Aesthetic gynecology

As a woman ages, her intimate body parts also change. Vaginal walls become thinner, less elastic and dry, and so, more prone to irritation, infections and itching. The labia may begin to lose their volume. Childbirth is another contributing factor to increasing discomfort in the intimate area due to the loss of elasticity of the vaginal tissue. Fortunately, all these issues can be treated using gentle, non-surgical methods. Our clients can benefit from several types of effective treatments which rely on the rejuvenating effect of blood plasma or hyaluronic acid. Plasma therapy and hyaluronic acid therapy promote tissue regeneration and help improve the aesthetic appearance of the genital area and treat scars associated with childbirth. Our clinics perform the following procedures:

  • Injection of platelet-rich plasma created from the patient’s own blood using BCT technology to stimulate regenerative and anti-inflammatory effects,
  • Cellular Matrix (a product which combines 20 mg/l hyaluronic acid and autologous plasma in a closed-system device) injections to assist natural skin regeneration and hydration,
  • DESIRIAL® hyaluronic acid injection treatments of vaginal itching and painful intercourse associated with vulvovaginal atrophy,
  • DESIRIAL® PLUS filler injections to restore the labia majora volume and improve the aesthetic appearance of the vulvovaginal area.

GynGen – genetic analysis

Genetic analysis specifically for women prepared on the basis of recent findings of molecular genetics. GynGen®, as a part of personalized preventive medicine, provides a unique option to do something extra for your body – to increase the quality of life and stay healthy.

Most people solve their health problems at the moment they arise and unpleasantly affect their everyday life. GynGen allows you to find out your genetic risks and set targeted prevention just for you. Thus you can completely avoid many severe diseases or health complications or detect them in time when they are easily treatable.

GynGen detects your inherited dispositions to so-called civilization diseases of our time:

CARDIOVASCULAR DISEASES

  • Thrombosis
  • Atherosclerosis
  • Hypertension (high blood pressure)
  • Myocardial infarction
  • Stroke

CANCER

  • Breast cancer and ovarian cancer
    **note: Screening for BRCA 1,2 genes mutations is performed only in women over 18 years of age

METABOLIC DISEASES

  • Type II diabetes
  • Obesity
  • Osteoporosis (fragility of bones)

GynGen will help you to choose the suitability of use of HORMONAL CONTRACEPTION or REPLACEMENT for your body. In addition, GynGen will assess your dispositions to inflammatory diseases.

A physician will discuss your history with you within a consultation and you will sign an informed consent form with genetic examination. Then a simple swab of the oral cavity or potentially blood sampling will be performed. DNA will be isolated from the sample and it will go through many laboratory tests.

After completion of the genetic analysis, the client receives an extensive report that assesses her genetic risks and risks arising from her personal and family history. Based on these findings, an individual preventive plan containing appropriate life style modification, follow-up and therapeutic measures is developed.
The analysis is performed within 3 months from receipt of the sample to be examined.


Gynaecological surgery

Scope of gynaecological surgery with an emphasis on mini invasive operational techniques and implementation of new methods.

Minor gynaecological interventions:

Induced abortion in the 1st trimester

Operation is performed under general anaesthesia on the patient´s own request or for medical reasons. Access to the uterine cavity is through the vagina. The content of the uterine cavity is removed by suction or by a curette. Duration is approx. 10-15min. We recommend observing sexual abstinence and enhanced hygiene for at least 14 days after the intervention. First menstruation comes 4-6 weeks after the intervention.

Uterine cavity revision after spontaneous abortion, missed miscarriage or labour
The operation consists of removal of the content of the uterine cavity. The operation is performed under general anaesthesia. Access to the uterine cavity is through the vagina. The content of the uterine cavity is removed by a curette. Procedure duration is about 15 minutes. Hospitalization depends on patient´s health status and takes 1 day.

The operation allows histological examination of the removed tissue. We recommend observing sexual abstinence and enhanced hygiene for at least 14 days after the intervention. Mild bleeding (spotting) after the procedure will subside within a week. First menstruation comes 4-6 weeks after the intervention.

Curettage

The operation consists of removal of the cervical and uterine body lining. The operation is performed under general anaesthesia. Access to the uterine cavity is through the vagina. The lining lies on the internal surface of the uterine wall facing the uterine cavity and is gently removed by a curette during the intervention.

The operation allows histological examination of the removed tissue and assessment of its changes. Healing usually takes 10 days and is associated with bloody discharge. Hospitalization does not usually exceed 1 day. The operation does not endanger the further course of the menstrual cycle or your sexual life and also the chance to get pregnant is maintained in women of childbearing potential.

Diagnostic hysteroscopy

Hysteroscopy consists of inspection of the uterine cavity using special optics, potential tissue sampling or treatment of some lesions in the uterine cavity. In case of abrasion we remove cervical and uterine body lining by a curette.

The operation is performed under general anaesthesia after thorough disinfection of the genitals. Access to the uterine cavity is through the vagina and cervix that is enlarged by dilation for introduction of hysteroscope instruments.

The operation allows histological examination of the removed tissue and assessment of its changes. Growth of new uterine lining takes usually about 14 days and is associated with bloody discharge. The hospital stay usually lasts one day. We recommend abstaining from intercourse until bloody discharge stops and a new lining is built.

Cervical treatment using LEEP method

Operation consists of removal of the affected part of the cervix. The operation is performed under general anaesthesia. Access to the cervix is through the vagina. Areas of altered tissue are removed by an electrical loop. Coagulation is used to stop bleeding of the wound area. It is usually accompanied by sampling of the cervix lining. It is a diagnostic procedure that helps to find out the current status of the cervical disease – all tissue is sent for histological examination. Often, it is also a curative procedure because it removes the affected tissue of the cervix and further treatment is not necessary.

Vaginal or cervical biopsy or biopsy of the vulva

The intervention consists of tissue sampling from a specified site and subsequent histological examination of the samples. The intervention is performed under general anaesthesia, respectively under local anaesthesia – according to the extent of the intervention.

Ablation of anogenital warts

The operation consists of ablation of warts from the area of external genitals, respectively from the vagina or the surface of the cervix.

Condylomata accuminata are warty growths found mainly in the area of external genitals, the vagina or around the anus and they are caused by viral infection. It is transmitted by intercourse. The intervention is performed under general anaesthesia.

Major gynaecological interventions:

Laparoscopy

Laparoscopy allows direct control of organs in the lesser pelvis (ovaries, fallopian tubes, uterus and their ligaments, appendix, peritoneum etc.). It is performed using mini invasive techniques via few small punctures across the anterior abdominal wall (so called endoscopy). The surgery is performed under general anaesthesia when a laparoscope, i.e. a device allowing inspection of the pelvis and the abdominal cavity, is inserted. It consists of a thin tube with optics connected to a video circuit and aid tools that allow access to various organs. They are inserted via short incisions approximately 1.5 cm long. The abdominal cavity is filled with carbon dioxide during this procedure. All removed tissue is sent for histological examination.

In comparison with classical abdominal operations, patients better tolerate the postoperative period, convalescence is shorter and patients return faster to normal life.

Surgical removal of the uterus through the vagina with laparoscopic assistance (laparoscopically assisted vaginal hysterectomy – LAVH)

The laparoscope is inserted via an incision just below the navel. Another two devices used to perform the intervention in the abdominal cavity are inserted via two small punctures (approx. 0.5-1.5 cm) above the pubic hair line. The abdominal cavity is filled with carbon dioxide during this procedure.

Removal of the affected uterus can be accompanied by removal of the ovaries and the fallopian tubes.

Following the laparoscopic phase, the operation continues by removing the uterus through the vagina. Uterine removal that starts with laparoscopic and subsequent vaginal access, may sometimes, due to previously unforeseen complexity of the operation, continue with abdominal cavity opening through a skin incision and may be completed in this way.

Because temporary impaired bladder emptying may occur after the operation, a catheter is inserted to the urinary bladder for 24 hours that continuously evacuates the formed urine to avoid renal impairment.

Hysterectomia vaginalis – surgical removal of the uterus through the vagina

The operation is performed under general anaesthesia or conduction anaesthesia through the vagina. It can be accompanied by removal of the ovaries and the fallopian tubes. In case of associated descent of the vaginal walls, vaginoplasty may be performed.

Because temporary impaired bladder emptying may occur after the operation, a catheter is inserted to the urinary bladder for 24 hours that continuously evacuates the formed urine to avoid renal impairment.

Hysterectomia abdominalis – surgical removal of the uterus through the abdominal wall
The surgical procedure is performed under general anaesthesia via a skin incision, usually transversal, above the pubic hair line. The result is removal of the uterus from its original location in the lesser pelvis; fallopian tubes or ovaries or respectively other affected organs may be removed simultaneously. Because temporary impaired bladder emptying may occur after the operation, a catheter is inserted to the urinary bladder for 24 hours that continuously evacuates the formed urine to avoid renal impairment.

Surgical hysteroscopy

The aim of the surgical hysteroscopy is inspection of the uterine cavity using special optics and treatment of some lesions in the uterine cavity (congenital uterine septum, a fibroid in the cavity, polyps in the uterine cavity, ablation of the endometrium).

The operation is performed under general anaesthesia and the access to the uterine cavity is through the vagina and cervix that is enlarged by dilation for introduction of the hysteroscope. Patients with major interventions in the uterine cavity are discharged from hospital on the 2nd day after the operation.


Care of infertile pairs

The ward offers consultancy to the clients with fertility disorder along with proposing diagnostic and therapeutic procedure. We offer performing laboratory hormone tests or ultrasound ovulation detection. In accordance with the type of the found disorder, hormonal therapy with ovulation induction is performed, and in case of failure care in a cooperating centre of assisted reproduction is arranged.


Consultancy and birth-control application

Birth-control consultancy – birth control “made-to-measure” to the patients: peroral contraception, insertion of an intrauterine device, subcutaneous implant IMPLANON, injection forms and other forms.


Prenatal care

Modern and complex attitude to pregnancy and birth. The tests and examinations which are a part of the prenatal clinic visit are the following: urinal test, evaluation of the body mass increase in the pregnant woman, blood pressure measuring, palpatory cervix examination and ultrasound examination of the foetus.

In the prenatal care, the ultrasound represents an irreplaceable examination method not only for the examination of a fetus, but also for the examination of a pregnant woman. The prenatal examinations are carried out during the 1st trimester in the 11th week + 3d-13+6 of the gravidity age, then in the 2nd trimester – with the fetus age of 19–22 weeks, and around the 30th week of the gravidity age. It is naturally possible to carry out the examination anytime in case of a need.

With regard to individual examinations:

  • In the 1st trimester of the gravidity, specifically at 11+3+13+6 of the fetus age, it is possible to examine the fetus in detail, as well as the fetal ovum, uterus, and the uterine area. It is usually carried out trans-abdominally. The biggest contribution is the measuring of the so-called nuchal translucence (NT). The NT is a sign, which – in combination with suitable biochemical examinations – may warn about a risk of certain genetic or anatomic congenital defects.
  • In April 2013 we acquired the first-trimester screening certificate, based on which we provide a complete first trimester screening to detect fetal congenital malformations and chromosomal aberrations.
    Modernization of our examination procedures enabled us to introduce better diagnosis of congenital malformations in human fetuses - the so-called first-trimester screening. Certification is the most important guarantee of quality examination and minimizes the risk of inaccurate results.
  • In the 2nd trimester of the gravidity, specifically between the 19th and the 20th week, we carry out a specialized examination of the fetus aimed at detecting and ruling out congenital defects of the fetus. This is also a suitable period for a detailed examination of the fetus heart.
  • In the 3rd trimester of the gravidity, around the 30th week, we aim at the position of the fetus in the uterus, and the placenta function.

More information can be found in this leaflet.


Gynaecological endocrinology

The ward offers care of patients with gynaecological diseases caused by hormonal disorders. By virtue of available spectrum of modern diagnostic and therapeutic methods, we provide diagnostics and therapy in hormone-related gynaecological diseases and pathologic conditions:

  • Menstrual cycle disorder
  • Dysmenorrhoea (painful menstruation)
  • Ovarial insufficiency
  • Hyper-prolactemia
  • Hyper-androgenic conditions
  • Syndrome of polycystic ovaries
  • Endometriosis
  • Habitual miscarriage

We also provide diagnostics and therapy of diseases and conditions caused by insufficiency of female sex hormones during climacterium – ultrasound check of the uterine mucous membrane, monitoring the bone tissue density, hormonal substitution therapy and phytoestrogens.


Ultrasound diagnostics in gynecology and obstetrics

It is noninvasive diagnostics, using physical phenomenon of reflection and absorption of acoustic waves at the divides of environments with different density. In gynecology and obstetrics, this method is also used due to the lack of risks and adverse effects.

Using the ultrasound diagnostics, we examine the organs of small pelvis, and other vascular supply. By default, we use the so-called vaginal probe in gynecology. If the vaginal examination is not possible, it is possible to use an examination via the abdominal wall (trans-abdominal).


Preventive gynaecological examination

It consists of the examination of external female genitals in the gynaecological specula, during which a colposcopic examination of the uterine cervix is performed at first (it is, in fact, something like a microscopic examination) and the cytology withdrawal is made (once a year). Cytology is a smear from the external area of the cervix and from the cervical canal. It is a basic examination within the framework of preventing cancer development in this area of the female genitals.

We have extended the option of cytology sampling in liquid medium for our clients.

The new LBC method significantly improves the examination quality and increases the possibility for early detection of severe cell changes in the uterine cervix. At the same time, the method enables the detection of HPV virus, which causes this serious cervical illness, using the already collected swab.

The laboratory analyses the samples in two ways: microscopic examination via the human eye of a specialist – cyto-pathologist, and then re-evaluation using an electron microscope, which can locate and identify even a single abnormal cell in a clear field. This process markedly reduces the risk of overlooking significant changes in these cells.

In the classic, almost 50 year old sampling method for cytology on slides, testing efficiency only reaches a level of 60-70% in detecting pathological cells and finding undervaluation. The new computer method finds all the cancerous cells, so the accuracy of the laboratory exceeds 90%.

Then palpatory examination of the uterine and ovaries follows. In necessary cases the examination through the rectum is added. The physician’s optional possibility is then vaginal or abdominal ultrasound examination.

Vaccination WHICH IS OFFERED BY OUR WARD appears to be another preventive measure for the future. The vaccination developed specifically for women should protect against the aggressive HPV types at most. It is not only for girls who has not started their sexual life yet, but also for all of the women who are sexually active. That is to prevent repeated infection inception and to decrease the probability of cancer development.

Breast disease – capture and dispensarisation, recommendation for mammography and breast ultrasound, tight cooperation with a mammologist.