ADVANCED GYNECOLOGIC SURGERIES
In the Section of Urogynecology and Reconstructive Pelvic Surgery, We have been performing a number of innovative techniques for the diagnosis and treatment of urinary and decal incontinence, pelvic organ prolapse and other pelvic floor disorders. We provide basic urodynamic testing to evaluate women with urinary disorder . There are many different treatments available for urinary and fecal incontinence, pelvic floor dysfunction and pelvic organ prolapse. We perform numerous procedures for the treatment of incontinence and prolapse. For urinary incontinence, different types of outpatient procedures performed include the tension free vaginal tape (TVT) procedure, transobturator vaginal tapes and sacral neuromodulation. To treat pelvic organ prolapse, common short stay procedures performed include laparoscopic sacral colpopexy, vaginal reconstruction with native tissue repair or mesh implantation, and explantation of vaginal mesh. Our physicians also provide innovative office procedures anti aging injection intramuscular (bladder) injections for severe urge incontinence. Soon, we will offer vaginal laser therapy for vaginal atrophy
It is important to start thinking about your female health now in order to prevent problems in the future. We can explain how preventive healthcare and annual visits, while you are developing, can help ensure better health both now and in the future we understand that your teenage years can be a very confusing time. Your body is changing, and you probably have many questions. You may not be comfortable talking to your parents. Maybe you sense that your parents are a bit uncomfortable with the subject, too. Your friends might act like they know everything, but you suspect some of this is just big talk not really based in fact. We want you to know that we understand your concerns. You do not have to be embarrassed to ask us about anything that concerns you. We will answer all of your questions honestly and give you all of the facts you need.
Our conversations will be confidential. Though we will not tell your parents what we talk about, we will encourage you to become comfortable talking to your parents.
You might be worried that your visit to our practice will involve an uncomfortable exam. This is usually not the case. Most of your visit will involve sitting together in our office and talking about teen health and anything that concerns you. Feel free to ask us about anything you like.
We look forward to meeting you.
- Frequently seen cases
- First Gynecology visit
- First Period
- Painful period
- Delayed Period
- Heavy Period
- Early or delayed Puberty
- Sexually transmitted disease and prevention
- HPV vaccination
- Vaginal discharge
- Genital itching
- Domestic violence
- Sexual abuse
- PMS (Pre menstrual syndrome)
Sexual health requires a positive, respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”
If you have questions or concerns about your sexual health or sexually transmitted diseases you can talk to us at Roya Medical Centre. Vaginal rejuvenation, Laser Vaginal Rejuvenation, the “Mommy Makeover”, “Designer Vaginas”, reduction labiaplasty and vaginal tightening are among the many terms used to describe operations focused on female genital enhancement. This is the fastest growing area of cosmetic surgery as women and surgeons become more aware that the nonmedical genital effects of childbirth, weight fluctuations, tissue laxity and anatomic idiosyncrasies can be addressed by a variety of procedures.
Although cosmetic vaginal surgery is the general term, external or vulvar structures are also commonly treated. These include the mons pubis, the labia majora and the labia minora including the clitoral hood or prepuce. The perineum which forms the muscular bridge of tissue between the anus and the vagina, and the lower third of the posterior vaginal wall are the areas typically operated in vaginal tightening procedures. The anterior vaginal wall plays a lesser role in vaginal tightening, but a far greater role in the surgical treatment of urinary incontinence. Prior to embarking upon cosmetic vaginal surgery, a thorough gynecologic evaluation should be performed to screen for pre-existing gynecologic, urogynecologic or urologic conditions which might alter the timing of the procedure or influence the surgical plan. Failure to do so may result in patient dissatisfaction with the cosmetic procedure or, worse, aggravation of the medical problem. Therapeutic and cosmetic surgeries can be performed under the same anesthesia in some instances. Another issue which must always be kept in mind is the potential effects of future vaginal childbirth on the cosmetic procedure and that a cesarean delivery by patient request may not always be available.
Cosmetic vaginal surgery can be performed with general anesthesia, epidural anesthesia, spinal anesthesia or intravenous sedation with local infiltration and pudendal block. Prophylactic antibiotics are routinely administered. Patients are typically positioned in dorsal lithotomy with boot-type stirrups, mild knee flexion and routine Intermittent pneumatic compression stockings to prevent deep venous thrombosis. Indwelling bladder catheterization and vaginal packing are employed during some operations.
Either mons pubis liposuction or mons pubis lifting will alter the appearance of the appearance of this region. Mons pubis liposuction is typically performed in the supine position at the time of general abdominal liposuction. The endpoint of mons pubis liposuction is an even thickness of the fat contours between the areas cephalad and caudad to the pubic bone without skeletonizing the latter. Mons pubis liposuction is also integral to abdominoplasty when the lower incision edge is thicker than the upper edge.
The mons pubis lift is an effective aesthetic option for women with significant laxity in the mons pubis region and sagging of the labia majora as viewed in the standing position. It is achieved by precise alignment of the central tension vectors at the time of abdominoplasty. The pubic lift integrates well with mons pubis liposuction and yields a more complete and balanced aesthetic solution for the abdominal wall.
The Clitoral Region
Cosmetic alterations in this region are focused on the excision of loose, redundant folds of skin from the prepuce. When planning surgery of this type in combination with a mons pubis lift, the lift is done first because it frequently produces a tightening of the prepuce in the vertical axis when the mons pubis is placed on cephalad traction.
Inferior to the prepuce, the trifurcation of the posterolateral portion or the prepuce, the frenulum and the labium minus must be addressed when prepuce alterations and reduction of the labia minora are requested by the patient.
The Labia Minora
Reduction labiaplasty is the most common treatment for patients dissatisfied with elongated, asymmetric or hyperpigmented labial tissue. When examining the labia minora, it is necessary to splay them laterally onto the labia majora to determine the degrees of hypertrophy, hyperpigmentation and asymmetry which may be present. When combined reduction labialplasty and vaginal tightening procedures are performed, vaginal tightening is performed first because it involves the resection of the fourchette with subsequent reconstruction in a more anterior position.
The Labia Majora
Three procedures are available for cosmetic alteration of the labia majora: augmentation by autologous fat transfer, skin tightening by resection of loose skin, and sclerotherapy. The labia majora frequently lose volume with both age and weight loss producing a deflated appearance with looseness and wrinkling of the overlying skin. In most patients, these changes can be addressed effectively with autologous fat transfer. Similar to fat grafting in facial applications, an sufficient amount of fat is harvested from a suitable site, prepared according the surgeon’s preferred technique then injected into the subcutaneous fat layer. Deep injections are avoided as they may disrupt the structures of the vestibule. When a greater degree of skin laxity and sagging are present, an ellipsoid full thickness skin resection in the long axis of the labia major either alone or in conjuction with autologous fat transfer will provide an effective cosmetic solution. Varicose veins of the vulvar region respond to sclerotherapy in much the same manner as those of the lower extremity. Not infrequently, these varicosities are a source of pelvic pain and a gynecologic workup for pain should rule out other etiologies prior to treatment. The veins are targeted in the standing position and injected in the supine position. The technique is identical to sclerotherapy of the leg varicosities working from proximal to distal veins. A pelvic compression garment is worn for the first seven days.
Commonly known as vaginal rejuvenation, procedures for tightening the vaginal dimensions originate from a class of gynecologic operations referred to as vaginoplasties or colporrhapies initially developed for the treatment of prolapse of the bladder (cystocele) and of the posterior vaginal wall (rectocele). Mild to moderate degrees of vaginal laxity can be corrected quite adequately by targeting the lower third of the posterior vaginal wall and the perineal body for this type of surgery. Experience with the management of complex pelvic surgical conditions is mandatory for surgeons embarking upon vaginal tightening procedures because of the frequency with which anatomic distortion from childbirth-related scarring is encountered in this region and also because of the close proximity to the bladder and rectum. Also, gauging the degree of tightening can be tricky in inexperienced hands and those considering offering these surgeries to their patients are well advised to seek specific training in these operations from experts.
Our focus is to care for the whole patient. With particular emphasis on the female reproductive system. Including routine primary and preventive care, pregnancy and delivery, menopause, and medical or surgical management of all gynecological problems.
We provide a full range of general gynecologic services for women. From yearly examinations and screenings to highly specialized procedures. General gynecologic services for the problems include abnormal bleeding, chronic pelvic pain, uterine fibroids, endometriosis, loss of bladder control, pelvic floor disorders, problems with pelvic support and contraceptive counseling.
In our center, we have full range of diagnostic tools to assist our providers in providing an accurate diagnosis at your initial visit. which is include ultrasound, endoscopic examination, laparoscopic surgery and Pap tests and colposcopy to evaluate abnormal Pap tests. We can initiate comprehensive evaluation and treatment for health concerns associated with menopause, including osteoporosis and cardiovascular disease. Many problems can be managed using medication, lifestyle modification or non-invasive techniques.
When surgery is necessary we offer the full-range of gynecologic services on surgical modalities including minimally invasive techniques. We are able to provide complete care for women with abnormal bleeding, fibroids, ovarian conditions, endometriosis, cervical conditions and other common gynecologic services for the disorders. At RMC we also offer expert consultation for the management of chronic pelvic pain and vulvae disorder
Frequently seen cases in gynecologic services:
- Annual Gynecology check up
- Annual well woman check up
- Irregular menstrual cycles
- Abnormal uterine bleeding
- Pelvic Pain
- Pre Menstrual Syndrome
- Ovarian cyst
- Uterine Fibroids
- STD s and vaginal infection
- Preconception consultation
- Pregnancy loss
- Birth trauma
- Vaginal relaxation /vaginal tightening
- Urinary incontinence
- Hormonal imbalances
- HPV testing and vaccination
We understand that each woman has unique medical and emotional needs.
In order to best address these needs, we work closely with highly qualified experts from other centers who specialize in a variety of medical fields . Required Meetings are held to discuss the best management for patients who need treatment. At these meetings, our gynecologist are joint by the gynecologic oncologists and specialists in the fields of medical oncology, radiation oncology, pathology, clinical trials, nursing and social services.
We work together to evaluate each patient’s situation and to customize a treatment plan that is in the best interests of each individual patient.
Our Cancer Prevention Program is discussed in Women’s Health section
ADVANCED GYNECOLOGIC SURGERIES
- Endometrial Biopsy
- Diagnostic Laparoscopy &Hysteroscopy
- laparoscopy and Hysteroscopy for
- Ovarian cyst
- uterine fibroids
- Endometrial Polyps
- Conization /LEEP
24-Chromosome Pre-Implantation Genetic Screening (PGS)
Pre-Implantation Genetic Screening (PGS) allows for the screening of embryos during In Vitro Fertilisation (IVF) in order to identify abnormalities in the chromosomes caused by aneuploidy . Comprehensive Chromosomal Screening, screens all 24 chromosomes for aneuploidy, increasing your chances of achieving a healthy pregnancy and decreasing your risk of miscarriage by identifying embryos with the healthy number of chromosomes.
Is ExactCCS™ right for me?
- Is PGS right for me?
- How does PGS work?
- What is Aneuploidy?
- Where can I get testing?
Is PGS right for me?
Couples with a variety of medical histories have become pregnant following IVF/PGS . Studies show that PGS may be most beneficial for couples meeting one of the following criteria:
- Maternal age of 35 years or older
- Repeated IVF failure
- History of recurrent pregnancy loss
Couples have also chosen to complete 24-chromosome CCS in the following circumstances:
- Improve IVF success rate and reduce risk towards miscarriage: Aneuploidy is the leading cause of over 60% of IVF failures and pregnancy loss.
- Male Factor Infertility: Male infertility factors, such as low quality sperm, have been linked with an increased rate of aneuploidy .
- Concern for Down syndrome: In cases of a previous pregnancy involving aneuploidy or to reduce the risk of Down syndrome.
- Interest in Gender Selection or concern for a sex-linked gender illness (if this service is offered by your healthcare provider).
Based on your medical history and personal preferenceOur Doctor in , Roya medical Center will consult with in order to determine if completing genetic testing such as PGS is right for you or not . For more information on PGS to discuss any questions related to genetic testing, or to learn about our IVF packaged contact Roya Medical Center ,Today !
Maternal age of 35 years or older:
As a woman ages, the quality of her eggs and her ovarian reserve diminish while the reproductive organs maintain their ability to carry a pregnancy. Several studies have shown that women of advanced maternal age are at an increased risk of producing aneuploid eggs and of spontaneous abortion, making maternal age of 35 years and older one of the most common indications for completing genetic testing such as PGS
Repeated IVF Failure:
Repeated IVF failure is defined as the absence of an ongoing pregnancy after 3 or more embryo transfers with high quality embryos. One of the leading contributing factor for repeated IVF failure is the development of aneuploid embryos. Studies show that at least 15% of couples with repeated IVF failure have an increased frequency of aneuploid embryos, a rate that substantially increases with maternal age.
History of Recurrent Pregnancy Loss:
In more than half of recurrent miscarriage cases, the diagnosis is unexplained infertility. Several scientific studies have verified that 80% of unexplained recurrent pregnancy loss in women over the age of 35 can be explained by aneuploid embryos. In every study completed using genetic screening services such as PGS, a decrease in the miscarriage rate was observed. Before choosing 24-chromosome PGS, couples that have had two or more miscarriages should consult with Dr. Roya Pourghorban about having their own chromosomes tested to rule out inherited chromosomal rearrangements called translocations and inversions . For more information on Pre-Implantation Genetic Diagnosis testing for Inversions and Translocation, read about Inversion/Translocation PGD and 24-chromosome aneuploidy screening .
Genetic Carrier Screening
At the time of your appointment we will be asking you some questions about your family history and ethnic background. There are several genetic conditions that are more common in specific ethnic groups. The information below briefly reviews some general information about testing for these conditions. If you have questions about this information, please address them with the doctor during your scheduled appointment.
What are genes?
Genes are made up of a chemical called DNA and are the codes or instructions that tell the body how to grow and develop. These genes are arranged on strings of information called chromosomes. We have two copies of each chromosome, one that is inherited from our mother and one that is inherited from our father; as a result, we have one copy of each gene.
What are recessive diseases?
Many conditions are now known to be caused by changes, or mutations, in genes. Some genetic conditions, known as recessive conditions, are caused when a change or mutation is present on both genes of a pair. This means that both the mother and father must pass on the same changed gene in order for a child to have a recessive condition.
What is a carrier?
A carrier is a person who has a change in only one gene of a pair and the other gene of the pair is working normally. A carrier is sometimes said to have the disease trait but has no physical symptoms of the disease. In many families, a recessive gene change or trait can be passed on through generations without ever being known. A recessive disease can only occur if a person who is a carrier has a baby with another person who is also a carrier. Such a couple would have a 1 in 4 (25 percent)
chance, in each pregnancy, of having a baby with that recessive disease.
Who should be screened?
DNA tests are available to help a couple determine if they are carriers of the same recessive disease trait and are at risk for having children with that recessive condition. Some diseases occur more often in certain ethnic groups. Information about the carrier frequency of the more common recessive disease traits in certain ethnic groups is provided below. There are many other recessive conditions, not listed below, for which testing is not typically performed because the conditions are less common or because testing is not available.
|Sickle cell anemia||1/30-1/50|
|European Caucasian:||Cystic fibrosis||1/29|
|African American:||Sickle cell anemia||1/10|
Is there prenatal testing?
If both parents are determined to be carriers of mutations for the same disease, a prenatal test is available to determine if the baby has that recessive disease. In our affiliated IVF centers in UAE preimplantation genetic diagnosis (PGD) is available to test an embryo for a genetic disorder before that embryo is transferred into the mother’s uterus.