Surgery

Admission for surgery – what to bring to the Hospital

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This article will help you to prepare the essential items that you need to bring to the hospital for your admission. The list here is just a suggestion or a guide only, and you may make your own adjustment, based on your own preference. Decide which items you will need for a comfortable stay and recovery. However, you should not over-pack so as to inconvenience everyone, including yourself during your admission or discharge. The items will also depend on the expected length of stay in the hospital.

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Bartholin glands disorders (Bartholin cyst / Bartholin abscess)

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The Bartholin gland is located on either side of the vaginal opening, on the inner aspect at about 5 and 7 o’clock position. The glands secrete a fluid (mucus) that keeps the vagina moist and helps lubricate the vaginal area during sexual activity. The gland is not visible or palpable unless it is swollen.

Common disorders of the Bartholin glands are:

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Cervical Polyps

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A cervical polyp is a benign fleshy growth on the cervix. The cervix is the part of the uterus that is visible during the speculum examination. It is also called the neck of the uterus. Cervical polyp arises from cells, either from the cervical canal (this type is also called an endocervical polyp) or from the outer surface of the cervix.

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Heavy Menstrual Bleeding (HMB)

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menstrual bleedingHeavy menstrual bleeding or HMB (previously called menorrhagia) is a significant cause of morbidity in women of reproductive age. It often involves soaking through ten or more sanitary napkins in a day, a menstrual flow that lasts for seven to 14 days or even longer. The presence of “flooding” or clots is indicative of heavy bleeding. Normal menstrual blood flows freely without clotting. This is because of the presence of an anti-clotting agent produced by the uterus. However, if the bleeding is excessive and far exceeds the amount of anti-clotting agent available, then the remaining blood that flows out will form clots. Bleeding between menstrual cycles is also abnormal. The presence of other clinical signs such as anaemia will further support the diagnosis and indicate the severity of the bleeding

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Endometrial polyps

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Endometrial polyps are growths that arise from the inner walls that lined the uterine cavity. It is sometimes called uterine polyps. It is believed to arise from the overgrowth of endometrial tissue. It may range in size from a few millimetres only to a few centimetres. Sometimes, there can be several polyps present at the same time. It may have a long stalk and can extends through the cervix into the vagina.
An endometrial polyp is usually a non-cancerous growth. However, in a small proportion of women, some of these polyps can lead to cancer (called pre-cancerous type). The risk of cancer in a polyp is increased in post-menopausal women. It can arise at any age but rarely occur in women under 20 years old.

Cause and risk factors

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Loop Electrosurgical Excision Procedure (LEEP/LLETZ) for CIN

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Loop electrosurgical excision procedure (LEEP), also known as large loop excision of the transformation zone (LLETZ), is a procedure for further diagnosis and treatment of cervical intraepithelial neoplasia (CIN). CIN lesion is an abnormal growth in the cervix. The CIN lesion is usually diagnosed during a routine Pap smear (or called Thin Prep) test. LEEP is a very safe way to remove abnormal tissue from the cervix that might otherwise progress to cancer. It minimizes the amount of tissue removed in order to preserve childbearing ability.

Reason for the procedure

• Presence of CIN lesions from the colposcopy evaluation and confirmed via cervical biopsy. Some types of CIN can progress to cervical cancer if not treated. This can be used as a treatment for CIN lesions.
• Unsatisfactory colposcopic evaluation whereby the whole transformation zone cannot be visualized or the cervix appeared abnormal and requires a bigger tissue specimen for a more accurate diagnosis to exclude cancer changes.

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Endometrial biopsy (Endometrial sampling or curettage)

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Endometrial biopsy is a procedure that involves the removal of tissues from the endometrium, which is the inner lining of the uterus.

Reason for the procedure

It is done to diagnose endometrial cancer or hyperplasia (with or without atypia). Endometrial hyperplasia is a potentially precancerous condition. This procedure is indicated in a woman with abnormal uterine bleeding. This includes bleeding between menstrual periods, excessive bleeding during a menstrual period, or bleeding after menopause. It is also done to exclude endometrial cancer in post-menopausal  women with abnormal endometrial finding on ultrasound scan of the uterus.

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Vasectomy – Male contraception

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Article contributed by Dr Peter Ng and Dr Beatrice Chua Yoong Ni

The aim of a vasectomy is to prevent sperm from reaching the semen by disconnecting the sperm duct. The resulting ejaculate is therefore sperm-free, eliminating the risk of pregnancy. Sort of like a cheap shark fin soup without the shark fins (sperms).

Vasectomy is the contraception of choice for 6%–8% of married couples worldwide. Vasectomy is a minor procedure that provides effective and permanent contraception. In fact, it is far more effective than many other methods of contraception, including female sterilization.

Prior to a vasectomy, it is important and both husband and wife be present together to be counseled by a specialist on the implications of the procedure. It is important that the completeness of family is ascertained and that both husband and wife had discussed beforehand and agreed that it is the husband who should undergo a vasectomy to attain permanent contraception.

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