Gynecological conditions occur in most women. Here, we will discuss non-cancerous gynecological conditions. The following are the most frequent symptoms of these conditions: abnormal vaginal bleeding, lumps in the vaginal area, frequent urination, pain or pressure in your pelvis that differs from menstrual cramps, painful bloating, sharp pains in the lower abdomen, constipation, and painful intercourse. Any of the above symptoms may be indications of the following 3 diseases.
1. Uterine fibroids
Fibroids are benign tumors comprised of the smooth muscle tissue found in the wall of the uterus. Fibroids are a typical condition in women of childbearing age and are commonly found among women aged 30 to 50 years. In fact, they can be found in at least 25 percent of women, which means that 1 in 4 women will have uterine fibroids. Several risk factors are known for developing fibroids, including having a family history of fibroids, being overweight, eating meat, and drinking alcohol. There is less than a 1 percent chance that the tumor will become cancerous, and most patients tend to have no symptoms. However, if left untreated and the tumor becomes enlarged, there may be pain in the lower abdomen. The tumor may also press on other nearby organs, such as the bladder. For these reasons, frequent urination or constipation can be indications of uterine fibroids. Or, if the tumor is inside the uterus, it may cause increased menstrual bleeding. In rare cases, blood clots and excessive bleeding can occur, to the point that fainting or low blood levels can occur. Finally, untreated fibroids can result in infertility, as well.
2. Ovarian Cysts
Under normal circumstances, women have two ovaries—one on the left and one on the right. Ovaries are responsible for producing female reproductive hormones, up until a point where they stop producing the hormones—what is known as menopause. The average age at which this occurs among Thai women around 50 or 51. There are two types of non-cancerous ovarian cysts:
- The first type is functional cysts. Each month, ovaries normally produce structures called follicles. Follicles produce the hormones estrogen and progesterone and release an egg during ovulation. If a follicle keeps growing longer than normal, it's known as a functional cyst. There are two types of functional cysts: follicular cysts and corpus luteum cysts. Usually, these functional cysts will dissipate on their own.
- The second type is a pathological cyst. These include chocolate cysts and non-cancerous ovarian tumors (dermoid cysts). The chance of these dissipating on their own is very rare.
Most women will have cysts at some point. Many times, there will be no symptoms at all. In the case where symptoms develop, symptoms may include mild to moderate pain in the abdomen. In cases where a condition known as ovarian torsion occurs, the cyst may cause sharp pain. Other possible complications include bleeding, clotting, rupture, or infection. These conditions may require emergency surgery. Therefore, an annual ultrasound examination is a good option to screen for cysts, thus allowing them to be detected in a timely manner in order to formulate a treatment plan before complications develop.
3. Endometriosis
Endometriosis happens when the endometrium, the tissue that usually lines the inside of a woman’s uterus, grows outside it. In this case, these endometrium tissues can end up growing on other organs, still behaving like they are inside the uterus. At the end of the menstrual cycle, they break apart and bleed. However, the blood has nowhere to go, possibly resulting in inflammation. When this occurs on the ovaries, it is known as a chocolate cyst. If it occurs within the muscular wall of the uterus, it is known as adenomyosis. If endometriosis occurs in the intestinal walls, it may cause rectal pain and blood may be present in the stool. One of the more common presentations of endometriosis is when it occurs on the peritoneum, which is the thin membrane surrounding the abdominal cavity. As a result, patients may experience chronic menstrual pain, painful intercourse, or infertility.
The best treatment for each condition depends on age, severity of the condition, and future desire to have children. Because symptoms across the three types of non-cancerous cysts can range from asymptomatic to severe, an annual ultrasound examination can be used to screen for cysts. Timely detection can facilitate an effective treatment plan before complications arise. Treatments range from pain medicine to surgery, including open surgery or laparoscopic surgery.
Presently, most gynecologic surgery is performed using minimally invasive techniques, such as laparoscopic surgery. While under general anesthesia, specialized surgeons will create 1 to 4 small incisions, each about 0.5-1 cm in size, depending on the type of surgery. After that, cameras and instruments are used to perform the surgery on the uterus, ovaries, or fallopian tubes, and the images will be displayed on a screen. Because the images displayed from laparoscopic surgery are magnified, laparoscopic surgery is highly accurate and safe.
Bangkok Hospital Khon Kaen can offer surgery using Advanced 3D Laparoscopic Surgery, which helps increase the accuracy by allowing the surgeon to see a clear and detailed picture. The surgeon can make precise measurements, almost like going inside the patient’s abdomen. This helps surgery to be safe and fast. The surgical incisions are small, reducing wounds, which is important to help patients recover faster. It also reduces complications from the surgery and avoids unsightly abdominal scars. Using a 3D Hi-Definition camera, the sharper images allow for reduced chance of infection and blood loss. This new technology gives the gynecologic surgery room a whole new atmosphere.