synthesis that will also reduce the pain with periods
Intrauterine Device: like the Mirena IUS
This has proven as very effective over 90% reduction in heavy periods or stop the periods completly. It is also suits women who require an effective contraception as effective as sterilisation
A. Minimal Invasive procedures like endometrial ablation or resection:
- Novasure ablation: this is a very effective procedure in reducing heavy periods. We conducted a study in our hospital and satisfaction rate was 95%.
- It will also suit women who want to avoid hysterectomy
- It can be carried out as a day procedure or even in the endoscopy suite under local anaesthetic
2. Treatment of Uterine Fibroids:
Fibroids are non-cancerous growths of your womb (uterus). They are also known as uterine myomas or leiomyomas.
Fibroids may not cause symptoms or they cause:
- A. Heave periods and can lead to anaemia
- B. Pass urine more often
- C. Heaviness or swelling in your pelvic area
- E. Constipation if press on your bowel
Fibroids could cause problems in pregnancy like repeated miscarriages or premature labour and delivery
Diagnosis of Fibroids:
That is simply done by an ultrasound scan or MRI
Treatment of Fibroids:
- Pain killers
- Monthly injections called (GnRh) to suppress your ovaries and shrink fibroid size
- Ulipristal (Esmya): new medications also stop the bleeding and shrink fibroid size
- Different hormonal medications: like Norethisterone which is progesterone hormone
Can be done by minimal invasive methods and depend on the location of the fibroids:
- A. Hysteroscopic removal of the fibroids: Usually a day case operation by telescope through the vaginal ,the fibroid will be removed without incision in the tummy
- B. Myomectomy: Removal of a fibroid thorough small incision in lower part of tummy
- C. Laparoscopic (key hole) myomectomy: The fibroid will be removed through small incisions in the tummy. Quick recovery and may go home next day
- D. Hysterectomy: If large fibroid or you completed your family
3. Treatment of Ovarian cysts:
Cysts on the ovary may be small or cause no symptoms.
However,if they are large or cause pain or heaviness in the abdomen,it is better to be removed
Occasionally,ovarian cysts are suspicious of being cancerous and again best removed or remove the whole ovary
The commonest cysts on the ovaries are functional cysts or dermoid cysts
Treatment (if needed) is by laparoscopic /key hole surgery. Usually it has a quick recovery and women can go home same day
4. Vulval conditions:
Vulval reduction (vulvoplasty): usually it is done if you feel the size of your labia causes discomfort during sex or rubs against the underwear or other symptoms
The result of the operation is often good and reduces the size of the vulva to a suitable size.
Vulval lichen sclerosus: present with itching and irritation. It responds well to steroids cream
5.Treatment of Endometriosis:
This condition usually present with long standing pain in the pelvis and could be cyclical with periods (dyemenorrhea). It can also cause pain with intercourse (dysparunea)
Infertility is more common in women with endometriosis.
Diagnosis is usually by ultrasound scan where a suspicion of cyst in the ovary (chocolate cyst) or with MRI
The main diagnosis and treatment is by athe key hole operation (laparoscopy)
Medical treatment is quite successful like hormonal treatment to suppress estrogen production from the ovary and ovulation like the combined pills, progesterone tablets, simple pain killers with antinflammatory effects like Diclofenac.
Injections like GnRH (Decapeptyl) given monthly for 6 months is quite effective as well
Mirena IUS (Device) also help to reduce the pain and heavy periods with endometriosis
Surgical treatment: Laparoscopic surgery:
Effective in either excision or ablation of the endometriosis deposits and also remove the chocolate cysts. It can increase chances of pregnancy
- Insertion of Intrauterine devices (IUD/IUS)
- Laparoscopic sterilisation: Can be done as a day case with a key hole Operation. Usually we put one clip on each fallopian tube
- Hysteroscopic sterilisation (ESSURE): usually done vaginally either under local anaesthetic or while asleep. No need for cuts
In this procedure, One implant will be inserted into the opening of the fallopian tube into the uterus.