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Gynaecology | Te Tai Tokerau (Northland) | Te Whatu Ora

Public Service, Obstetrics and Gynaecology

Description

Formerly Northland DHB Gynaecology

What is Gynaecology?

Gynaecology is the area of medicine that deals with health issues and conditions that are specific to women. This generally includes the female reproductive organs and genitalia. The reproductive organs consist of the ovaries that release an egg every month, the fallopian tubes that lead from the ovaries, the uterus (womb), which is where a baby will grow if the egg is fertilised during sexual intercourse, the cervix (opening of the uterus) and the vagina.
 
 

Referral Expectations

Your GP will need to complete some examinations and tests before you are referred to the clinic (except in emergency situations). All patients require a history to have been taken and examination, including pelvic (internal), performed.  If a smear test has not been performed recently and is due, this needs to have been completed by the GP prior to you being seen in the hospital.  Blood tests may also be required depending on which type of problem you have.

When a referral is received, a specialist will grade it to ensure that people with serious or life-threatening conditions are seen soon.  Sometimes, if there is not enough information to make this decision, the referral will be sent back to the GP with a request for more information.

Common Conditions / Procedures / Treatments

Bladder Sling Procedures

Sling procedures are common surgical operations to stop stress incontinence. This is a condition where urine leaks out when movements, such as coughing, laughing or sneezing put pressure on the bladder. Stress incontinence occurs when the muscles supporting the urethra (tube that carries the urine out of the body) become weak and the urethra no longer works well as a valve to keep the urine in the bladder. Sometimes this results from the effects of childbirth. Sling procedures provide support to the weakened muscles by placing a stitch or strip of mesh under the urethra so that it won’t accidentally release urine when there is pressure on the bladder. Burch Procedure In the Burch procedure, permanent stitches are placed on both sides of the urethra to give it more support. The Burch procedure is done under a general anaesthetic (you sleep throughout the procedure) and can be performed by laparoscopic surgery. Tension-Free Vaginal Tape (TVT) Procedure In tension-free vaginal tape (TVT) surgery, a mesh-like tape is placed under the urethra to give it support. The TVT procedure is done through small cuts in the vagina and in your pubic area or upper thighs. It is usually performed under local anaesthetic (this means that you don’t have to go to sleep during the operation).

Sling procedures are common surgical operations to stop stress incontinence. This is a condition where urine leaks out when movements, such as coughing, laughing or sneezing put pressure on the bladder. Stress incontinence occurs when the muscles supporting the urethra (tube that carries the urine out of the body) become weak and the urethra no longer works well as a valve to keep the urine in the bladder. Sometimes this results from the effects of childbirth. Sling procedures provide support to the weakened muscles by placing a stitch or strip of mesh under the urethra so that it won’t accidentally release urine when there is pressure on the bladder.
Burch Procedure
In the Burch procedure, permanent stitches are placed on both sides of the urethra to give it more support. The Burch procedure is done under a general anaesthetic (you sleep throughout the procedure) and can be performed by laparoscopic surgery.
Tension-Free Vaginal Tape (TVT) Procedure
In tension-free vaginal tape (TVT) surgery, a mesh-like tape is placed under the urethra to give it support. The TVT procedure is done through small cuts in the vagina and in your pubic area or upper thighs. It is usually performed under local anaesthetic (this means that you don’t have to go to sleep during the operation).
Cervical Dysplasia

Cervical dysplasia is the growth of abnormal cells around the cervix (entrance to the uterus). Although this condition is not cancer there is a small risk that these cells could become cancerous. Sometimes no treatment is needed as the condition may improve by itself. For more severe dysplasia, treatment involves removing the abnormal cells by freezing, laser therapy (a tiny beam of light) or electrical burning. Whether you have treatment or not, you should have more frequent Pap smears in the future.

Cervical dysplasia is the growth of abnormal cells around the cervix (entrance to the uterus). Although this condition is not cancer there is a small risk that these cells could become cancerous.

Sometimes no treatment is needed as the condition may improve by itself. For more severe dysplasia, treatment involves removing the abnormal cells by freezing, laser therapy (a tiny beam of light) or electrical burning. Whether you have treatment or not, you should have more frequent Pap smears in the future.

Cervical Smear

Cervical Smear

Colposcopy

Colposcopy

Endometrial Ablation

The endometrium is the lining of your uterus (womb). Endometrial ablation is the surgical removal or destruction of this lining. There are different methods of destroying the endometrium including electricity, laser therapy or freezing. A specialist performs the operation and it is done through the vagina, so there is no need for the abdomen to be cut open. The endometrium will heal leaving scarring, which usually reduces or stops menstrual periods. In women who have very heavy periods (menorrhagia), an endometrial ablation can be done instead of a hysterectomy as it is an easier procedure than a hysterectomy and is quicker to recover from. Endometrial ablation is only performed in women who no longer wish to have children.

The endometrium is the lining of your uterus (womb). Endometrial ablation is the surgical removal or destruction of this lining. There are different methods of destroying the endometrium including electricity, laser therapy or freezing.
 
A specialist performs the operation and it is done through the vagina, so there is no need for the abdomen to be cut open. The endometrium will heal leaving scarring, which usually reduces or stops menstrual periods.
 
In women who have very heavy periods (menorrhagia), an endometrial ablation can be done instead of a hysterectomy as it is an easier procedure than a hysterectomy and is quicker to recover from. Endometrial ablation is only performed in women who no longer wish to have children.
Endometriosis

Endometriosis

Fibroids

Fibroids are noncancerous growths or tumours on the muscular part of the uterus (womb); sometimes they are also called myomas. Fibroids may be very small (about 5mm) or can grow to be quite large (about 100mm). Many women with fibroids do not notice any symptoms and will not need treatment, whereas others may experience problems such as painful and heavy periods. Treatment includes medication to shrink the fibroids and, in some women, surgical removal.

Fibroids are noncancerous growths or tumours on the muscular part of the uterus (womb); sometimes they are also called myomas. Fibroids may be very small (about 5mm) or can grow to be quite large (about 100mm).
 
Many women with fibroids do not notice any symptoms and will not need treatment, whereas others may experience problems such as painful and heavy periods. Treatment includes medication to shrink the fibroids and, in some women, surgical removal.
Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT)

Hysterectomy

Hysterectomy

Hysteroscopy and Dilatation and Curettage (D&C)

This is an operation where the cervix (entrance to the uterus) is dilated and a hysteroscope (small lighted mini telescope) is inserted into the uterus through the vagina and cervix so the specialist can see the inside of the uterus. If no cancer is present, a small spoon-like instrument with a long handle, called a curette, is inserted and the lining of the uterus is scraped off and sent to the laboratory for examination. This procedure can be done under a general (you are asleep) or local (you are awake but the area being investigated is numb) anaesthetic.

This is an operation where the cervix (entrance to the uterus) is dilated and a hysteroscope (small lighted mini telescope) is inserted into the uterus through the vagina and cervix so the specialist can see the inside of the uterus. If no cancer is present, a small spoon-like instrument with a long handle, called a curette, is inserted and the lining of the uterus is scraped off and sent to the laboratory for examination.
 
This procedure can be done under a general (you are asleep) or local (you are awake but the area being investigated is numb) anaesthetic.
Laparoscopy

This is a procedure to view the inside of the abdomen (stomach) through a specially lit type of mini telescope (laparoscope) that is inserted through a small cut in the abdomen. The laparoscope also contains a small camera that sends pictures to a screen that the doctor can watch. Sometimes surgical procedures (keyhole surgery) can be performed at the same time. A laparoscopy is performed under a general anaesthetic (you are asleep).

This is a procedure to view the inside of the abdomen (stomach) through a specially lit type of mini telescope (laparoscope) that is inserted through a small cut in the abdomen. The laparoscope also contains a small camera that sends pictures to a screen that the doctor can watch. Sometimes surgical procedures (keyhole surgery) can be performed at the same time. A laparoscopy is performed under a general anaesthetic (you are asleep).

Menopause

Menopause

Menstruation

Menstruation

Oophorectomy

An oophorectomy is an operation to remove one or both ovaries. It is done for many reasons including ovarian cancer, ovarian cysts or to remove the source of the hormone oestrogen that is produced by the ovaries and can stimulate some cancers. If both ovaries are removed, your periods will stop and you will not be able to have children. Sometimes an oophorectomy is done together with a hysterectomy.

An oophorectomy is an operation to remove one or both ovaries. It is done for many reasons including ovarian cancer, ovarian cysts or to remove the source of the hormone oestrogen that is produced by the ovaries and can stimulate some cancers. If both ovaries are removed, your periods will stop and you will not be able to have children. Sometimes an oophorectomy is done together with a hysterectomy.
Ovarian Cysts

Ovarian Cysts

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS)

Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS)

Urinary Incontinence

Urinary Incontinence

Uterine or Bladder Prolapse

Uterine or Bladder Prolapse

Vaginal Infections

The most common vaginal infections are yeast infections (also called candidiasis or thrush), trichomoniasis, or bacterial infections (also called bacterial vaginosis). Symptoms of an infection may include irritation, itching, discharge and odour. To make a diagnosis a doctor will usually do a vaginal swab, which involves wiping a type of cotton bud gently across the infected area. The swab is then sent to the laboratory for analysis. There are many medicines that can successfully treat these infections.

The most common vaginal infections are yeast infections (also called candidiasis or thrush), trichomoniasis, or bacterial infections (also called bacterial vaginosis). Symptoms of an infection may include irritation, itching, discharge and odour.
 
To make a diagnosis a doctor will usually do a vaginal swab, which involves wiping a type of cotton bud gently across the infected area. The swab is then sent to the laboratory for analysis. There are many medicines that can successfully treat these infections.

Contact Details

This page was last updated at 8:45AM on December 17, 2021. This information is reviewed and edited by Gynaecology | Te Tai Tokerau (Northland) | Te Whatu Ora.