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“Advancements in detecting and treating gynecological disorders have had a major impact on women’s health in recent years,” says Rosana Chow, M.D., a gynecologist at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School.

Recently Dr. Chow discussed advanced surgical techniques and preventive measures that have made a dramatic difference and that will continue to make a difference in women’s lives.

She points out that many major gynecological procedures are now performed with minimally invasive approaches. These procedures involve small incisions on the abdomen through which an instrument called a laparoscope is inserted to view the surgical site and to perform procedures. A camera attached to the laparoscope enables the surgeon to view the operating site on a TV monitor. Two to three additional small incisions are made to accommodate the operating instruments. Some of the minimally invasive procedures now performed regularly include hysterectomies, fibroid surgery, removal of ovaries or cysts, cancer surgeries including lymph nodes dissection, and surgery for urinary incontinence. The advantages to patients who undergo minimally invasive procedures rather than traditional open surgical procedures include less bleeding, less pain, and quicker recoveries.

Another highly advanced procedure is called hysteroscopy, which is a visual inspection or treatment of conditions in the uterine cavity. These procedures involve going through the vagina and cervix without having to make any skin incisions. A hysterocope, a tube-shaped instrument, is then inserted through the cervix and into the uterine cavity. A gas or liquid medium flowing through the hysteroscope distends the uterine cavity allowing visualization of the uterus. Hysteroscopy is now an approach used to perform a variety of procedures. One such procedure is called endometrial ablation. This is used as a treatment for women with heavy and irregular periods, a condition commonly affecting women who are starting to go through menopause. To stop the excess bleeding, the lining of the uterus can be cauterized by using different devices through the hysteroscope.

Dr. Chow points out that there is a device called Essure that is now starting to be used to perform tubal ligations through hysteroscopy. Essure is a flexible coiled tube that can be inserted into a woman’s fallopian tubes through the hysteroscope. The device then blocks the fallopian tubes by causing scar tissue to form, which prevents the sperm and egg from meeting. The discomfort from this procedure is so minimal that it can even be done in the office.

Another area where medical advancement is making a difference in women’s lives involves detection of the human papilloma virus (HPV). HPV is the most common sexually transmitted infection, particularly among young adults. It is estimated that at least 80 percent of women who have been sexually active have had the virus. Fortunately, most people developed antibodies to this virus and its presence is short-lived. The virus can cause either genital warts or cervical cancer. Greater than 95 percent of cervical cancers are caused by the HPV virus. There are over 100 subtypes of HPV. HPV 16 and 18, which are commonly found in cervical cancer, can now be detected through a woman’s annual pap smear. Dr. Chow indicates that a vaccine against the major types of HPV is now going through clinical trials and should be approved for general use shortly. The vaccine has been shown to be highly effective and may have the potential of eradicating cervical cancer.

Dr. Chow says, “Detection, treatment and prevention of many gynecological conditions affecting the lives of so many women continue to improve. Not only are we saving more lives, but we are now able to improve the quality of life for so many women.”

To sign up for the Mount Auburn Hospital prepared childbirth series of classes, please call us at 617-499-5094.