Category: Womens Health

Chronic Pelvic Pain

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hronic pelvic pain (CPP) is one that is located at the level of the lower abdomen, the pelvis, or intrapelvic structures, persisting for at least six months, which occurs continuously or intermittently.

If it is not acute and the mechanisms of central pain sensitization are well documented, pain is understood as chronic regardless of the elapsed time. In all cases, it is frequently associated with negative consequences in the cognitive, behavioral, sexual, and emotional areas.

Chronic pelvic pain is a complex condition in which symptoms of the reproductive, urological, gastrointestinal, abdominal wall, pelvic floor, and psycho-social factors are frequently intermingled, so an exhaustive clinical history becomes very important.

Multidisciplinary Management of Pain

CPP is a symptomatic complex that can originate from gastrointestinal, urological, reproductive, musculoskeletal, or neurological diseases. When the cause of the pain is evident, the treatment is directed to treat it. However, a subgroup of patients persists with pain despite treatment of the underlying cause.  It is in this context that the multidisciplinary management of CPP, with the planned and interactive participation of different specialists (urologist, gynecologist, gastroenterologist, coloproctologist, pain specialist, psychiatrist, psychologist, kinesiology among others) is very important in both the study and treatment.

Multimodal therapy is redirected to treat the pain and the underlying cause -if it exists- and all those biological, psychological, and environmental factors that are influencing it.

A proper therapy for this condition includes medical treatment (non-steroidal anti-inflammatory drugs, opioids, antidepressants, neuromodulators, muscle relaxants, alpha-blockers), but also psychotherapy, non-pharmacological therapy of the pelvic floor (biofeedback, myofascial massage), pelvic floor pharmacological therapy (injections in points trigger, botulinum toxin), bladder instillations, neuromodulation and surgical interventions (adhesiolysis, uterine neuroablation, presacral neurectomy) when appropriate.

At The Harley Street Hospital, we have the best specialists who can help you to treat chronic pelvic pain effectively. Book a consultation.

Cervical Smear Test

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n women, there may be precancerous cervical lesions for many years without causing any symptoms. The slow growth of these lesions offer many opportunities for early detection and easy healing. The cervix can be palpated and seen in a gynecological examination so that the doctor can easily obtain a smear of its surface for a cytological examination of the cells that detach from the surface of the cervix.

The smear cells are examined in the laboratory, which allows early diagnosis of a precancerous lesion, that is, an abnormality of the cells on the surface of the cervix called dysplasia that, over the years, can cause cancer. By means of the smear, it is also easy to detect incipient cancer, before it becomes dangerous (malignant).

In the laboratory examination, the cells in the smear can:

• Be normal.
• Reveal a mild dysplasia that is usually due to HPV infection.
• Reveal moderate or severe dysplasia. Such injuries could progress to cervical cancer if left untreated.
• Reveal cervical cancer.

A vaginal infection can prevent proper examination of the cells of a smear. In that case, a new smear is made after the infection has been cured by proper treatment.

In addition to cytology, specifically in cases of uncertain cytological diagnosis, the presence, and type of HPV (Human Papilloma Virus) can be analysed in the laboratory, which will provide information on the risk of presenting abnormalities associated with HPV infection. The results of the HPV test do not affect in any way the future treatment plans

Experts recommend doing this test once a year after a woman has started active sexual life. At The Harley Street Hospital, we have the best doctors to perform cervical smear tests. Book an appointment.

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Well Woman Check

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here are many diseases that can be cured if they are detected early.  For this reason, it is of vital importance to carry out the corresponding medical check-ups, according to the age and the risk factors that patients have.

A routine gynecological examination should be performed for the following reasons:

• Detect health problems focused on gynecology, including breast diseases and cervical, uterus, or womb lesions.
• Evaluate the risk factors that can develop diseases in the female genitals or breasts.
• Monitor health changes through time.
• Provide advice on contraceptive methods if the patient requests it.
• Promote and provide teachings about their well-being and habits for good health.

Who should take a gynecological routine exam?

• Women should start to perform their gynecological exams at 18 years old or when they begin their sex life.
• When there are alterations in the menstrual cycle.
• Those women who have family history in first grade of breast cancer, that is, mother or sister.
• Preconceptional exam, that means, before getting pregnant.

Below, we give you a guide with the routine gynecological exams required for every woman:

Gynecological Control

All women of childbearing age or with alterations in menstrual periods should be monitored once a year. This should continue after menopause.

In this control, risk factors, the patient’s menstrual history, your sex life in terms of age at start and number of partners, among other important aspects.

Mammography

It serves to detect early breast cancer and must be performed annually starting at 40 years old. A woman with a background of relatives with breast cancer must undergo more rigorous control, which implies an early review.

Transvaginal Ultrasound

This test is done with the objective of evaluating specifically uterus and ovaries. It’s not performed routinely, its periodicity will depend on the symptoms or findings.

Vaginal Cytology

This exam is aimed at detecting very early precancerous lesions in the cervix. It is recommended to do this examination every year or earlier if in the result of the previous cytology presented some alteration.

Bone Densitometry

It is advisable to evaluate the state of the bones, especially of those women who are in the stage of menopause. If the results are normal, it is recommended to repeat it every two or three years.

At Harley Street Hospital, we have recognized doctors who can perform well woman checks. Book an appointment with us to stay healthy.

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