Welcome to Caring Gynae

We are a specialist clinic located at the third floor (East Wing) of the KPJ Klang Specialist Hospital in Klang, Selangor. The best gynaecologist in Klang.

Located at the end of the NKVE (Bukit Raja exit) and the Federal highway, the hospital is easily accessible. We offer personalised and supportive care for women through every stage of their lives. Each woman faces differing challenges and we strive to provide the highest standards of professional care in a caring and compassionate environment. The usage of advanced technologies and minimally invasive surgical techniques, backed by KPJ Healthcare's 30 years of experience enables us to help women make informed decisions in achieving the highest standards of care for their overall wellbeing.

Dr Vijay is specialised in:

Gynae Oncology
Gynae Laparoscopy Hysterectomy
Gynae Ovarian Cyst
Gynae Fibroids

Dr Vijayavel is the best gynaecologist doctor in Klang.

Gynae Oncology Malaysia

 

What is a Gynecologic Oncologist?

Gynecologic oncologists are specialists in the area of female reproductive cancers. After medical school, they spend another 4 years obtaining their specialist degree and qualify as an Obstetrician and Gyanecologist. After that they spend a further 3-4 years sub-specialising in gynae cancers. They are trained in all the treatments for gynae cancers - surgery, radiation and chemotherapy.

What can a gynae-onc do that other doctors can't?

Gynaecologic oncologists do not only perform surgery on the female reproductive system, but on all the organs of the pelvic and abdominal tissues and organs which may be involved if cancer has spread. Most importantly, they are extensively trained in the vital techniques of surgical staging and cyto-reductive surgery (also called "debulking"). These procedures can ultimately be a matter of life and death. In some cases, accurate surgical staging does not take place because the patient does not see a gynaecologic oncologist and is ill informed. They are only referred to gynaecologic oncologist after surgery and this usually alters the outcome.

Even when other O&G specialists perform surgical staging procedures, they are less likely to do it as accurately as a gynae oncologist. My trainers used to tell me - "it's not about the money, it's about doing what is right especially when it involves cancer or suspicion of cancer".

Finding the exact stage of the cancer is vital to planning the best treatment. In the case of surgery, gynae oncologists simply do a better job of finding and removing tumours that have spread in the pelvic and abdominal areas.

Gynae Laparoscopy Malaysia

Dr Vijayavel, the top Gynae Laparoscopy surgeon in Malaysia.
Watch Dr Vijayavel performs in this vide: Laparascopic Hysterectomy Specialist in Selangor.

Take a look at the technique Dr Vijayavel in his daily work.

What is Laparoscopic Gynaecologic Surgery?

Laparoscopic Gynaecologic Surgery is done through a small telescope. There are many different types of laparoscopic surgery for women. Some of the most common procedures include:

• Hysterectomy

- small or large uterus

• Vault Suspension

- for vault prolapse

• Myomectomy

- fibroid removal

• Uterine Suspension

- for prolapse, IVF procedure

• Bladder Support

- for incontinence (leaking urine)

• Cyst Removal

- endometriosis, dermoid cyst

• Diagnostic Laparoscopy and diathermy

- PCOS and other benign gynaecological conditions

*This list is just a small portion of the total amount of laparoscopic procedures that can be performed for women.

How Does Laparoscopic Gynaecological Surgery Work?

Laparoscopic surgery is minimally invasive. This means that these procedures are designed to be done with small incisions, as opposed to traditional open surgery. During a typical laparoscopic procedure:

• A small incision is made in the abdomen.
• The laparoscope, which includes a light and camera, is inserted in through the incision.
• This tool allows the surgeon to view the surgical site, and then make adjustments with surgical tools as needed. Other small incisions will be made as necessary.

The rest of the procedure will vary depending on which specific type of surgery is being performed.

Some positive aspects of laparoscopic gynaecology include:

• Smaller incisions
• Less pain and faster recovery
• Shorter hospital stays
• Potential for outpatient procedures
• Less blood loss
• Reduced scarring
• Faster healing time within two weeks of surgery

Laparotomy (the technique by which most gynaecologic procedures are done) involves an incision in the abdomen usually measuring 5 to 11 inches long. This incision is horizontal (the so-called "bikini" incision) or vertical (from the pubic bone to the belly button). This large incision is required for gynaecologists to use standard surgical instruments. This significantly larger incision is associated with a much longer recovery, more postoperative pain, longer hospital stays, and more potential complications than the same procedure performed by laparoscopic techniques.

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 me and my experienced team at KPJ Klang Specialist Hospital. Dr. Vijayavel is the best Gynae Oncology doctor in Malaysia.

Women's Cancer - Ways To Lower Womens Cancer

Many people probably know that carrying too much weight around isn’t good for your heart, but did you know that it’s a major risk factor for women's cancer as well? Obesity is the culprit behind some 14% of cancer deaths, and more than 3% of new cancer cases, every year.

“Our No. 1 recommendation for cancer risk reduction is to stay as lean as possible within a healthy weight range. This may be one of the most important ways to prevent cancer,” says Alice Bender, MS, RD, manager of nutrition communications at the American Institute for Cancer Research (AICR).

In November 2007, the AICR put out an expert report summarizing how food, nutrition, and physical activity affect cancer and cancer prevention. Being overweight, according to the AICR report, is linked to a wide variety of cancers, including esophageal, pancreatic, gall bladder, breast, endometrial, and kidney cancers.

Fatty tissue in women who are overweight produces additional estrogen, a sex hormone which can increase the risk of uterine cancer. This risk increases with an increase in body mass index (BMI; the ratio of a person's weight and height). About 40% of cases are linked to obesity.

It seems fair and just that conscientiously working out should confer disease-fighting benefits, especially against women's cancer, and an accreting body of research suggests that under certain conditions and against certain forms of cancer, fitness may be remarkably protective. A major review article published in February on the Web site of the British Journal of Cancer synthesized the results of more than two decades’ worth of studies and concluded that the most active people are 24 percent less likely to develop uterine cancer than sedentary people are, regardless of their diets, smoking habits or body weight. Another study, this one presented in May at the annual meeting of the American College of Sports Medicine reported that women over age 30 who defined themselves as “highly competitive” by disposition and who exercised more than the average for the group had much less risk of developing breast cancer than women who worked out for less than 60 minutes per week. 

Prevention

Different factors cause different types of cancer. Researchers continue to look into what factors cause this type of cancer. Although there is no proven way to completely prevent this disease, you may be able to lower your risk. Talk with your doctor for more information about your personal risk of cancer.

Research has shown that certain factors can lower the risk of uterine cancer:

• Taking birth control pills, especially over a long period of time
  
• Considering the risk of uterine cancer before starting HRT, especially estrogen replacement therapy alone. Using a combination approach to HRT may help lessen risk.
  
• Maintaining a healthy weight
  
• If diabetic, maintaining good disease control such as regularly monitoring blood glucose levels
  

Along with a healthy diet and lifestyle choices, regular exercise is one of the best things women can do to keep the risk of a first-time women's cancer or recurrence as low as it can be. This study adds to other research suggesting that regular exercise reduces breast cancer risk. Regular exercise also helps keep your physical and mental health in top shape. No matter how old you are, it’s never too late or too soon to get moving. And once you do start, keep at it! 

Dr Vijayavel is a top gynae oncology surgeon in Malaysia.

 

 

Intramural Fibroid

 

What are Intramural Fibroids? 

Intramural fibroids are one of the most common types of uterine fibroids, found in 70% of women of childbearing age. Unlike subserosal fibroids, which develop on the outside covering of the uterus, and submucosal fibroids, which develop just under the lining of the uterine cavity, intramural fibroids develop within the wall of the uterus.

Intramural fibroids begin as small nodules in the muscular wall of the uterus. With time, intramural fibroids may expand inwards, causing distortion and elongation of the uterine cavity. Sometimes these fibroid tumors may grow towards the endometrial cavity to become submucosal fibroids or they may even grow towards the outer surface of the uterus to become subserosal fibroids. 

Effect of Fibroids on Reproduction

The impact of fibroid tumors on successful reproduction, have a lot to do with location. For the most part, only those fibroids that impinge upon the endometrial cavity (submucosal) affect fertility. Exceptions include large intramural fibroids that block the openings of the fallopian tubes into the uterus, and where multiple fibroids cause abnormal uterine contraction patterns. Another lesion that can cause significant problems is the one that grows off the back side of the uterus and occupies to a greater or lesser degree, the cui de sac (area behind the uterus). This location is very important in the physiology of conception, therefore it is not uncommon to see patients with these kinds of lesions present with infertility. 

Surgery to treat fibroids can also affect fertility in several ways. If the endometrial cavity is entered during the surgery, there is a possibility of post operative adhesion formation within the uterine cavity. This should always be checked for through the performance of a hysteroscopy or fluid ultrasound prior to beginning fertility treatment. Because myomectomy can be bloody, there is a high likelihood of abdominal adhesion formation, which could encase the ovaries, preventing the release of the eggs or block the ends of the fallopian tubes, or otherwise interfere with the normal functioning and relationships of the pelvic organs. For this reason it is important that only accomplished surgeons, who are familiar with techniques to limit blood loss and prevent adhesion foundation, perform myomectomies. In some cases multiple uterine fibroids may so deprive the endometrium of blood flow, that the delivery of estrogen to the uterine lining (endometrium) is curtailed to the point that it cannot thicken enough to support a pregnancy. This can result in early 1st trimester (prior to the 13th week of pregnancy) miscarriages. Large or multiple fibroids, by curtailing the ability of the uterus to stretch in order to accommodate the spatial needs of a rapidly growing pregnancy, may precipitate recurrent 2nd trimester (beyond the 131h week) miscarriages and/or trigger the onset of premature labor. As stated above, the location of the lesions is very important in the symptoms/impact. A lesion positioned just beneath the endometrial lining can make the structural integrity of the endometrium quite unstable and therefore, unable to develop in a progressive manner in preparation for implantation of the embryo. 

Treatment of Intramural Fibroids

If intramural fibroids aren't interfering with a woman's ability to get pregnant and aren't causing any pain, it is likely they will be left untouched. However, if the intramural fibroids are large, treatment might be necessary to reduce the symptoms produced by them.

These uterine fibroids are generally treated by means of three types of surgical procedures:

• Removal of one or more intramural fibroids by open abdominal surgery called abdominal myomectomy.
• Destruction of the fibroids through uterine artery embolization in which polyvinyl alcohol beads are injected into the uterine artery with a catheter to block the flow of blood to the intramural fibroids.
• Hysterectomy which looks to remove the uterus.

At the present time, effective medicines that can permanently shrink these fibroidsare not available. Hence, surgical removal is the best option available for the treatment of intramural fibroids.

In this video, Dr. Vijayavel performed laparascopy on a patient who had large intramural fibroid [10cm by 12cm] and how he safely removed all of them.

What are Subserosal Fibroids?

Subserosal uterine fibroids develop on the outer surface of the uterus and continue to grow outwards, giving the uterus a knobby appearance. At times, these fibroids tumors may be connected to the uterus by the means of a long stalk or a stem-like base. Such stalked fibroids are called pedunculated subserosal fibroids. These fibroids are often difficult to distinguish from an ovarian mass. 

Over time, subserosal uterine fibroids may grow quite large but, unlike submucosal fibroids, which can greatly disrupt the shape of the uterine cavity as they develop beneath the uterine lining, these fibroids do not typically affect the size of the uterus’ cavity. Like intramural fibroids, which grow inside the wall of the uterus, subserosal fibroids are also quite prevalent among women in their prime reproductive age. 

What are the Symptoms of Subserosal Fibroids?

In the majority of women, subserosal fibroids produce no symptoms. Problems are customarily caused by large and pedunculated subserosal fibroids tumors. Some of the typical symptoms experienced by women with subserosal fibroids include:

• Pelvic pain
• Back pain
• Constipation and bloating
• A generalized feeling of heaviness or pressure
• Frequent urination
• Kidney damage due to compression of the ureter
• Abdominal cramping and pain
• At times, pedunculated subserosal fibroids can twist and cause pain 

As subserosal fibroids are located on the outer surface of the uterus, they typically do not affect a woman’s menstrual flow. 

In this video, Dr. Vijayavel performed laparascopy on a patient who had fibroids and how he safely removed all of them.

 

Women's Cancer - Uterine Cancer

The uterus is a hollow, muscular organ where a fetus grows. Uterine cancer is one type of womens cancer and can start in different parts of the uterus. Most uterine cancers start in the endometrium (the inner lining of the uterus). This is called endometrial cancer. Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make mucus and other fluids).

Because endometrial cancer is often discovered at an early stage of its development in the body, most women are cured. Even if the disease is not discovered until after it has advanced, treatment is still possible but the likelihood of a long-term cure is lower. 

Uterine sarcoma is an uncommon form of uterine cancer that forms in the muscle and tissue that support the uterus.

Obesity, certain inherited conditions, and taking estrogen alone (without progesterone) can increase the risk of endometrial cancer. Radiation therapy to the pelvis can increase the risk of uterine sarcoma. Taking tamoxifen for breast cancer can increase the risk of both endometrial cancer and uterine sarcoma.

The most common sign of endometrial cancer is unusual vaginal bleeding. Endometrial cancer can usually be cured. Uterine sarcoma is harder to cure. 

Symptoms

If you are concerned about symptoms it is important that you see a gynaecologist (specialist doctor in women’s health). It is more likely that your symptoms are not related to cancer but it is important to have any symptoms checked.

Symptoms of endometrial cancer include:

• bleeding after you have been through menopause (once your periods have stopped for twelve months)
• unusually heavy periods and bleeding inbetween your periods
• an unusual fluid or discharge from your vagina that is watery, bloody or smelly
• pain in your belly or abdomen
• trouble going to the toilet to pass urine (wee) or pain when you do go.

See a doctor if you have any of these symptoms and they don’t go away and/or are unusual for you. 

Treatment

Treatment options include surgery, radiation therapy, and chemotherapy.

Surgery to remove the uterus (hysterectomy) may be done in women with early stage 1 cancer. The doctor may also recommend removing the tubes and ovaries.

Surgery combined with radiation therapy is another treatment option. It is often used for women with

• Stage 1 disease that has a high chance of returning, has spread to the lymph nodes, or is a grade 2 or 3.
• Stage 2 disease.

Chemotherapy or hormonal therapy may be considered in some cases, most often for those with stage 3 and 4 disease.