General Gynaecology Services at Mediclinic

Menstrual disorders refer to a group of conditions that affect a woman's menstrual cycle, which is the regular pattern of changes in hormones and the uterus that prepare a woman's body for pregnancy each month.

Menstrual disorders can lead to irregular or heavy bleeding, missed periods, and pain, affecting a woman’s quality of life. Common types include:

1. Amenorrhea: The absence of menstrual periods in a woman of reproductive age.
2. Dysmenorrhea: Painful periods that can range from mild to severe.
3. Menorrhagia: Heavy menstrual bleeding that lasts longer than 7 days.
4. Metrorrhagia: Irregular bleeding between periods.
5. Premenstrual Syndrome (PMS): A group of physical and emotional symptoms that occur before a woman's period.
6. Premenstrual Dysphoric Disorder (PMDD): A more severe form of PMS that can cause extreme mood swings and other symptoms.

There are many other types of menstrual disorders as well, and they can be caused by a variety of factors, including hormonal imbalances, uterine fibroids, endometriosis, polycystic ovary syndrome.

If you are experiencing menstrual irregularities or other symptoms, it is important to talk to your healthcare provider to determine the cause and appropriate treatment. 

Polycystic ovary syndrome (PCOS) is a common hormonal disorder impacts reproductive-age women. It is characterised by the presence of numerous small cysts on the ovaries, along with increased levels of androgens (male hormones) and an imbalance of estrogen/progesterone in the body.

The symptoms of PCOS include:

1. Irregular or absent periods
2. Excessive facial, chest, or abdominal hair
3. Acne or oily skin
4. Weight gain or trouble losing weight
5. Infertility or difficulty conceiving
6. Darkened skin in areas like the neck or armpits
7. Skin tags or excess skin in regions like the armpits or neck

The exact cause of PCOS is unknown, but it is believed to be related to a combination of genetic and environmental factors.

PCOS is typically diagnosed through a pelvic exam, ultrasound, hormone tests (DUTCH test/blood test) and some blood tests.

Treatment for PCOS typically focuses on managing symptoms and may include lifestyle changes such as weight loss and exercise, hormonal therapy and some medications to regulate menstrual cycles and lower androgen levels, and fertility treatments if needed.

Women with PCOS are also at increased risk for other health problems such as diabetes, high blood pressure, and heart disease, so it is important to work with a healthcare provider to manage the condition and monitor for these complications.

Osteoporosis is a medical condition characterised by weakened bones that are more prone to fracture or break. It occurs when the body loses too much bone mass, produces too little bone tissue, or both. This can increase the risk of fractures, particularly in the spine, hip, and wrist.

Osteoporosis can affect both men and women, but it is more common in women, especially after menopause.

There are several risk factors for osteoporosis, including age, sex, family history, low body weight, a history of smoking, excessive alcohol consumption, and certain medical conditions such as hyperthyroidism or rheumatoid arthritis. A lack of calcium and vitamin D in the diet can also contribute to the development of osteoporosis.

The symptoms of osteoporosis may not be apparent until a fracture occurs. However, some signs may include back pain, loss of height over time, and a stooped posture.

Osteoporosis typically diagnosed through a DEXA-scan.

Treatment for osteoporosis may include lifestyle changes, such as regular exercise, a healthy diet with adequate calcium and vitamin D, and avoidance of smoking and excessive alcohol consumption. Medications may also be prescribed to slow bone loss and increase bone density.

Vaginitis is an inflammation of the vagina that can cause discharge, itching, and pain. The cause is frequently a vaginal bacteria imbalance or infection. Vaginitis can also result from menopause-induced estrogen deficiency and skin diseases.

The most prevalent kinds of vaginitis are:

Bacterial vaginosis: Overgrowth of vaginal bacteria destroys the normal balance. Grayish-white, foul-smelling discharge may occur

Yeast infections: Candida albicans is typically responsible. Cottage cheese-like discharge may occur.

Trichomoniasis: This is caused by a parasite and is often sexually transmitted. a greenish-yellow, sometimes foamy discharge may occur

Symptoms of vaginitis can vary depending on the infection and may include:

1. Changes in vaginal colour, odour, or discharge
2. Vaginal itching
3. Painful urination
4. Spotty vaginal bleeding

Treatment for vaginal infections may include antibiotics, or antiparasitic medications depending on the infection type. For hormonal changes estrogen might be prescribed to ease symptoms.

Gynaecological oncology diagnoses and treats cancers that are located on a woman’s reproductive organs including, cervical, uterine, ovarian, fallopian tubes, vaginal and vulvar types.

Gynaecological oncologists are gynaecologists who have subspeciality training in surgical oncology of the female reproductive tract. They provide care for women with a gynaecological cancer and carry out screenings for female cancer, as well as manage pre-malignant diseases. In addition, they deal with complex gynaecological cases such as endometriosis, fibroids and pelvic masses.

Gynaecological cancers are complex, and treatments often takes many forms including surgery, chemotherapy and radiation.

An integrated approach to gynaecological cancers

At Mediclinic, we offer an integrated, multidisciplinary approach for every cancer patient. For those suffering from gynaecological cancers in particular, we take into account all the factors which impact women’s quality of life including body image issues, sexual function issues, menopause symptoms, and emotional distress.

Breast cancer is a type of cancer that forms in the cells of the breast. The cells in the breast can become abnormal and divide uncontrollably, forming a lump or mass of tissue. These abnormal cells can invade nearby tissues or spread to other parts of the body through the lymphatic system or bloodstream.

Breast cancer is most commonly found in women, but it can also occur in men. There are several types of breast cancer, and the most common types are invasive ductal carcinoma and invasive lobular carcinoma.

Breast cancer signs and symptoms may include:

1. An unusual breast bulge or thickening.
2. Breast size, shape, or appearance changes
3. Changes in breast skin, such as dimpling
4. Nipple inversion
5. Skin peeling, scaling, crusting, or flaking around the nipple (areola) or breast skin
6. Redness or pitting of the skin around your breast, similar to the skin of an orange
7. Breast cancer can be detected through routine screening, such as mammography and breast ultrasonography

Treatment options for breast cancer may include surgery, radiation therapy, chemotherapy, targeted therapy, hormone therapy, or a combination of these approaches. The choice of treatment will depend on the type and stage of the cancer, as well as the patient's overall health and preferences.

Mediclinic Middle East practises a multidisciplinary approach to treating cancers.  Our tumour boards encompass various medical disciplines, including surgeons, oncologists, radiation oncologists, consultants and specialist doctors, all of whom, together, will decide on a personalised course of treatment, following accepted and recognised international guidelines.

Gynaecological oncology services at Mediclinic

• Minimal access surgery (laparoscopic and hysteroscopic)
• Screening for diseases of the cervix (HPV testing and colposcopy)
• Managing complex gynaecological cases of endometriosis and fibroids
• Managing cancers of the uterus, ovaries, fallopian tubes, cervix and vulva.  This includes:
  • Investigations such as image guided biopsies, MRI, CT, PET-CT, histopathology
  • Surgery such as fertility sparing surgery where appropriate, minimal access surgery (laparoscopic), sentinel nodes sampling, radical surgery.
  • Chemotherapy
  • Radiotherapy including external beam radiotherapy and brachytherapy.
• Counselling and managing patients for familial cancers of the ovary, uterus and breast.
• Gynaecological screening for patients with breast cancer.

Mediclinic offers some of the most advanced services for the diagnosis and treatment of urogynaecological issues and female pelvic floor disorders in the UAE.

We provide a 360-degree service, from accurate diagnosis to medical and minimally invasive robotic and laparoscopic surgery for:

• Rectal prolapse
• Chronic constipation and obstructed defecation syndrome
• Pelvic dysynergia
• Hemorrhoids or piles
• Bladder, Uterine, and vaginal prolapse
• Urinary and fecal incontinence
• Pelvic and anal pain
• Sexual dysfunction and pain
• Anal fistula
• Anal fissure
• Anal stenosis

Multidisciplinary team

The pelvic floor surgery team is a multidisciplinary team composed of female and male general surgeons specialised in pelvic floor diseases, gynaecologists, urologists, gastroenterologists, clinical nutritionists and physiotherapists. We provide anoscopy, rectoscopy, colonoscopy, anorectal manometry and rectal sensation, tone and compliance testing.  We also offer endorectal 3D ultrasound, very useful for studying anal fistula and muscular damage after episiotomy in addition to deep infiltrating endometriosis. In selected cases, we perform MR defecogram or proctogram, a special magnetic resonance exam performed in order to correctly evaluate pelvic floor disorders. Full uro-gynaecological evaluation is also available with ultrasound, pap-smear, urodynamics tests and much more.

Therapy

We believe that medical therapy has an important role in pelvic floor diseases, suggesting that patients adopt a healthy lifestyle and giving them diet advice in cooperation with our clinical nutritionist and gastroenterologists.  In addition, we prescribe up to date medical therapy and promote pelvic floor physiotherapy with our women’s health physiotherapists.

Surgery

We offer the latest up-to-date vaginal and abdominal minimally invasive approaches for all female pelvic floor diseases, including the latest da Vinci robotic surgery. Most of our surgical minimally invasive techniques are performed in day surgery or one night stay setting, guaranteeing a short, smooth and painless postoperative course and quick return to daily activities.

Minimally invasive surgery

Minimally invasive surgery (MIS) is a surgical technique that uses small incisions to access the inside of the body instead of large incisions used in traditional open surgeries. This approach has revolutionised women's health surgery, and has become the standard of care for many gynaecological procedures.

Some of the benefits of minimally invasive surgery for women's health include:

1. Smaller incisions: MIS techniques use smaller incisions compared to traditional surgery, which results in less tissue damage and scarring.
2. Reduced pain: Smaller incisions usually mean less pain for patients, and also lead to a faster recovery.
3. Shorter hospital stays: MIS typically requires shorter hospital stays compared to traditional surgeries, as patients can often go home on the same day or within a few days.
4. Faster recovery: Patients who undergo MIS can usually return to their normal activities quicker than those who have open surgery.

MIS techniques can be used to treat a range of women's health conditions, including:

1. Fibroids: MIS techniques can be used to remove uterine fibroids, which are non-cancerous growths in the uterus that can cause pain and bleeding.
2. Endometriosis: MIS can be used to remove tissue that grows outside the uterus and causes pain and infertility.
3. Ovarian cysts: MIS techniques can be used to remove ovarian cysts, which are fluid-filled sacs that can cause pain and discomfort.
4. Hysterectomy: MIS can be used to remove the uterus for a variety of reasons, including fibroids, endometriosis, and cancer.

Overall, minimally invasive surgery is a safe and effective option for many women's health conditions. It is important to discuss the best treatment options with your healthcare provider to determine the most appropriate approach for your individual needs.

Aesthetic gynaecology encompasses a range of surgical and non-surgical procedures designed to enhance both the aesthetic and functional aspects of women’s reproductive organs. The primary goal is to rejuvenate the genital area, improving sexual experiences, and boosting self-esteem and energy.

For instance, issues such as enlarged or asymmetrical labia minora, saggy labia majora, or darkened and rough skin in the intimate area can be addressed through aesthetic gynaecology. Treatments, whether surgical or non-surgical, aim to restore confidence and improve intimate life.

Functional problems, including painful or unenjoyable intercourse, may arise from vaginal dryness, laxity, decreased sensitivity, recurrent infections, scarring from childbirth, or age-related changes. Conditions like vaginismus can also affect intimacy. Fortunately, aesthetic gynaecology offers effective, non-surgical solutions using advanced technology and regenerative medicine. These treatments are typically painless, quick, and require no downtime.

Additionally, aesthetic gynaecology addresses urinary incontinence and pelvic organ prolapse (cystocele or rectocele). Depending on the condition’s severity, both non-surgical and surgical options are available.

Aesthetic gynaecology is not exclusive to women who have given birth. Young women also seek cosmetic procedures such as labiaplasty, clitoral hood lifting, and non-surgical treatments for labia whitening and augmentation.

Aesthetic Gynaecology Procedures

Enhance offers state-of-the-art equipment and well-trained staff to perform any procedure with the utmost care, precision, and safety.

All these treatments are FDA-approved to ensure your safety and satisfaction.

Non-Surgical Procedures for Aesthetic Gynaecology

The aesthetic gynaecology non-surgical procedures that we offer include the following:

1. Vaginal and vulva tightening
2. Vaginal rejuvenation
   1. FemiLift laser
   2. Radio frequency exilis
   3. Fotona
   4. BTL Emsella
3. PRP
4. O-shot
5. G-shot
6. Labia majora augmentation with fillers
7. Laser vaginal bleaching
8. Laser anal bleaching

Surgical Procedures

The aesthetic gynaecology surgical procedures offered by our clinic include:

1. Labiaplasty
2. Majoraplasty
3. Clitoral hood reduction (hoodectomy)
4. Perineoplasty
5. Vaginoplasty
6. Labia majora lifting

Who should you choose an aesthetic gynaecology procedure?

Any woman wanting to improve their intimate area’s visual appearance or sensation should consider an aesthetic gyanecological procedure.

A prospective client should:

• Be in good overall health
• Have realistic expectations about the procedure
• Proceed with a positive mindset

They may also experience one or more of the following concerns:

• Loose or sagging vagina
• Bladder control problem
• Difficulty using tampons during their period due to vaginal laxity
• Pain or discomfort due to large labial lips
• Dissatisfaction with how her genitals look

The following patients are not suitable for an aesthetic gynaecological procedure:

• Pregnant women
• Patients with severe organ prolapse
• Patients looking for a treatment for a psychosexual dysfunction

Benefits of Aesthetic Gynaecology Procedures

Cosmetic or aesthetic gynaecology has multiple benefits as it plays an essential role in improving a woman’s mental and physical health:

• It increases a woman’s sexual drive or libido
• It helps improve a woman’s sexual intimacy with a partner
• It helps rectify the trauma caused to the vagina and labia during childbirth
• It helps improve the vulva’s appearance after dramatic weight loss
• It enhances the overall look and feel of a woman’s reproductive organs

General Expectations from Aesthetic Gynecology Procedures

Most aesthetic gynaecology procedures are performed in a practitioner’s office inside a clinic/hospital/facility. Every procedure, be it surgical or non-surgical, is minimally invasive, may involve anaesthesia, and has some downtime associated with it.

All details are discussed with the client before the procedure and all questions will be answered before a personalised treatment plan is determined. 

FAQs

1. What is Aesthetic Gynaecology?  

Aesthetic Gynaecology is the subspeciality of gynaecology, which deals with the appearance but also with functional problems of the intimate area.By saying appearance, we mean the size, shape, colour and skin texture of the big and the small lips (labia minora and majora) as well as the mons pubis.

2. How does the client prepare for these procedures?

No preparation is required for non-surgical treatments. We only have to make sure that the period has finished and there is no vaginal infection. For surgeries there is also no preparation, unless the patient is taking certain medication, which will have to be discontinued for a few days prior to the surgery. Not smoking a few days before and a few weeks after the surgery is strongly recommended for better healing.

3. What if the client is not a good candidate for a surgical procedure?

Aesthetic gynaecology offers a wide variety of treatments, meaning that if someone is not a good candidate for surgery, there are many non-surgical alternatives to be considered.

4. At what age can you be seen by an aesthetic gynaecologist?

Aesthetic gynaecologists can see females of any age, at any point of their lives when there are complaints to be addressed. As your body changes with age, any internal or external factors can affect your intimate area.

3. Are aesthetic gynaecology procedures painful?

Non-surgical aesthetic gynaecology procedures done at the clinic are non-invasive treatments and are not painful, with no down time at all. Surgeries, like vaginal tightening or labia plasty minora or majora, are also not painful but patients should be careful during the recovery time and follow the doctor’s post operation instructions for the next six weeks.

The da Vinci Xi HD 4 arm robotic system, one of the most sophisticated surgical technologies on the market, is now available at Mediclinic City Hospital in Dubai.

Da Vinci robotic surgery is a state-of-the-art surgical procedure in which the conventional laparoscopic technique is combined with high precision robotic technology using four robotic arms which are expertly commanded by the surgeon from the surgical console using a 3D high-definition view of the surgical area. Articulated instruments allow the same movement capacity as the human wrist and the tremor filter eliminates any small uncontrollable movement in the surgeon's hands.  Minimally invasive surgery with da Vinci is widely used in general surgery, urology and gynaecology procedures, as well as in several other specialities.

How the da Vinci robotic system works?

The da Vinci robotic system is combination of conventional laparoscopic technique and high precision robotic technology.  It uses four robotic arms that are expertly commanded by the surgeon sitting on the console making minute movements inside the body with the help of 3D high-definition view for accurate targeting of the surgical area for the procedure. 

The da Vinci robotic system has the same movement capacity as the human wrist. The design gives surgeons a better range of motion and dexterity than the human hand. In addition, the tremor filter eliminates any small uncontrollable movement in the surgeon's hands. All of these features favour a better outcome, involving less blood transfusions, less conversion from minimal invasive to open surgery, in addition to a decrease in the length of stay, and the 30-day complication rate after surgery.

Robotic gynaecological procedures

Robotic gynaecological procedures include surgeries of the female reproductive (sex) organs which includes cervix, uterus, ovaries, fallopian tube, vagina and vulva.

A) Endometriosis resection

Endometriosis is a condition when tissues similar to the uterus lining start growing abnormally outside the uterus. This condition causes intense pain and discomfort to women. In case of severe condition, surgery is considered as viable option. Through the Da Vinci robot, the surgeon can easily remove excess tissues using its capabilities and movement while leaving the other organs intact.

B) Hysterectomy

Hysterectomy is the surgical removal of the uterus that is performed when a patient is suffering from abnormal uterine bleeding, benign or cancerous uterine conditions and prolapse. With the use of the Da Vinci robot, the surgeon can perform a hysterectomy either with small incisions or with one single incision through the belly button. The single site hysterectomy performed with Da Vinci is virtually scarless.

C) Myoma resections

Myoma resection is a removal surgery of fibroids (non-cancerous growth) that have developed on the walls of uterus. Patients with fibroids suffer from heavy periods, abnormal bleeding and severe abdominal pain. With the Da Vinci robotic system, the surgeon can perform myoma resection / myomectomy (removal of fibroids from uterine wall) with small incisions and more precision, keeping the uterus intact.

D) Oophorectomy and ovarian cystectomy

Oophorectomy is the surgical removal of an ovary or ovaries which is performed in case of a benign or malignant ovarian tumour.  Ovarian cystectomy is the removal of a benign cyst from the ovary in order to preserve ovarian function and tissue. The Da Vinci robotic system allows the surgeon to perform oophorectomy, or cystectomy with better visualisation of the anatomy which is critical in performing this surgery around delicate surrounding areas, and also performing surgery on a site which has previously been worked on.

E) Pelvic organ prolapse and female pelvic reconstruction
The prolapse (or misalignment) of pelvic organs (uterus, vagina, cervix, bladder, urethra or rectum) due to weakening of muscles and ligaments. Sacrocolpopexy is one form of correction surgery performed via the Da Vinci robotic system that uses tiny incisions involving complex suturing and dissection made easier with the robot to give a durable support even for women suffering from these devastating conditions. 

F) Severe adhesions

Adhesions are formed in the body after previous surgeries or because of infections involving pelvic and abdominal organs. These adhesions can cause multiple medical problems, including severe pain. The robotic approach with the precise instrumentation, allows the surgeon to navigate through these layers of body tissue, and cut these adhesions with no injury to adjacent organs.

Women who have delivered by C-section can have uterine scarring that causes infertility, pain and abnormal bleeding. This results when the uterine incision does not heal properly and forms a pouch in the lower uterine segment filled with fluid and altering normal menstrual bleeding. Robotic surgery can correct the problem, restoring, fertility, reducing pain and abnormal bleeding.