Patel Hospital, Civil Lines, Jalandhar City, (Pb) India.
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Uro Gynaecology – ( Female Urology )

Uro-gynaecology deals with the diagnosis and treatment of urinary incontinence and dysfunction of the pelvic floor. The pelvic floor includes muscles, ligaments, and connective tissue that help to support the womb, vagina, bladder and rectum.

It can be damaged by a number of conditions such as pregnancy, childbirth, chronic disease, surgery and repeated heavy lifting. Some problems due to pelvic floor dysfunction and their symptoms include:

  • Incontinence: loss of bladder or bowel control
  • Prolapse: descent of pelvic organs (bladder, womb, vagina or rectum)
  • Emptying disorders: difficulty urinating or moving bowels
  • Overactive bladder: frequent need to pass urine
  • Bladder pain

STRESS INCONTINENCE

Stress incontinence is the inability to control your urge to urinate in certain circumstances.It’s a serious and embarrassing disorder and can lead to social isolation. Any pressure placed on the abdomen and bladder can lead to the loss of urine.

URODYNAMIC STUDY

(no need to leak) Urodynamic testing or urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and URODYNAMIC STUDY releasing urine.

TRANSOBTURATOR TAPE

WHAT IS TRANSOBTURATOR TAPE ?
This is a narrow strip of synthetic material placed in your body to support the urethra. How likely is it that a transobturator tape will cure incontinence?

In women who have incontinence due to weakness in the pelvic floor and poor support of the urethra (i.e. “genuine stress incontinence”), 8 or 9 o u t o f 1 0 w o m e n s h o u l d b e completely dry or much better after surgery than before. Nine out of every 10 women are able to be as active as they like after placement of a transobturator tape e.g. lift children, dance or exercise. As a result, 19 out of every 20 women are satisfied by the results of the procedure.

LAPAROSCOPIC PELVIC EXENTERATION

Pelvic exenteration (or pelvic evisceration) is a radical surgical treatment that removes all organs from a person’s pelvic cavity after failed primary treatment for carcinoma cervix, carcinoma uterus, carcinoma bladder etc. The urinary bladder, urethra, rectum, and anus are removed. The procedure leaves the person with a permanent colostomy and urinary diversion. It is life saving for the patient after primary treatment failure.

INDICATIONS

Cervical Cancer

  • PE is used for recurrent cervical carcinoma, both squamous and adenocarcinoma, with well-documented salvage potential.
  • Up to 25% of women with FIGO stage IB-IIA cervical cancer may recur after initialtherapy.
  •  Radical surgery offers an alternative curative treatment.
  • Survival rates ranging from 16 to 60% are reported for these patients
  • Long-term survival is directly correlated with complete tumor resection
  • Pelvic Exenteration has also been utilized as a potentially curative primary treatmentfor locally advanced cervical cancer

Uterine Cancer

  • Cases of PE for a variety of histologic types of uterine cancer have been reported, with outcomes similar to PE for other indications.
  • Women with loco-regional recurrence may be candidates for PE with curative intent.
  • Morris et al.reported a five-year survival rate of 45% following PE for recurrent endometrial cancer.

Vulvar Cancer

  • Vulvar cancer has a propensity for regional metastases.
  • For patients with advanced primary or recurrent vulvar cancer who do not have the option of treatment with radiation therapy, PE may be appropriate

Ovarian Cancer

  • This technique may be used to achieve optimal cytoreduction in patients with disease requiring bladder and rectosigmoid resection.

Vaginal Cancer

Palliative PE

  • Indications include intractable hemorrhage due to tumor invasion and fistulae.