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Topics:
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da Vinci (Robotic) Surgery
 What is da Vinci robotic surgery?
What surgeries can be performed using the system?
What benefits can I have by undergoing robotic surgery?
What is the recovery time after a da Vinci robotic surgery?
Where can I find information on da Vinci Robotic surgery?
Urinary Incontinence
What is urinary incontinence?
What causes urinary incontinence?
What should I do if I have leaking of urine?
What is MUT (Multichannel Urodynamic Testing)?
How can urinary incontinence be treated?
Minimally Invasive Surgery
What is minimally invasive surgery?
What is laparoscopy?
What are the advantages of minimally invasive procedures?
When can I return to work after a minimally invasive procedure?
How can urinary incontinence be treated?
Pregnancy
What can I do for nausea and vomiting during pregnancy?
Is it safe to exercise and continue working during pregnancy?
What causes headaches during pregnancy?
What can I do to treat headaches during pregnancy?
Are leg cramps normal?
What can I do to reduce or prevent heartburn during pregnancy?
Is it safe to have sex during pregnancy?
Are hemorrhoids common during pregnancy?
What can I do to get relief from hemorrhoids?
May I travel during pregnancy?
da Vinci (Robotic) Surgery
What is da Vinci robotic surgery?
You've just been diagnosed with a condition requiring surgery. Until very recently your options included traditional surgery with a large open incision or laparoscopy, which uses small incisions but is typically limited to very simple procedures.
Thanks to a breakthrough surgical technology, there is a new category of minimally invasive surgery for which you may be a candidate. It is an effective, minimally invasive alternative to both open surgery and laparoscopy. Through the use of the da Vinci® Surgical System, surgeons are now able to offer a minimally invasive option for complex surgical procedures.
Imagine major surgery performed through the smallest of incisions. Imagine having the benefits of a definitive treatment but with the potential for significantly less pain, a shorter hospital stay, faster return to normal daily activities – as well as the potential for better clinical outcomes.
The da Vinci robotic surgery represents the most advanced technology with respect to surgical techniques.
What surgeries can be performed using the system?
The da Vinci surgical system can be used to perform the following gynecologic surgeries:
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Hysterectomy
Myomectomy
Sacrocolpopexy |
What benefits can I have by undergoing robotic surgery?
The da Vinci surgical system can be used to perform the following gynecologic surgeries:
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Significantly less pain
Less blood loss
Shorter recovery time
Less scarring
Potentially better clinical outcome |
What is the recovery time after a da Vinci robotic surgery?
Since the surgery involves smaller skin incisions, the hospital stay and recovery are much shorter than open surgery. You should be able to leave the hospital in 1 to 2 days and return to your usual activities 2 to 3 weeks following the procedure.
Where can I find additional information on da Vinci Robotic surgery?
http://www.davincisurgery.com/
Urinary Incontinence
What is urinary incontinence?
Urinary incontinence is the inability to hold urine during physical activity, such as jogging, golf, tennis, other types of exercise, coughing, sneezing.
What causes urinary incontinence?
Problems of the urinary tract can be caused by aging, disease or injury. The muscles in the bladder and/or the urethra can become weaker with age. That may lead to retention of urine and/or frequent infections. In addition, weakening of the urethral sphincter and the pelvis muscles may lead to involuntary leaking of urine due to increased pressure during cough or exercise.
What should I do if I have leaking of urine?
In order to solve your urinary problems, you should first contact a gynecologist or urologist.
You will be asked about your medical history, including past surgeries and current prescriptions. A questionnaire regarding your fluid intake and output will be given to you in order to determine the existence and type of urinary incontinence. The next step in evaluating urinary incontinence is performing Multichannel Urodynamic Testing.
What is MUT (Multichannel Urodynamic Testing)?
Multichannel urodynamic testing is a comprehensive evaluation of the urinary tract responsible for urinary incontinence, such as bladder and urethra. The testing facilitates a more accurate diagnosis of the type of incontinence and the appropriate treatment plan.
How can urinary incontinence be treated?
Treatment of urinary incontinence depends on the type of incontinence that you have. Urgency incontinence can be treated with bladder training exercises and aided by a prescription. Stress urinary incontinence can be treated with pelvic muscles exercise. It can also be treated with surgery, in which a sling is placed under the urethra in order to increase the midurethral pressure.
Minimally invasive surgery
What is minimally invasive surgery?
Minimally invasive surgery involves small incisions. The following surgeries are considered minimally invasive:
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Laparoscopy
Transobrturator tape replacement
Hysteroscopy |
What is laparoscopy?
Laparoscopy (pronounced "lap-a-ROSS-coe-pee") is a surgical procedure performed through very small incisions in the abdomen, using specialized instruments. A pencil-thin instrument called a laparoscope is used, and it gives the surgeon an exceptionally clear view, on a TV monitor, of the inside of the abdominal cavity.
The following procedures can be performed using laparoscopy:
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Removal of the uterus
Removal of the ovaries
Removal of the fallopian tubes
Removal of endometriosis
Ovarian cysts
Lysis of adhesions |
What are the advantages of minimally invasive procedures?
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Less bleeding
Lower infection rate
Higher precision
Faster recovery and return to work |
When can I return to work after a minimally invasive procedure?
It depends on the procedure. For removal of an ovary, ovarian cyst, or a placement of a tot, the patient can normally be discharged the same day. Removal of the uterus normally requires a one to two day stay.
How can urinary incontinence be treated?
Treatment of urinary incontinence depends on the type of incontinence that you have. Urgency incontinence can be treated with bladder training exercises and aided by a prescription. Stress urinary incontinence can be treated with pelvic muscles exercise. It can also be treated with surgery, in which a sling is placed under the urethra in order to increase the midurethral pressure.
Pregnancy
What can I do for nausea and vomiting during pregnancy?
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Eat smaller and more frequent meals. Six small meals and snacks are best.
Drink fluids between meals instead of during meals.
Drink chilled or cold beverages.
Eat slowly and rest immediately following meals.
Eat dry toast, crackers, or dry pre-sweetened cereals. They may relieve nausea.
Ask your doctor about medicine to control nausea
Call your doctor if you have following symptoms:
- Inability to keep food or liquid down
- Fainting
- Vomiting blood
- Rib pain
- Jaundice (greenish or yellow skin)
- Weight loss above five lbs per wee
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Is it safe to exercise and continue working during pregnancy?
For years it was believed that pregnant women should spend nine months prone on the couch, resting comfortably. Doctors feared that the jarring motion of aerobics or running could damage the fetus, and prescribed rest for even the most intense of professional athletes. Fortunately, the tide has turned. Pioneers such as James Clapp., M.D. and Elizabeth Noble have proven through their work that exercising actually makes for an easier pregnancy and delivery. In fact, Dr. Clapp found through a study of 500 pregnant women that those who exercised delivered a healthier baby with a stronger fetal heart rate. Even more compelling is the fact that of the women who exercised, time spent in labor was shortened by about a third, with 65% of the women delivering in four hours or less. And when you're in labor, every extra hour seems like an eternity.
The reality is that women have been active throughout pregnancy for centuries; there is no such thing as maternity leave (unfortunately) in most of the world. Exercising also seems to ease some common ailments, such as lower back pain and fatigue. However, there are some basic guidelines that should be followed:
- Start slowly. Even if you never exercised regularly before, a program can be undertaken safely. If you are following a regular exercise regime, there is no reason you should not be able to continue on the same level for the first trimester. It is important to listen to your body- if it feels like too much, take it down a notch. This is not the time to break your previous land speed record. Particularly if you suffer from morning sickness, be aware of your limits.
- Monitor your heart rate and breathing. As a general rule, your heart rate should not exceed 140 beats per minute. The fetal heart rate is tied to your own; if your heart is racing, your baby's is too. A heart rate monitor, at around a hundred dollars, is a worthwhile investment. Most feature an alarm that sounds if you exceed the safe target range. If you feel breathless, which is common during the first trimester, slow down or take a break. The first three months are an adjustment period, when your blood volume is initially too low to accommodate both you and a growing fetus- this can result in breathlessness and faintness. Adjust your exercise levels accordingly.
- Avoid exercising at extreme altitude or in hot, humid environments. Your body temperature affects the baby, and it is critical that neither of you becomes overheated.
- Drink plenty of water.
- As the pregnancy progresses, reduce the intensity level. This tends to happen naturally. Remember that even if you are exercising less intensely, the actual level of what you are doing is more difficult, due to the added weight of the baby.
- Be careful not to over-stretch. Early in pregnancy, a hormone called Relaxin fills your system. This hormone induces hyper-flexibility in the joints and musculature, which allows for the expansion of the uterus and the repositioning of the pelvic floor. It is common for women to strain muscles and ligaments during pregnancy as a result of this new flexibility. It is still important to stretch after exercising- just know your limits and try not to exceed them.
- In the last trimester, avoid ballistic movements, such as jumping or running. The exercise community is divided on this one. These motions can strain the pelvic floor, which is already supporting more weight than ever before. There are plenty of exercises that can be done without bouncing motions. It is better to be on the safe side.
- Do Kegel exercises religiously. The pelvic floor supports the bladder, uterus, and intestines. The added weight of the uterus during pregnancy can stretch out that floor, causing either the intestines or bladder to drop down. This is one of the reasons that so many elderly women suffer from incontinence. Prevention is the best medicine. Kegel exercises involve contracting and releasing the PF muscles, similarly to stopping the flow of urination. Tighten and relax the muscle quickly several times a day.
A healthy woman with no complications during her pregnancy can keep working until the end of her pregnancy. Some women may need to make certain changes.. If you are experiencing work related problems, discuss it with your doctor.
What causes headaches during pregnancy?
Experiencing headaches during pregnancy is one of the most common discomforts and complaints. Headaches may occur at any time during your pregnancy, but they tend to be most common during the first and third trimesters. Experiencing headaches during pregnancy is one of the most common discomforts and complaints. Headaches may occur at any time during your pregnancy, but they tend to be most common during the first and third trimesters.
An increase in headaches during the first trimester is believed to be caused by the surge of hormones along with an increase in the blood volume circulating throughout your body. These headaches may be further aggravated by stress, poor posture or changes in your vision. Other causes of headaches during pregnancy may involve one or more of the following:
- Lack of sleep
- Low blood sugar
- Dehydration
- Caffeine withdrawal
- Stress (too many changes)
Women who have regular migraine headaches may discover that they experience fewer migraines during pregnancy; however, some women may encounter the same number or even more migraine headaches. If you are pregnant, it is important to talk to your doctor about any medications that you may be taking for headaches.
Headaches during the third trimester tend to be related to poor posture and tension from carrying extra weight. Headaches during the third trimester may also be caused by a condition called preeclampsia, which is high blood pressure during pregnancy.
What can I do to treat headaches during pregnancy?
The best way to deal with headaches is to avoid them altogether. Avoiding tension headaches is easiest when you follow these tips:
- Practice good posture (especially during the third trimester)
- Get plenty of rest and relaxation
- Exercise
- Eat well-balanced meals
- If you are not able to prevent headaches, there are still things that you can do to help them go away. During pregnancy, you want to try and relieve your headache by natural means if possible. Pain relief medications ,such as aspirin and ibuprofen, are not recommended in most pregnancies; however, acetaminophen may be recommended by your doctor.
You may want to try to relieve your headache with one or more of the following natural remedies:
- If you have a sinus headache, apply a warm compress around your eyes and nose
- If you have a tension headache, apply a cold compress or ice pack at the base of your neck
- Maintain your blood sugar by eating smaller, more frequent meals. This may also help prevent future headaches
- Get a massage. Massaging your shoulders and neck is an effective way to relieve pain
- Rest in a dark room and practice deep breathing
- Take a warm shower or bath
- You may also reduce the likelihood of migraine headaches by avoiding common triggers of migraine headaches. Potential triggers include:
- Chocolate
- Alcohol
- Yogurt
- Aged cheese
- Peanuts
- Breads with fresh yeast
- Preserved meats
- Sour cream
Contact your doctor:
- Before taking any medications
- If you do not experience any relief from the remedies above
- Your headaches get worse or more persistent
- You experience headaches that are different than normal
- Your headaches are accompanied by: blurry vision, sudden weight gain, pain in the upper right abdomen, and swelling in the hands and face
Are leg cramps normal?
In the first 3 months of pregnancy you may find that you have more leg cramps. Get plenty of calcium (three glasses of milk per day, TUMS) and potassium (bananas and oranges). Stretching your legs before going to bed may help relieve cramps.
What can I do to reduce or prevent heartburn during pregnancy?
Heartburn during pregnancy, particularly in the last trimester, can be brutal. If you're suffering from heartburn or know someone who is, try some of these ideas to help reduce the pain.
You should definitely consult your doctor if your heartburn is severe, just to rule out any underlying medical condition. Your doctor may even be able to prescribe a short-term medication to help get you through these painful last weeks. Your doctor can also let you know what over-the-counter antacids are safe during pregnancy. Maalox, Tums, Pepcid or Zantac may be helpful.
You can try some creative solutions to try to reduce your heartburn without using medication. These ideas are simple, quick, and very inexpensive.
- Raise the upper portion of your bed. Ask your spouse, a friend, or relative to place some boards under the headboard section of your bed. Raise it at least 6 inches if you can so that you are sleeping on an incline.
- Stop eating spicy foods, especially within a couple of hours of bedtime. You may be craving spicy food late at night, but you'll probably regret while trying to sleep.
- Eliminate caffeine from coffee and soda. You should probably reduce your caffeine intake during pregnancy anyway to be healthy for your baby. Caffeine can lead to heartburn so cutting back may be a quick way to help. Plus, you'll save a few dollars.
- Reduce your sugar and simple carbohydrates.
- Have five to six smaller meals a day instead of two to three large meals.
- Do not eat or drink at least two hours before bed time.
Is it safe to have sex during pregnancy?
If you're having a normal pregnancy, sex is considered safe during all stages of the pregnancy.
So what's a "normal pregnancy"? It's one that's considered low-risk for complications such as miscarriage or pre-term labor. Talk to your doctor if you are uncertain about whether you fall into this category.
Of course, just because sex is safe during pregnancy doesn't mean you will necessarily want to have it! Many expectant mothers find that their desire for sex fluctuates during certain stages in the pregnancy. Also, many women find that sex becomes uncomfortable as their bodies get larger.
You and your partner need to keep the lines of communication open regarding your sexual relationship. Talk about other ways to satisfy your need for intimacy, such as kissing, caressing, and holding each other. You also may need to experiment with other positions for sex to find those that are the most comfortable.
For a healthy woman with a normal pregnancy, intercourse is safe into the last weeks of pregnancy. For your comfort, you and your partner may try to use different positions. Your doctor may advice you to limit or avoid sexual intercourse if they are signs or problems in your pregnancy.
If your doctor anticipates or detects certain significant complications with your pregnancy, he or she is likely to advice against sexual intercourse. The most common risk factors include:
- A history or threat of miscarriage
- A history of pre-term labor (you've previously delivered a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions)
- Unexplained vaginal bleeding, discharge, or cramping
- Leakage of amniotic fluid (the fluid that surrounds the baby)
- Placenta previa, a condition in which the placenta (the blood-rich structure that nourishes the baby) is situated down so low that it covers the cervix (the opening of the uterus)
- Incompetent cervix, a condition in which the cervix is weakened and dilates (opens) prematurely, raising the risk for miscarriage or premature delivery
- Multiple fetuses (you're having twins, triplets, etc)
Are hemorrhoids common during pregnancy?
Pregnancy makes you more prone to hemorrhoids, as well as to varicose veins in the legs and sometimes even in the vulva, for a variety of reasons. Your growing uterus puts pressure on the pelvic veins and the inferior vena cava, a large vein on the right side of the body that receives blood from the lower limbs. This can slow the return of blood from the lower half of your body, which increases the pressure on the veins below your uterus and causes them to become more dilated or swollen.
Constipation, another common problem during pregnancy, can also cause or aggravate hemorrhoids. That's because straining leads to hemorrhoids, and you tend to strain when having a hard bowel movement.
In addition, an increase in the hormone progesterone during pregnancy causes the walls of your veins to relax, allowing them to swell more easily. Progesterone also contributes to constipation by slowing down your intestinal tract.
What can I do to get relief from hemorrhoids?
Apply an ice pack (with a soft covering) to the affected area several times a day. Ice may help decrease swelling and discomfort. Some women find cold compresses saturated with witch hazel to be soothing.
- Soak your bottom in warm water, in a tub or a sits bath. A sits bath is small plastic basin that you fill with water and position over your toilet, allowing you to submerge your rectal area simply by sitting down.
- Try alternating cold and warm treatments. Start with an ice pack followed by a warm sits bath.
- Gently but thoroughly clean the affected area after each bowel movement using soft, unscented, white toilet tissue, which causes less irritation than colored, scented varieties. Moistening the tissue can help, too. Many women find using pre-moistened wipes more comfortable than using toilet tissue. You can buy medicated wipes (such as Tucks) made specifically for people with hemorrhoids.
- Ask your healthcare practitioner to recommend a safe topical anesthetic or medicated suppository. There are many hemorrhoid-relief products on the market, but consult your practitioner before trying one on your own. Most of these products should be used for a short course of treatment only (a week or less). Continued use can cause even more inflammation.
May I travel during pregnancy?
Most women can safely travel until close to their due date. Many women have questions regarding seat belts. Seat belts are necessary during driving; both lap and shoulder belts should be worn at all times. The lap belt should be worn low on the hips and should not over the uterus. During longer trips, we recommend that you take a short walk every two hours. Car accidents are the most common cause of trauma during pregnancy.
Air travel in pregnancy is allowed until 36 weeks for domestic and 35 weeks for international flights. In general, air travel does not pose an increased risk for healthy pregnant women. In order to prevent developing blood clots, it is strongly advised stretch your legs and walk if your flight is over two hours.
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