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Surgical Techniques

 



Laparoscopy
It is a technique which introduces a small camera inside the abdominal cavity for the diagnosis and the treatment of several diseases in women. The incisions are small, usually between 5 and 15 mm. The advantages are many: less pain, fewer infections, reduced bleeding, lower immunosuppression, reduced, and smaller scars. Hospitalization time is reduced and the return to professional or daily activities faster. Technically, the optical enlarging using the camera allows performing more accurate surgery. In rare cases further intervention can be done, if necessary, using conventional techniques laparotomy (cesarean incision for example).

Laser surgery
The laser can be used for laparoscopy (surgery within the abdominal cavity) or colposcopy (vaginal surgery limited to the cervix, vagina and vulva). The use of laser during laparoscopic procedures is particularly well suited to surgery of endometriosis: a wide beam (defocused), allows to destroy superficial endometriosis by vaporization, and a focused beam allow to cut. Its benefits are: accuracy, power cut, coagulation (cauterization), vaporization (destruction) of endometriosis. Laser surgery can be done under visual control, layer by layer, until the healthy tissue. In addition, damage to surrounding tissues are reduced compared to the conventional coagulation technique. The laser is a tool that is particularly well suited for the surgical treatment of endometriosis. The laser also allows the treatment of benign and precancerous cervix. The disadvantages are that the surgeon must have accumulated advanced expertise, and the cost and maintenance of the equipment.

Hysteroscopy
Hysteroscopy is a minimally invasive technology that allows the exploration of the interior of the uterus, without anesthesia and surgery. It becomes easier to detect diseases (polyps, fibroids or other) that may explain bleeding. These diseases may be surgically removed using hysteroscopy. The advantages are the ability to perform investigations and minimally invasive surgeries, without or with minimal anesthesia. Hospitalization time is also greatly reduced.

Robotic Surgery
A state-of-the-art option used in Laparoscopy today is the robotic surgery. With the use of a robot, the surgeon is able to operate through very small incisions, having enhanced vision and unprecedented control. The robot features a high-definition 3D vision system, which provides the surgeon a precise view of the internal body making thus the removal of the endometrial implants precise and successful.

New technologies
New techniques can be used, depending of the disease and the size of the uterus, for example. It is possible to use cameras and instruments measuring 3 mm. The width of the incisions is considerably reduced. Another option is the single incision technique (LESS: laparoscopic endoscopic single incision): a single incision in the belly button folds can be done with a special device, and all instruments introduced to perform the operation. The advantage is a single incision. Finally, the laparoscopic procedure can be performed with the assistance of a robot.

FAQs

• What is endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus is also found elsewhere in the body, mainly in the abdominal cavity.

• Who gets endometriosis?
Endometriosis typically affects women during their menstruating years – also known as their “reproductive years”. These are typically the years between the onset of menstruation until menopause. It is estimated that 176 million women across the world has endometriosis – this is one in ten women during the reproductive years (10%).

• What are the symptoms of endometriosis?
The most common symptom of endometriosis is pelvic pain. The pain is often with menstruation, during ovulation, and/or in connection with sexual intercourse. However a woman with endometriosis may also experience pain at other times during her monthly cycle. Another symptoms is infertility, and some women with endometriosis also experience severe fatigue.

• How is endometriosis diagnosed?
The only way to diagnose endometriosis for sure is during a laparoscopy, which is a small surgical procedure. However, many physicians are able to “diagnose” endometriosis based on a woman’s symptoms and start treatment on that basis.

• Is there a cure for endometriosis?
No. But it can be treated, and for many women it is possible to manage their symptoms through a combination of long-term treatments.

• Where do I find someone who specializes in endometriosis?
Most national or local support groups will be able to advise you where to find specialist help. Also read our article on how to find a center, which specializes in treating endometriosis and the questions you need to ask your physician before you decide on the right specialist and the right treatment for you. Internationaly, Dr. Jean-Marie Wenger is considered as one of the best surgeons specialized in endometriosis.

• Is endometriosis a sexually transmitted disease or infectious?
No. Endometriosis cannot be transferred from one human being to another. The cause of endometriosis is not yet known, but it is not an infectious disease.

• Is endometriosis inherited?
The cause of endometriosis is not yet known, but research does show that first-degree relatives of women with this disease have a seven-fold risk of developing endometriosis.

• Will I be able to have children?
It is estimated that 30-40% of women with endometriosis may have difficulties in becoming pregnant. This, however, means that 60-70% will have no problems. If fertility is a great wish, then please discuss your symptoms with your physician so that together you can develop the best treatment plan for you.

• Will a hysterectomy cure endometriosis?
Some women chose, as a last resort, to have a hysterectomy. However, this does not guarantee complete pain relief. If you opt for a hysterectomy it is important that all the endometriosis is removed at the same time.

• Will pregnancy cure endometriosis?
No. Some women find that their pain symptoms are reduced during pregnancy, but this is not the case for everyone. In most cases, endometriosis will return after giving birth and stopping breast feeding.

• Is endometriosis cancer?
No. Endometriosis cysts are sometimes referred to as “benign tumors”, because they may “behave similarly” to cancer, but endometriosis is not the same disease. In very rare cases, endometriotic implants has lead to cancer, but this is very rare. Some research suggests that some women with endometriosis may be at a slightly higher risk of developing certain cancers but this is still controversial.

 

Glossary

 

A
Adenomyosis: Disease characterized by growth of the endometrium into the walls of the uterus.
Adhesions Scar: tissue that is formed by bleeding endometriosis lesions and surgery. This scar tissue can bind together internal organs and surfaces.
Adnexal mass: A mass in the area of the Fallopian tube or ovary.
Adnexal torsion: A twisting of the Fallopian tube.
Amenorrhea: Refers to a woman who is not having her period, either because of a medical condition or because her menstruation is being suppressed by drug treatment.
Anovulation: The failure to ovulate.
Antepartum: The pre-delivery pregnancy period.
Artificial Insemination (AI): The depositing of sperm in the vagina near the cervix or directly into the uterus, with the use of a syringe instead of by coitus. This technique is used to overcome sexual performance problems, to circumvent sperm-mucus interaction problems, to maximize the potential for poor semen, and for using donor sperm.
Asherman’s Syndrome: A condition where the uterine walls adhere to one another. Usually caused by uterine inflammation.
Assisted hatching: Perforating the zona pellucida (‘shell’ of the egg) to help the very early embryo (the blastocyst) escape, i.e. to hatch. Can be done by needle, by the use of an acide, or by laser.
Assisted Reproductive Technology (ART): The term used to describe several procedures employed to bring about conception without sexual intercourse, including IUI, IVF, GIFT and ZIFT.
Atrophy: Thinning and decreased blood flow to tissue resultant from a lack of hormones, most commonly estrogen.
Autoimmune Disorders: When a person has an autoimmune disorder, immune cells mistakenly attack the body’s own cells. Examples of autoimmune disorders are lupus, rheumatoid arthritis, and Grave’s Disease. Some autoimmune factors, such as antiphospholipid antibodies, may affect fertility or pregnancy.

 

B
Bacterial Vaginosis Infection: A vaginal infection that causes a burning sensation and a gray, malodorous discharge. May interfere with fertility.
Basal Body Temperature (BBT): The body reaches a basal metabolic temperature early in the morning when we are at rest. Charting this temperature variation helps determine when ovulation occurs. The basal body temperature is measured with a special basal thermometer.
Beta hCG Test: A blood test used to detect very early pregnancies and to evaluate embryonic development.
Bicornuate Uterus: A congenital malformation of the uterus where the upper portion (horn) is duplicated.
Bilateral salpingo-oophorectomy: Removal of both ovaries and fallopian tubes.
Bladder neck: Junction between urethra and bladder
Blastocyst: The very early embryo.
Bowel resection: A surgical procedure performed when a blockage of the intestines occurs. The procedure removes the portion of the bowel where the obstruction is located.

 

C
Candidiasis: An infection that may be uncomfortable and itchy and may impair fertility.
Catheter: A hollow flexible tube that is passed into the body. In IVF, a special catheter is used to transfer fertilized embryos into the uterus.
Cauterise: To burn tissue with electrical current (electrocautery) or with a laser. Caterization is used in surgical procedures to remove unwanted tissue such as adhesions and endometriotic implants. It is also used to control bleeding.
CBC (Complete Blood Count): A routine blood test is that analyses the three major types of cells in blood: red blood cells, white blood cells, and platelets. A CBC is a general indicator of overall health.
Cervical mucus: A viscous fluid plugging the opening of the cervix. Most of the time this thick mucus plug prevents sperm and bacteria from entering the womb. However, at midcycle, under the influence of estrogen, the mucus becomes thin, watery, and stringy to allow sperm to pass into the womb.
Cervical smear: A sample of the cervical mucus examined microscopically to assess the presence of oestrogen (ferning) and white blood cells, indicating possible infection.
Cervical Stenosis: A blockage of the cervical canal from a congenital defect or from complications of surgical procedures.
Cervix: The opening between the uterus and the vagina. The cervical mucus plugs the cervical canal and normally prevents foreign materials from entering the reproductive tract. The cervix remains closed during pregnancy and dilates during labor and delivery to allow the baby to be born.
Chlamydia: A sexually transmitted infection caused by the microorganism chlamydia trachomatis, which if left untreated in a woman may cause pelvic inflammatory disease (PID), pelvic adhesions, and tubal blockage.
Cilia: Tiny hair-like projections lining the inside surface of the fallopian tubes. The waving action of these “hairs” sweeps the egg toward the uterus.
Coagulation: A method of destroying endometrial lesions by dehydrating the cells with a bipolar or thermal coagulator.
Cone biopsy: A surgical procedure used to remove pre-cancerous cells from the cervix.
Controlled ovarian hyperstimulation (COH): Stimulation of multiple ovulations with fertility drugs; also known as superovulation.
Corpus luteum: The yellow-pigmented glandular structure that forms from the ovarian follicle following ovulation. The gland produces progesterone, which is responsible for preparing and supporting the uterine lining for implantation. Progesterone also causes the half-degree basal temperature elevation noted at mid-cycle during an ovulatory cycle. If the corpus luteum functions poorly, the uterine lining may not support a pregnancy. If the egg is fertilized, a corpus luteum of pregnancy forms to maintain the endometrial bed and support the implanted embryo. A deficiency in the amount of progesterone produced (or the length of time it is produced) by the corpus luteum can mean the endometrium is unable to sustain a pregnancy. This is called luteal phase defect (LPD).
Culdoscopy: A procedure by which an endoscope and light can be inserted through the posterior wall of the vagina to examine the pelvic organs.
Cystocele: Prolapse of the bladder into the vagina. This can be seen as a bulge from the anterior wall of the vagina.

 

D
D&C (Dilation and Curettage): Surgical dilation of the cervix followed by surgical scraping of the interior of the uterine cavity with a curette (spoon-shaped surgical instrument) to remove growths (eg. pregnancy, tumors, etc.) or diseased tissue.
DHEAS (dihydroeprandrostone): One of the androgens (male hormones) naturally present in women. (Other androgens include testosterone and androstenedione.) These hormones play an important role in ovulation. High levels of androgens in women may indicate an abnormality in the ovulation process.
Disease: A disease is defined as any deviation from or interruption of the normal structure or function of any part, organ, or system, or combination thereof, of the body that is manifested by a characteristic set of symptoms or signs.
Dysmenorrhea: Painful menstruation. This may be a sign of endometriosis.
Dyspareunia: Painful intercourse.

 

E
Ectopic pregnancy: A pregnancy outside of the uterus, usually in the Fallopian tube.
Eggs: Female cells containing 23 chromosomes that are stored in the ovaries. When fertilized by sperm, an egg forms an embryo. A woman is born with all the eggs she will ever have. Each month, an egg is released during ovulation. If it is not fertilized, menstruation will occur about two weeks later. During IVF fertility drugs are given, which cause the ovaries to produce numerous eggs instead of just one.
Endometrial cells: The cells that make up the lining of the uterus. These cells build up a thick lining cyclically, which is then discarded through menstrual flow.
Endometrial biopsy: A test to check for Luteal Phase Defect during which a sample of the uterine lining is collected for microscopic analysis. The biopsy results will confirm ovulation and the proper preparation of the endometrium by oestrogen and progesterone stimulation.
Endometrioma (chocolate cyst): A cyst in the ovary that is filled with old blood, also known as a “chocolate cyst”. It occurs when endometriosis invades an ovary.
Endometriosis: See the section ‘Endometriosis’.
Endometrium: The lining of the uterus, which grows and sheds in response to oestrogen and progesterone stimulation; the bed of tissue designed to nourish the implanted embryo.
Endorphins: Natural narcotics manufactured in the brain to reduce sensitivity to pain and stress. They may contribute to stress-related fertility problems.
Enterocele: A true herniation into the top of the vagina. This results from loops of small bowel herniating through a fascia tear into the space between the pelvic fascia and the vaginal wall.
Endoscopy: The visualization of the internal organs and cavities of the body with illuminated optic instruments such as a laparoscope.
Excision: A method of removing endometriosis by physically cutting it out of the body, normally with a laparoscopy.

 

F
Fallopian tubes: Ducts through which eggs travel to the uterus once released from the ovary.
Ferning: A pattern characteristic of dried cervical mucus viewed on a slide. When the fern pattern appears, the mucus has been thinned and prepared by oestrogen for the passage of sperm. If it does not fern, the mucus will be hostile to the passage of the sperm.
Fertility: The capacity to initiate or support conception.
Fertility specialist: A physician specializing in the practice of fertility.
Fertility treatment: Any method or procedure used to enhance fertility or increase the likelihood of pregnancy. The goal of fertility treatment is to help couples have a child.
Fertility workup: The initial medical examinations and tests performed to diagnose or narrow down the cause of fertility problems.
Fertilization: The combining of the genetic material carried by sperm and egg to create an embryo. It normally occurs inside the fallopian tube (in vivo) but may also occur in a petri dish (in vitro). See also In Vitro Fertilization (IVF).
Fibroid (myoma or leiomyoma): A benign tumor of the uterine muscle and connective tissue.
Fimbria: The opening of the fallopian tube near the ovary. When stimulated by the follicular fluid released during ovulation, the fingerlike ends grasp the ovary and coax the egg into the tube.
Follicular fluid: The fluid inside the follicle that cushions and nourishes the ovum. When released during ovulation, the fluid stimulates the fimbria to grasp the ovary and coax the egg into the fallopian tube.
Follicular phase: The pre-ovulatory portion of a woman’s cycle during which a follicle grows and high levels of oestrogen cause the lining of the uterus to proliferate (thicken). This normally takes between 12 and 14 days.

 

G
Gonad: The gland that makes reproductive cells and “sex” hormones, such as the testicles, which make sperm and testosterone, and the ovaries, which produce eggs (ova) and oestrogen.
Gynaecologist: A specialist physician specialized in female disorders, particularly those of the reproductive and urological organs.

 

H
Hemostasis: The arrest of bleeding.
Hormone: A chemical secreted from a part of the body (usually an endocrine gland) and carried in the bloodsream to another part to stimulate or retard its function.
Hormone Replacement Therapy – HRT: Also referred to as Oestrogen Replacement Therapy. The practice of medically administering oestrogen after the menopause, after procedures such as hysterectomy, or together with menopause-inducing drugs to reduce side effects and reduce medical risks such as osteoporosis.
Hostile mucus: Cervical mucus that impedes the natural progress of sperm through the cervical canal.
Human Chorionic Gonadotropin – hCG: The hormone produced in early pregnancy, which keeps the corpus luteum producing progesterone. Also used via injection to trigger ovulation after some fertility treatments, and used in men to stimulate testosterone production.
Human Menopausal Gonadotropin – hMG: A combination of the hormones FSH and LH, which is extracted from the urine of post-menopausal women. Used to induce ovulation in several fertility treatments.
Hyperstimulation – Ovarian Hyperstimulation Syndrome: A potentially life-threatening side effect of ovulation induction treatment. Arises when too many follicles develop and hCG is given to release the eggs. This may be prevented by withholding the hCG injection when ultrasound monitoring indicates that too many follicles have matured.
Hyperthyroidism: Overproduction of thyroid hormone by the thyroid gland. The resulting increased metabolism “burns up” oestrogen too rapidly and interferes with ovulation.
Hypo oestrogenic: Having lower than normal levels of oestrogen.
Hysterectomy: Surgical removal of the uterus. When the ovaries and the fallopian tubes are also removed, it is called hysterectomy with bilateral salpingo-oopherectomy. See also our article on hysteretomy.
Hysterosalpingogram (HSG): An x-ray of the pelvic organs in which a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. This test checks for malformations of the uterus and blockage of the fallopian tubes.
Hysteroscopy: A procedure in which the doctor checks for uterine abnormalities by inserting a fiber-optic device. Minor surgical repairs can be executed during the procedure.

 

I
Imperforate hymen: A condition where the membrane (hymen) covering the vagina fails to open and allow menstrual flow.
Inflammation: A tissue reaction to irritation, injury or infection, marked by localized warmth, swelling, redness and pain.
Intra-abdominal: Inside the abdominal cavity.
Intrauterine: Inside the uterus.
Infertility: The inability to conceive after a year of unprotected intercourse or the inability to carry a pregnancy to term.
Infertility specialist: A physician who specializes in infertility. Most are board-certified reproductive endocrinologists, but some gynaecologists have considerable experience in infertility and may be considered experts in the field.
Intrauterine insemination (IUI): A technique in which sperm are introduced directly into a woman’s cervix or uterus to produce pregnancy, with or without ovarian stimulation to produce multiple eggs.

 

L
Laparoscope: The instrument used to perform a laparoscopy. It is a small telescope, which can be inserted into a hole in the abdominal wall for viewing the internal organs.
Laparoscopy: A surgical procedure used as the primary means of diagnosing endometriosis; also used to treat endometriosis. A lighted tube is inserted into the belly button through which the surgeon can view the inside of the abdomen. Instruments can be inserted into other small incisions to remove or destroy endometriosis.
Laparotomy: Open abdominal surgery. Laser ablation A method of destroying endometriosis using a concentrated beam of light.
Leiomyoma: See Fibroids.
Leydig cell: The testicular cell that produces the male hormone testosterone. The Leydig cell is stimulated by LH from the pituitary gland.

 

M
Menopause: The transition between the reproductive and postreproductive stages in an older women’s life, or when a woman ceases to menstruate or ovulate.
Menorrhagia: Heavy or prolonged menstrual flow.
Menstruation: The physiologis cyclical shedding of the uterine endometrium (the lining of the uterus), unless pregnancy intervenes, and is characterized by vaginal bleeding of three to seven days’ duration. Menstruation is also referred to as the “menstrual period” or “monthly period”.
Mesovarium: The upper free portion of the broad ligament, above the proper ovarian ligament and investing the Fallopian tube.
Metrorrhagia: Menstrual spotting during the middle of the cycle.
Mucosa: Epithelial tissue encountered in the mouth, vagina, anus, etc.
Myoma: See Fibroids.
Myomectomy: Surgery performed to remove fibroid tumors.
Myometrium: The outer lining, layer/muscular coat of the uterus.

 

O
Obstetrics: The medical specialty of caring for pregnant mothers and delivering babies.
Obstetrician: A specialist gynaecologist specialized in looking after pregnant women, and the delivery of babies.
Oestradiol/Oestrogen: The female sex hormone produced in the ovary. Its production is signaled by the pituitary gland in the brain and is responsible for formation of the female secondary sex characteristics. It supports the growth of the follicle and the development of the uterine lining. At midcycle the peak oestrogen level triggers the release of the LH spike from the pituitary gland. The LH spike is necessary for the release of the ovum from the follicle. Fat cells can also produce oestrogen, and this is known as aromatase.
Oligomenorrhea: Infrequent menstrual periods.
Oncology: The branch of medicine concerned with the study of and treatment of cancer.
Oophorectomy: Removal of one or both ovaries.
Oocyte: The egg; the reproductive cell from the ovary; the female gamete; the sex cell that contains the woman’s genetic information.
Ovaries: Two small organs on either side of a woman’s lower pelvis which produce ova, or eggs, and hormones; the female gamete-producing glands.
Ovarian cyst: A fluid-filled sac inside the ovary. An ovarian cyst may be found in conjunction with ovulation disorders, tumors of the ovary, and endometriosis. See also endometrioma.
Ovarian failure: The failure of the ovary to respond to FSH stimulation from the pituitary because of damage to or malformation of the ovary. Diagnosed by elevated FSH in the blood.
Ovarian follicle: The ovum together with its surrounding cells, located within the ovary.
Ovulation: The cyclical occurrence in a woman’s reproductive years when an egg is released from the ovary and picked up by the fallopian tubes and guided into the uterus where it will either be fertilized or discarded with menstruation.
Ovulation induction: Medical treatment performed to initiate ovulation.
Ovulatory Failure (anovulation): The failure to ovulate.
Ovum/ova: An egg(s).

 

P
Pap smear:
A screening test for pre-cancerous changes of the uterine cervix.
Pelvic floor dysfunction: Disorders of the pelvic floor related to physiological or anatomical abnormalities. They include incontinence, prolapse, pain syndromes, and others.
Pelvic floor: The floor of the abdominal cavity. It pertains to those structures that form the natural bottom of the pelvic and intra-abdominal cavities.
Pelvic ultrasound: A procedure in which the doctor checks for structural abnormalities or other problems in the female reproductive system.
Pelvic Inflammatory Disease (PID): An infection in the pelvic area that can be caused by a variety of bacteria and can attack various pelvic organs.
Pituitary gland: The master gland; the gland that is stimulated by the hypothalamus and controls all hormonal functions. Located at the base of the brain just below the hypothalamus, this gland controls many major hormonal factories throughout the body including the gonads, the adrenal glands, and the thyroid gland.
Polycystic Ovarian Syndrome (PCOS): A condition found in women who don’t ovulate, characterized by excessive production of androgens (male sex hormones) and the presence of cysts in the ovaries. Though PCOS can be without symptoms, some include excessive weight gain, acne, and excessive hair growth.
Premature menopause: Menopause that occurs naturally before the age of 40. Also known as premature ovarian failure.
Premature ovarian failure: A condition where the ovary runs out of follicles before the normal age associated with menopause.
Primary infertility: Infertility in a woman who has never had a pregnancy.
Progesterone: The hormone produced by the corpus luteum during the second half of a woman’s cycle. It thickens the lining of the uterus to prepare it to accept implantation of a fertilized egg.
Prolapse: Falling out of, falling down, or dropping, bulging.
Prostaglandins: Substances found in bodily tissues, which are often responsible for the contractions of smooth muscles such as the uterus. Prostaglandins keep blood pressure low and influence hormone activity.
Proteomics: The science that deals with the analysis of proteins (presence, activity, function, dysfunction) in body tissues and fluids with respect to specific diseases
Puberty: The time of life when the body begins making adult levels of sex hormones (oestrogen or testosterone) and the youngster takes on adult body characteristics: developing breasts, growing a beard, pubic hair, and auxiliary hair; attaining sexual maturity.

 

R
Rectocele: Prolapse of the rectum into the vagina. This can be seen as a bulge from the lower wall of the vagina.
Recto-vaginal septum: The fascial layer, which separates the vagina from the rectum.
Resection: Surgical excision (removal by cutting) of a portion of an organ or other structure.
Resistant ovary: An ovary that cannot respond to the follicle-stimulating message sent by FSH. Primitive germ cells will be present in the ovary; however, they will not respond to FSH stimulation.

 

S
Salpingectomy: Surgical removal of the fallopian tube.
Salpingitis: Inflammation of the Fallopian tube.
Salpingostomy/Fimbrioplasty: Surgical repair made to the fallopian tubes; a procedure used to open the fimbria.
Secondary infertility: The inability of a couple which has successfully achieved pregnancy to achieve another. In other words: it refers to a couple which has one biological child but is unable to conceive another.
Septate uterus: A uterus divided into right and left halves by a wall of tissue (septum). Women with a septate uterus have an increased chance of early pregnancy loss.
Sexually transmitted disease (STD): An infection that is spread by sexual contact. Also called a sexually transmitted infection (STI).
Sonogram (ultrasound): Use of high-frequency sound waves for creating an image of internal body parts.
Sterility An irreversible condition that prevents conception.
Stress urinary incontinence: Incontinence related to episodes of increased intra-abdominal pressure, thus leakage of urine.

 

T
Thromboembolisis: Blood clotting and migration of clots to plug distant blood vessels.
Thyroid conditions: Any condition in which the thyroid is not functioning properly, such as underactive (hypo) or overactive (hyper) thyroid.
Thyroid gland: The endocrine gland in the front of the neck that produces thyroid hormones to regulate the body’s metabolism.
Transvaginal ultrasonography: Ultrasonography which sends into the pelvic cavity and receives ultrasonic waves through the vagina by using a probe placed inside the vagina.
Trichomonas: An infection that may produce a greenish, bad-smelling vaginal discharge.
Tubal ligation: A type of female sterilization in which the fallopian tubes are cut, clipped, or tied in order to prevent pregnancy.
Tubocornual anastomosis: Surgery performed to remove a blocked portion of the fallopian tube and to reconnect the tube to the uterus. Tubouterine implantation may also be performed to remove fallopian tube blockage near the uterus and reimplant the tube in the uterus.
Tubotubal anastomosis: Surgery performed to remove a diseased portion of the fallopian tube and reconnect the two ends; sterilisation reversal.

 

U
Ultrasound: A test used to visualize the reproductive organs. The instrument works by bouncing sound waves off the organs, and a picture displayed on a TV screen shows the internal organs.
Ultrasonography: The delineation of deep bodily structures by sending ultrasonic waves (sound waves of frequency higher than the range audible to the human ear, i.e. above 20,000 cycles per second) toward an organ or mass, which in turn bounces back (echoes); the patterns produces are graphically displayed on a fluorescent screen for interpretation.
Umbilical cord: Two arteries and one vein encased in a gelatinous tube leading from the baby to the placenta. Used to exchange nutrients and oxygen from the mother for waste products from the baby.
Unicornuate: uterus An abnormality in which the uterus is “one sided” and smaller than usual.
Ureter: The muscular tubes carrying urine from the kidneys to the bladder.
Urethra: The tube that allows urine to pass between the bladder and the outside of the body.
Urinary tract disorders: Disorders of the urinary tract causing painful urination, frequency of urination, and/or urine leakage, such as interstitial cystitis. Sometimes confused with the symptoms of endometriosis on the bladder.
Uterine fibroids: Abnormal, benign (non-cancerous) growths of muscle within the wall of a woman’s uterus.
Uterine polyps: Abnormal, benign (non-cancerous) growths attached to a short stalk that protrudes from the inner surface of a woman’s uterus.
Urinary incontinence: Urinary incontinence related to bladder muscle contractions which occur involuntarily and in the setting of an inability to suppress those contractions.
Urinary obstruction: Inability to pee.
Urodynamic assessment: Dynamic testing of the urological system whereby pressure differentials are measured.
Urologist: A physician specializing in the genitourinary tract.
Uterosacral ligaments: Ligaments attaching the lower part of the uterus to the sacral bone. One of the main supports of the uterus and upper vagina, and a common place to find endometriosis.
Uterus: The hollow, muscular organ that houses and nourishes the foetus during pregnancy.

 

V
Vagina: The canal leading from the cervix to the outside of the woman’s body; the birth passage.
Vaginismus: Painful spasm of pelvic floor muscles on vaginal entry, such as sexual intercourse.
Vaginitis: Yeast, bacterial vaginosis, or trichomonas infections of the vagina. Frequent vaginitis may indicate the presence of pelvic adhesions and tubal blockage from other infections, such as chlamydia. Vaginitis may interfere with sperm penetration of the cervical mucus, and the symptoms may even interfere with the ability and desire to have intercourse.
Vaporization: A method of destroying endometriosis by boiling of the cellular water with a laser or electrosurgical knife.
Venereal Disease: Any infection that can be sexually transmitted, such as chlamydia, gonorrhea, ureaplasma, and syphilis.
Vulva: The female external genital organs.
Vulvodynia: Painful vulva also sometimes associated with urinary symptoms, painful intercourse and generalized pelvic pain.

 

X
X chromosome: The congenital, developmental, or genetic information in the cell that transmits the information necessary to make a female. All eggs contain one X chromosome, and half of all sperm carry an X chromosome. When two X chromosomes combine, the baby will be a girl. See also Y chromosome.

 

Y
Y chromosome: The genetic material that transmits the information necessary to make a male. The Y chromosome can be found in one-half of the man’s sperm cells. When an X and a Y chromosome combine, the baby will be a boy. See also X Chromosome.

Z
Zona pellucida: The outer protein coat (shell) of an ovum, which must be penetrated by a sperm cell for fertilization to take place.
Zygote: A fertilized egg, which has not yet divided.
Zygote Intrafallopian Transfer (ZIFT): An assisted reproduction technology (ART) in which eggs are removed from a woman’s ovaries, fertilized with the man’s sperm in a lab dish, and the resulting embryos are transferred into the woman’s fallopian tubes during a minor surgical procedure.

 

© Dr. Jean-Marie Wenger 2016
Avenue de la Roseraie 76A, 1205 Geneva, Switzerland
  +41 22 321 26 66 |   +41 22 321 26 70
  info@jmwenger.com

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