Conditions
Endometriosis
Endometriosis is a chronic and often painful gynaecological condition where endometrial tissue grows outside of the uterus. It is commonly found on the ovaries, the fallopian tubes and elsewhere in the pelvis. and, occasionally, in other parts of the body.
Common symptoms include pelvic pain, painful periods and painful sex. In some cases endometriosis can make conception more difficult. More worrying symptoms include bowel pain (pain passing a stool) especially around the time of menstruation or pain passing urine. These can be markers of bowel or bladder involvement and may indicate urgent treatment is required.
Previously it was thought that the diagnosis could only be made by laparoscopy but now, ultrasound, if done by an expert, can be used to make the diagnosis for many women. Mr Holland is very experienced in the ultrasound diagnosis of endometriosis including severe endometriosis of the bowel, bladder and kidneys, meaning he is often able to offer informed discussions around treatment options including medical treatment without the need for surgery.
Fibroids
Fibroids are benign (non-cancerous) growths of the uterine muscle wall (myometrium), which is the smooth muscle layer of the womb. They can protrude into the cavity of the uterus, within the uterine wall or extend outside of the uterus into the pelvis.
Fibroids are very common and are often so small that they do not cause any symptoms. However they tend to grow until the menopause and some women can get symptoms such as heavy and prolonged periods (menorrhagia), which can cause iron deficiency (anaemia), bleeding between periods, pelvic pain and abdominal discomfort due to pressure. Depending on their size and positioning, fibroids may affect bowel and bladder function and can sometimes affect fertility.
Ultrasound Diagnosis
Ultrasound is an effective tool for the diagnosis of size, location and effect on fertility and menstrual problems of any fibroids present. These results can be used to discuss the treatment options including the suitability of laparoscopic (key hole) surgery. Mr Holland is experienced in the open and laparoscopic removal of fibroids and has published research in this area.
Ovarian Cysts
Ovarian cysts are common and many are related to ovulation and resolve without treatment. This can normally be assessed on ultrasound scan. Persistent cysts which can cause pain, bloating or discomfort sometimes need removal and this can usually be achieved with key hole surgery (laparoscopy) using very small incisions in the abdomen. Occasionally ovarian cysts can be malignant and this would require a larger operation.
Operations
Laparoscopy
Many operations which previously required open surgery can now be performed using telescopes via small incisions in the abdomen. These operations include the diagnosis and removal of endometriosis, removal of ovarian cysts, removal of fibroids (laparoscopic myomectomy) and removal of the uterus (laparoscopic hysterectomy).
Hysteroscopy
Hysteroscopy involves using a telescope to look inside the uterus through the cervix (without making any incisions). This can be used to remove polyps or fibroids or diagnose the cause of abnormal bleeding.
If you have any questions or would like to discuss any aspect of the service, don’t hesitate to get in touch