Gynaecology

 

What is gynaecology?

Gynaecology is a branch of medicine that specialises in the female reproductive system. It is primarily concerned with the uterus (womb), ovaries, and internal and external genitalia. This speciality provides both medical and surgical care for common conditions such as fibroids, polycystic ovarian syndrome, endometrial disease, ovarian disease, cervical disease and pelvic organ prolapse.

What we offer

At the Royal Free Hospital Private Patient’s Unit (PPU), our leading consultants offer world-class gynaecological care within the safety of an NHS trust.  We recognise that every woman is unique, and that each procedure carries its own risks and benefits. Every member of our multidisciplinary team is dedicated to ensuring each individual receives the right care at the right time. Our expert team are proud to offer the following procedures:

Hysteroscopy

Hysteroscopy is a minimally-invasive procedure in which a narrow instrument with a camera is passed through the cervix into the uterine (womb) cavity. This procedure can be used to visualise the cervix and endometrial space inside the womb in order to detect disease (a diagnostic hysteroscopy), or to treat certain conditions (an operational hysteroscopy). Developments in hysteroscopy technology have enabled this to be a safe, effective and well-tolerated procedure.

A common procedure carried out using hysteroscopy is transcervical resection of endometrium (TCRE), which is used to treat women with heavy periods (menstrual blood loss). The procedure involves the removal of the top layer of the endometrium (the inner lining of the womb) and has been shown to effectively reduce menstrual blood loss. 

Myomectomy

Myomectomy is the removal of a portion of the wall of the uterus. This procedure is most commonly used to treat uterine fibroids (non-cancerous growths of the uterine wall). Myomectomies can be carried out through traditional open surgery, where the uterus is accessed through an incision in the abdomen. However, for suitable conditions and patients, myomectomies are increasingly being carried out using a keyhole (laparoscopic) approach. Laparoscopic myomectomy is associated with lower levels of postoperative pain, lower rates of postoperative fever and a shorter stay in hospital, when compared with open myomectomy. There are similar rates of recurrence with both open and laparoscopic myomectomy. 

Hysterectomy

Hysterectomy is the complete surgical removal of the uterus. This is typically carried for conditions that have not responded well to medical treatment such as fibroids, endometriosis, excessive menstrual bleeding, and pelvic organ prolapse (protrusion of pelvic organs including the uterus, bladder, bowel, or vaginal wall into or past the vaginal opening) as well as for cervical, uterine, and/or endometrial cancer. It can be performed in the following ways: 

  • Through traditional open hysterectomy surgery, where the uterus is accessed through an incision in the abdomen
  • As a vaginal hysterectomy, where the womb is removed through the vaginal opening
  • Laparoscopically, through keyhole surgery

Ovarian cystectomy

Ovarian cystectomy is the surgical removal of cysts from the ovary.  This procedure aims to treat benign (non-cancerous) disease whilst preserving the ovary and its functioning. Most benign ovarian surgery is now achieved using laparoscopic (keyhole) surgery. Open ovarian cystectomy, where the ovaries are accessed through a larger incision in the abdomen, may be more suitable for cancers of the ovary. Our team of leading surgical experts are expertly trained to deliver both open and laparoscopic surgery using the latest techniques. 

Vaginal repair

Vaginal repair, known as colporrhaphy, can target different regions of the vagina and can therefore be divided into anterior colporrhaphy (repair of the front side of the vaginal canal), posterior colporrhaphy (repair of the back side of the vaginal canal), and vault colporrhaphy (repair of the top or roof of the vaginal canal). All three vaginal repair surgeries are used to treat different types of pelvic organ prolapse, a condition where pelvic organs including the uterus, bladder, bowel, or vaginal wall protrude into or past the vaginal opening. 

Bulkamid

This is a procedure used to treat stress urinary incontinence, which is the loss of urine when coughing, laughing, sneezing, or exercising. It typically occurs due to changes in the muscles and structures that support and keep the bladder in place. During this safe and effective day case procedure, an injection is applied to the urethra to minimise the symptoms of urinary incontinence.

Our expert team of specialists

All our consultants also work for our NHS Foundation Trust and take pride in upholding the high safety standards of an acute NHS hospital. Our surgical gynaecology team consists of a range of leading consultants.