FERTILITY SURGERY

For many women surgery can help them conceive. The benefit of surgery is that it can allow a couple to conceive on their own, woman can have more than one pregnancy from a single surgical procedure and most surgeries are covered by the BC MSP Heath Plan.

Genesis surgeons are highly skilled and experienced at performing minimally invasive surgery as well as larger invasive procedures to improve fertility.

Minimally invasive surgical procedures, include:

  • Hysteroscopy
  • Laparoscopy
  • Mini-incision tubal reversal

These minimally invasive surgeries have short recovery times, minimal scarring, and immediately improvement in fertility.

HYSTEROSCOPY

A hysteroscopy is a procedure used to look inside the uterus. This is done by inserting a thin telescope (called a hysteroscope) through the cervix and into your uterus. Salt water (saline) flows into the uterus once the hysteroscope is in place. This opens the uterine cavity and creates a clear picture on a TV monitor.

When is it used?
Hysteroscopy can be used to diagnosis or treat problems of the uterus.

Your doctor may suggest a diagnostic hysteroscopy if you have irregular or heavy menstrual periods, frequent miscarriages (lost pregnancies) or difficulty getting pregnant. It may also be used to investigate unusual findings on an HSG (x-ray of the uterus and tubes). Hysterscopy is also be recommended after a miscarriage or if it had been over one year since your uterine cavity has been assessed. No matter what your fertility problem, making sure your uterine cavity is as normal as possible is important.

If a problem is found on an ultrasound, hysterosalpingogram (HSG) or a diagnostic hysteroscopy then hysteroscopic surgery may be recommended. You must be asleep (i.e. have a general anaesthetic) to undergo hysteroscopic surgery. Hysteroscopic surgery can be used to remove fibroids, polyps or scar tissue from inside the uterus. It can also be used to treat septums of the uterus that some women are both with.

What are the risks?
There is a slight risk of infection (less than 1%), which is usually minor and can be treated with antibiotics. If you experience sharp abdominal pain, an increase in vaginal bleeding or a foul-smelling discharge, please contact the clinic immediately. To lessen the chance of infection, do not use tampons or put anything into the vagina for at least one day after the procedure, or until the bleeding stops.

What can I expect after a hysteroscopy?
A diagnostic hysteroscopy takes about 15 minutes. Many women feel some cramping as the hysteroscope goes into the uterus. After the procedure you will have a watery discharge and a small amount of bleeding. This can last for one to two days. After the hysteroscopy you can resume regular activities.

Hysteroscopic surgery takes 30 to 60 minutes, depending on what is being treated. The recovery takes approximately 24 hours, but you can expect bleeding for up to 1 week after the surgery.

How do I prepare for the hysteroscopy?
For a diagnostic hysteroscopy (done at Genesis) please take 400-600 mg of ibuprofen (Advil, Motrin or generic ibuprofen) 30-60 minutes before your procedure. You will be asked to sign a consent form prior to the procedure.

For hysteroscopic surgery no preparation is necessary. You will be put to sleep (i.e. given a general anaesthetic) by an anaesthetist at the hospital prior to the surgery.

It is important that you are not pregnant and not bleeding when a hysteroscopy is done. If there is a chance that you may be pregnant or bleeding at the time of the procedure, please let us know as we may reschedule and/or cancel the procedure.

How do I book a diagnostic hysteroscopy?
On the first day of your period, call us at (604) 879-3032 between 8:00 am and 3:30 pm. Press 0 to reach the switchboard and ask to speak to your doctor’s secretary. If your period starts on the weekend or the secretary is unavailable, leave a message and we will contact you by the next working day. You can also email us at genesis@genesis-fertility.com to book the appointment.

Please note: Hysteroscopies are booked on a first come/first served basis. We cannot guarantee a booking, but we’ll do our best to assist you.

A PDF version can be viewed here.

LAPAROSCOPY

Laparoscopy is a surgical procedure that involves looking directly into your abdomen and pelvis using a small (0.5 cm) camera that is placed through an incision in your umbilicus. This allows your doctor to evaluate and potentially treat gynecologic problems such as scar tissue (adhesions), endometriosis, and ovarian cysts that may affect fertility.

For this operation you will require a general anesthetic (you will be asleep), but in most cases you will go home the same day.

What are the risks?
There is a slight risk of infection (less than 1%), which is usually minor and can be treated with antibiotics.

Uncommon (1/1000 cases) but potentially serious complications including but not limited to injuries to the bowel (intestines), bladder, blood vessels and ureters have been reported with laparoscopy. Such complications may require further surgery to repair.

How do I prepare for the laparoscopy?
After meeting with your Genesis physician and deciding that laparoscopy is right for you, you will be given a date for your surgery by a Genesis staff member. The surgery centre will be calling you 2 days prior to your surgery date to confirm the time you need go to the centre.

It is important that you are not pregnant at the time of your surgery. We suggest that you either use birth control (eg. condoms) or abstain from intercourse for one month prior to you surgery. You will be asked to do a pregnancy blood test 2 to 3 days before your surgery to confirm that you are not pregnant.

What to expect after surgery
Getting Home: After an anesthetic, you are considered legally “impaired” and are unable to drive a car for 24 hours. You will need to have a friend/family member drive you home from the hospital.

Incision care: You will likely have 2 to 4 small incisions in your abdomen. After 48 hours of your surgery, your incisions are “sealed,” and it is safe to shower if you wish. At that time you can remove the outer bandage. Leave the inner bandages (Steri-Strips®) in place for 5-7 days after your surgery, if possible.

Pain: You will have some minor discomfort from your skin incisions in the first week after surgery. You can take pain medications such as Ibuprophen 600 mg every 6 hours and/or Tylenol 650 mg every 4 hours. You will also be given a prescription for Tylenol #3.

Most women experience bloating, abdominal discomfort and/or back and shoulder tip pain for 24-48 hours after surgery. This is normal and is related to the gas used to distend your abdomen during the surgery. This pain should NOT be severe and should gradually improve over 24-48 hours.

You should call your doctor if you have:

  • Pain not controlled with pain medications listed above
  • Worsening pain beyond 24-48 hours after surgery
  • Nausea and vomiting
  • Concerns regarding skin infection (increasing pain, redness or discharge from the incisions)

 

For daytime and non-urgent questions, please call Genesis at (604) 879-3032.

For urgent problems after business hours, please go to the nearest emergency department.

A PDF version can be viewed here.

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