Monday, April 25, 2016

What is the difference between Kista Endometriosis and Ovarian Cysts?



Kista Endometriosis is a condition in which tissue similar to the lining of the uterus is located outside the uterus. Usually there are implants of this tissue in the pelvis. When the lining of the uterus bleeds during the menstrual cycle, these implants also bleed. This causes pain and scarring in the pelvis. The other pelvic structures react to this bleeding by becoming adherent to each other so that tubes, ovaries and intestine are stuck together. If the endometrial tissue is within an ovary, that ovary will fill with blood. These are called endometriomas and are cysts in the ovary filled with old blood. This old blood has the appearance of thin chocolate or motor oil. They are also called chocolate cysts of the ovary. Endometriomas are frequently found at surgery for ovarian cysts. An elevated Ca-125 is often associated with endometriosis. (Source: William M. Rich, M.D. Clinical Professor of Obstetrics and Gynecology, University of California, San Francisco, Director of Gynecologic Oncology, University Medical Center, Fresno, California).

A video explanation on Kista endometriosis and its symptoms:



Ovarian cysts are fluid-filled sacs in the ovary. They are common and usually form during ovulation. Ovulation happens when the ovary releases an egg each month. Many women with ovarian cysts don't have symptoms. The cysts are usually harmless. (Source: Cheryl B. Iglesia, M.D., FACOG, Professor, Department of Obstetrics and Gynecology, Georgetown University School of Medicine; Director, Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center; Food and Drug Administration Advisory Committee).

A video explanation on Ovarian Cysts and its symptoms:

Why are so few major gynaecologic procedures performed laparoscopically?

The answer is relatively simple. Major laparoscopic surgical procedures are difficult for most gynaecologic surgeons to master. The gynaecologist must perform many simple laparoscopic procedures to develop the skill necessary to perform the more complex surgeries. They must perform these procedures on a regular basis to develop and maintain expertise. As a result, unfortunately, most gynaecologic surgeries for benign disease are still performed abdominally, although experts throughout the world agree that the vast majority could safely and efficiently be performed laparoscopically. However, it is important that the patient understand that these procedures should be performed by a qualified gynaecologic oncologist who has experience in the proposed procedure either using traditional surgical methods or Laparoscopic surgery.

The surgeries shown in the video clips are entirely done by Dr Vijayavel and my experienced team at KPJ Klang Specialist Hospital.

Dr Vijayavel's laparoscopic surgery removing kista endometriosis:

Dr Vijayavel's laparoscopic surgery removing ovarian cyst (gangrenous):

Further interesting viewing: 

World's largest ovarian cyst.
Giant ovarian cyst or pregnant?

Friday, April 22, 2016

Ovarian Cysts

Ovarian cysts: These growths can develop in a woman during her reproductive years. They can cause torsion (twisting), infection, rupture, and cancer. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis).

Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months. 

What causes functional ovarian cysts? 

A functional ovarian cyst forms because of slight changes in the way the ovary makes or releases an egg. There are two types of these cysts: 
  • A follicular cyst occurs when a sac on the ovary does not release an egg, and the sac swells up with fluid.
  • A luteal cyst occurs when the sac releases an egg and then reseals and fills with fluid.
Further viewing: 

Wednesday, April 20, 2016

Women's Health - Pregnancy Care

Pregnancy care consists of prenatal (before birth) and postpartum (after birth) healthcare. 

It usually consists of regular prenatal visits to monitor the wellbeing of the mother and baby as the both of them go through the journey to birth and identify any complications before they become serious.

Some doctors also have a provision for clinics after office hours at no extra charge to facilitate visits by the working mother.

Pregnancy Care and supplements? 

"It will be beneficial to take folate three months prior to conception. This reduces the occurrence of neural tube defects like spina bifida significantly. Some women may also want to take calcium and DHA as part of their supplementation." says OB-GYN Dr. Vijayavel, at KPJ Klang Specialist Hospital in Klang, Selangor.

Neural tube defects develop in the first 28 days after conception, before many women know they are pregnant. Spina bifida is a type of neural tube defect (NTD) that affects the spine, or spinal cord. With this condition, the neural tube does not close completely.  

Myelomeningocele is the most serious type of spina bifida-a sac of fluid with part of the spinal cord comes through an opening in the baby’s spine damaging the nerves. Neural tube defects happen in the first month of pregnancy, often before a woman even knows that she is pregnant. (

"The three most widely prescribed nutrients, are folic acid, iron and calcium," says Dr Vijayavel.

Folic acid is a water-soluble B vitamin. Folic acid helps prevent neural-tube defects; iron is important for the delivery of oxygen to the baby and prevents anemia in the mom; and calcium helps build your baby's bones and prevents bone loss in the mother.

It is recommended pregnant mothers shall take a 400 microgram folic acid tablet every day while trying to get pregnant until the twelfth week of pregnancy.

If you didn't take folic acid before you conceived, you should start as soon as you find out that you are pregnant.

Your diet shall contain folate (the natural form of folic acid), such as green leafy vegetables and brown rice. Foods that are naturally high in folic acid include leafy vegetables, fruits (such as bananas, melons, and lemons) beans, yeast, mushrooms, meat (such as beef), orange juice, and tomato juice.

It is difficult to get the amount of folate recommended for pregnancy from food alone, which is why it is important to take a folic acid supplement.

Your health care professional will prescribe a daily prenatal vitamin and or other vitamin and mineral supplements to help meet your additional needs.

Spina bifida?


The name spina bifida means split or divided spine and is used to describe a neural tube defect that affects the spine. If the neural tube fails to close in an area that goes on to develop into the spine the protective bones surrounding the spinal cord (vertebra) are unable to fuse together properly. As a result the spinal cord and its protective sac (meninges) may be pushed through the open part of the spine.

The symptoms associated with spina bifida vary depending on where in the spine the opening has occurred and how much of the spinal cord and/or protective sac are pushed through this opening. Generally the condition is more severe if the opening is above the base of the spine and if the spinal cord is pushed through the opening.

There are three different types of spina bifida which are defined according to the location and severity of the abnormality: 

Occulta is the mildest form and refers to when the outer vertebrae are not completely joined but the spinal cord and protective covering are unaffected. The only visible sign maybe a dimple, tuft of hair or small swelling at the site of the abnormality. There are usually no problems associated with this form of spina bifida. 

Meningocele is when the outer parts of the vertebrae fail to fuse and a cyst or fluid filled sac is pushed through the divide in the vertebrae. The sac contains the membranes that protect the spinal cord but no spinal nerves. The spinal cord itself is normal and not affected. The defect can be surgically closed after birth. 

Myelomeningocele is severest form of spina bifida. In these cases both the spinal cord and the protective covering are pushed through the opening in the vertebrae. Affected babies will have some degree of leg paralysis, after surgery, as well as bowel, bladder and other complications.  

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