Treatments

A Caesarean section is the delivery of a baby through a surgical incision in the abdomen and uterus. Caesarean sections can be classified as either ‘elective’ (planned) or ‘emergency’. Emergency Caesarean sections can then be subclassified into three categories, based on their urgency. This is to ensure that babies are delivered in a timely manner in accordance to their or their mother’s needs. The Royal College of Obstetricians and Gynaecologists (RCOG) recommends that when a Category 1 section is called, the baby should be born within 30 minutes (although some units would expect 20 minutes). For Category 2 sections, there is not a universally accepted time, but usual audit standards are between 60-75 minutes. Emergency Caesarean sections are most commonly for failure to progress in labour or suspected/confirmed fetal compromise.

Transurethral resection of the prostate (TURP) is a surgical procedure that involves cutting away a section of the prostate. The prostate is a small gland in the pelvis only found in men. It's located between the penis and bladder and surrounds the urethra (the tube that carries urine from the bladder to the penis). If the prostate becomes enlarged, it can place pressure on the bladder and urethra. This can cause symptoms such as having difficulty peeing. Why TURP is carried out TURP is often recommended when prostate enlargement causes troublesome symptoms and fails to respond to treatment with medication. Symptoms that may improve after TURP include: problems with starting to pee a weak flow of pee, or stopping and starting having to strain to pee a frequent need to pee waking up frequently during the night to pee a sudden urge to pee being unable to empty your bladder fully How TURP is performed TURP is carried out using a device called a resectoscope, which is a thin metal tube containing a light, camera and loop of wire. This is passed along your urethra until it reaches your prostate, which means no cuts (incisions) need to be made in your skin. The loop of wire is then heated with an electric current and used to cut away the section of your prostate causing your symptoms. A thin tube called a catheter is then inserted into your urethra to pump fluid into the bladder and flush away pieces of the prostate that have been removed. General or spinal anaesthesia is used during the procedure so you don't feel any pain while it's carried out.

Percutaneous Nephrolithotomy (PCNL) Kidney stones are formed in the urinary tract due to the crystallization of chemical compounds in the urine. PCNL is a technique used to remove certain stones in the kidney or upper ureter (the tube that drains urine from the kidney to the bladder) that are too large for other forms of stone treatment such as shock wave lithotripsy or ureteroscopy. The Surgery This procedure has been performed on many patients over the last several years and is an accepted standard of care for patients with kidney stones that are large, very firm, or resistant to other forms of stone treatment. As such it has replaced open operations for kidney stones in the vast majority of patients. Typically, the length of the surgery is one to two hours. The surgery is performed by making a small 1 cm incision in the patient’s flank area. A tube is placed through the incision into the kidney under x-ray guidance with the help of a C-Arm. A small telescope is then passed through the tube in order to visualize the stone, break it up and remove it from the body. If necessary a laser or other device called a lithotripter may be used to break up the stone before it can be removed. This procedure has resulted in significantly less post-operative pain, shorter hospital stays, and an earlier return to work and daily activities when compared to open stone surgery. This technique also has a higher success rate for clearing all stones in one setting than other techniques such as extracorporeal shock wave lithotripsy (ESWL), which often require several attempts. Potential Risks and Complications Although this procedure has proven to be very safe, as in any surgical procedure there are risks and potential complications. The safety and complication rates are similar when compared to open surgery. Potential risks include: Bleeding Infection Tissue / Organ Injury Conversion to open surgery Failure to Remove the Stone

Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue's range of motion. With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth, so it may interfere with breast-feeding. Someone who has tongue-tie might have difficulty sticking out his or her tongue. Tongue-tie can also affect the way a child eats, speaks and swallows. Sometimes tongue-tie may not cause problems. Some cases may require a simple surgical procedure for correction. Treatment for tongue-tie is controversial. Some doctors and lactation consultants recommend correcting it right away — even before a newborn is discharged from the hospital. Others prefer to take a wait-and-see approach. Frenotomy Tongue-tie and release of lingual frenulum Tongue-tie A simple surgical procedure called a frenotomy can be done with or without anesthesia in the hospital nursery or doctor's office. The doctor examines the lingual frenulum and then uses sterile scissors to snip the frenulum free. The procedure is quick and discomfort is minimal since there are few nerve endings or blood vessels in the lingual frenulum. If any bleeding occurs, it's likely to be only a drop or two of blood. After the procedure, a baby can breast-feed immediately. Complications of a frenotomy are rare — but could include bleeding or infection, or damage to the tongue or salivary glands. It's also possible to have scarring or for the frenulum to reattach to the base of the tongue. Frenuloplasty A more extensive procedure known as a frenuloplasty might be recommended if additional repair is needed or the lingual frenulum is too thick for a frenotomy. A frenuloplasty is done under general anesthesia with surgical tools. After the frenulum is released, the wound is usually closed with sutures that absorb on their own as the tongue heals. Possible complications of a frenuloplasty are similar to a frenotomy and are rare — bleeding or infection, or damage to the tongue or salivary glands. Scarring is possible due to the more extensive nature of the procedure, as are reactions to anesthesia. After a frenuloplasty, tongue exercises might be recommended to enhance tongue movement and reduce the potential for scarring.

A lipoma is a lump under the skin that occurs due to an overgrowth of fat cells. Doctors consider lipomas to be benign tumors, which means that they are non-cancerous growths. However, people may wish to remove a lipoma that causes pain, complications, or other symptoms. Some people also have concerns about the cosmetic appearance of lipomas. Lipomas can occur anywhere on the body where fat cells are present, but they tend to appear on the shoulders, chest, trunk, neck, thighs, and armpits. In less common cases, they may also form in internal organs, bones, or muscles. Lipomas feel soft and may move slightly under the skin when people press down on them. They usually grow slowly over a period of months or years and typically reach a size of around 2–3 centimeters (cm). Occasionally, people have giant lipomas, which can grow to more than 10 cm. At Sukhayu Hospital we have successfully treated many patients with lipomatosis

The Bartholin's glands are located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina. Sometimes the openings of these glands become obstructed, causing fluid to back up into the gland. The result is relatively painless swelling called a Bartholin's cyst. If the fluid within the cyst becomes infected, you may develop a collection of pus surrounded by inflamed tissue (abscess). A Bartholin's cyst or abscess is common. Treatment of a Bartholin's cyst depends on the size of the cyst, how painful the cyst is and whether the cyst is infected. Sometimes home treatment is all you need. In other cases, surgical drainage of the Bartholin's cyst is necessary. If an infection occurs, antibiotics may be helpful to treat the infected Bartholin's cyst.