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Hysterectomy: Then and Now

A hysterectomy, or removal of the womb, is one of the most commonly performed operations by gynaecologists - second only to Caesarean Sections.

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The Project - 28 August 2017

Gynaecologist Michael East and endometriosis coach Deborah Bush speaking out about endometriosis.


 

 

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The Goop Lab episode that managed to win over an actual gynaecologist

Stuff.co.nz Jan 29 2020

Critics might have deemed it "irresponsible" before it was even released, but Gwyneth Paltrow's new Netflix show The Goop Lab has found an unlikely fan — a Kiwi gynaecologist. 

The six-episode series, which showcases Paltrow's controversial lifestyle brand, guides viewers through an array of wellness topics, including psychedelics, cold therapy, energy healing and psychic mediums. While many were skeptical about the show and what it would promote, the third episode — centred around female pleasure — has won praise from both viewers and health professionals. 

"I thought I was going to hate it," said Dr Olivia Smart, a consultant gynaecologist in Christchurch. 

"I was initially very skeptical about what the content might be around. In the past, she's talked about vaginal steaming and jade eggs and all that sort of nonsense which, from a medical standpoint, we've frowned upon. But I was pleasantly surprised by the content."

The episode features 90-year-old sex educator Betty Dodson and her business partner Carlin Ross, who begin by schooling Paltrow on the difference between a vagina and a vulva.

"The vagina is the birth canal only," Dodson explains.

"You want to talk about the vulva, which is the clitoris and the inner lips and all that good s... around it."

A series of photos of real women's vulvas are later shown as part of a "genital show-and-tell" session. 

Smart said in her own practice, she often used resources like the "Labia Library" to dispel common myths about female anatomy, and praised Paltrow's show for employing a similar tactic.

"We're seeing a rise in women seeking cosmetic revision of their labia, wanting to change the shape or size of what is essentially normal genital anatomy," she said. "Often all they need is reassurance. I thought it was really good to show the wide variation in labial appearances." 

Another groundbreaking moment sees Dodson explain her "rock and roll" orgasm technique, with Ross giving a demonstration — and achieving an on-camera climax.

"Some people may feel shocked or affronted by seeing female orgasm on television," Smart said. "But it challenges the status quo and it brings down the walls and the stigma that's associated with it." 

Goop, which Paltrow founded in 2008, has frequently come under fire for its dubious health claims. In 2018, the company had to pay US$145,000 (NZ$218,000) after claiming products such as jade and rose quartz eggs, designed to be inserted into the vagina, had medical benefits.

Smart has also spoken out against Goop previously, saying a "vagina" scented candle the company was selling sent the wrong message to women.

While she remained wary of Goop, she said the female pleasure episode contained something for any woman who is interested in her own sexual pleasure — and for that reason, it could be "very useful".

"With all the information bombarding us from the media, you're led to believe that if you drink fresh celery juice and don't eat for 23 hours a day, you're going to fart magical unicorn dust," she said. "We have to appraise all the information that's given to us at an individual level and where you want to evaluate outcomes there should be a scientific approach to that.

"But I think this fell outside a scientific scope and it was more of a holistic approach to sexual wellness."

https://www.stuff.co.nz/entertainment/tv-radio/119125042/the-goop-lab-episode-that-managed-to-win-over-an-actual-gynaecologist

 

Gwyneth Paltrow's 'vagina-scented' candles send dangerous message, says doctor

stuff.co.nz January 15 2020

Gwyneth Paltrow's "This Smells Like My Vagina" candle is sending the wrong message to women, according to a Christchurch gynaecologist.

Dr Olivia Smart of Oxford Women's Health said she was uncomfortable about the way the candle, which is currently sold out with a waitlist on Paltrow's lifestyle website Goop, was being marketed. 

According to the product description, the candle has "a funny, gorgeous, sexy, and beautifully unexpected scent" derived from "geranium, citrusy bergamot, and cedar absolutes juxtaposed with Damask rose and ambrette seed."

But that's not how any real vagina smells, said Smart, and Goop's description could cause distress or even damage to women. 

"The ingredients for Gwynnie's candle don't smell like any vagina I have seen," she said.

"I think it's sending the wrong message to women about what their vaginas might smell like, or should smell like, which is always an area that women can be self-conscious about and you don't want to do anything that could exacerbate or enhance that."

She was concerned that "likening vaginal smell to fragranced candles could encourage the use of scented cleansers or, even worse, vaginal douching."

Chemical products could be very irritating to the genital area and could cause problems like bacterial vaginosis, while douching could interrupt the healthy bacteria in the vagina.

Vaginas, Smart said, are "self-cleaning" and have a natural odour which could vary according to factors like what part of her menstrual cycle a woman was in or whether or not she had recently had sex. 

"Even general well-being and stress levels can affect the balance of the naturally occurring bacteria called the vaginal microbiome."

In general, Smart said the scent of your vagina "shouldn't be something that you worry about", although a particularly foul odour could be a sign of infection and should be checked out by a doctor.

While Smart appreciated that the name of the Goop candle was a marketing strategy, it was part of a bigger mechanism that traded in "women's vulnerabilities and self-consciousness".

"That's the premise of the vast majority of marketing to women, be it your hair's not long enough, you're not slim enough, you've got too many wrinkles... (This is) just an extension of that."

She said women were generally becoming much more comfortable talking to each other or their doctor about concerns related to their genitalia and encouraged anyone who was concerned to seek out good information that could answer their questions "in a sensible and medically justified way".

And listen to doctors, not celebrities, Smart said.

"A healthy vagina can smell like a lot of different things - but bergamot is not one of them."

https://www.stuff.co.nz/life-style/well-good/118782690/gwyneth-paltrows-vaginascented-candles-send-dangerous-message-says-doctor

 

3-D tech helps surgeons get full picture

The Press/stuff.co.nz January 29 2018

Surgeons at a private Christchurch health clinic say new 3-D imaging has revolutionised their work and will speed up patient recovery time. Gynaecologists at Forte Health Hospital are the first to use the equipment, the first of its kind in the South Island, in procedures to treat endometriosis and hysterectomies. Previously specialists could see two-dimensional images of surgical sites using a camera attached to a laparoscope, an instrument used to view organs through a small incision in the abdomen.

To navigate the surgical site, they relied on the 2-D images, their knowledge of anatomy, and the ability to sense where their instruments were without being able to see everything. The new three-dimensional equipment allows them to view the surgical site in full.

"What you have got now is a 3-D image where you can see that depth and you can progress more quickly and accurately," Oxford Women's Health gynaecologist Mike East said.

The equipment had made the procedures easier, faster and enabled surgeons to be more precise, he said.

"Very often the endometriosis is very close to vital structures or the rectum and also the reproductive area so you have to be mindful of protecting them, so you have to move very carefully and this has made it a little bit easier."

In many cases patients could have shorter recovery time as a result of the equipment. Beyond this, it was difficult to assess improvements for patients, East said. 

"We believe we did a good job with the previous equipment . . . it's hard to measure because complication rates are low anyway." 

East said he felt much more confident using the new technology, especially in difficult procedures for more advanced endometriosis. 

Despite a price tag of $250,000, the equipment would become standard throughout operating theatres in New Zealand in future, he said.

The Canterbury District Health Board did not respond to queries about plans to purchase the equipment for use by public hospital surgeons in time for publication.

http://www.stuff.co.nz/national/health/100912470/3-D-tech-helps-surgeons-get-the-full-picture-in-Christchurch

 

Oxford Women's Health - Preserving Future Fertility

Metropol Magazine October 2016

For young woman facing a diagnosis of endometriosis, fertility is usually the last thing on their minds. But according to specialists at Oxford Woman's Health, being proactive in dealing with pelvic pain can help to preserve future fertility.

"Unfortunately women who have endometriosis have a higher chance of experiencing fertility problems," says Richard Dover, a clinician at Oxford Woman's Health and specialist at Genea Oxford Fertility. "We need to ensure that future fertility is considered throughout our conversations and we need to treat the pain." 

Mr Dover says the subject of fertility often arises when mothers who have experienced endometriosis and fertility issues come into appointments with their daughters. "Mothers who have had endometriosis are very switched on about potential fertility. Their daughters don't always appreciate how precious it is." 

It is thought that as many as 10% of women may have endometriosis. In many of these women, the disease will be chronic and progressive. Early diagnosis and intervention will improve symptoms, reduce the chances of developing chronic pain and minimise potential fertility issues.

Mr Dover stresses that the management of endometriosis does not always include surgery, although it does have an important role. He advocates a multidisciplinary approach, which includes the options of medical and surgical therapies, but also addresses the role of diet, physiotherapy and education.

"We've developed a multidisciplinary team at Oxford Women's Health that includes nutritionists; a physiotherapist with an interest in pelvic pain; a clinical psychologist; clinicians who are actively involved with Endometriosis New Zealand; and a group of senior gynaecological surgeons who are all recognised for their advanced laparoscopic surgical skills." 

"We want to eradicate endometriosis but not at the risk of damaging future fertility. Endometriosis is not a black and white issue so we offer a range of surgical, medical and holistic options. 

"And we have access to our own world class facility clinic, Genea Oxford Fertility. A large proportion of patients at Genea Oxford Fertility have endometriosis so we've developed a special protocol to manage their fertility treatment."

"We can tailor our treatment plans and pain management to suit each individual. It's an example of how we use our gynaecological expertise to treat endometriosis proactively and improve fertility outcomes for out patients."

If you suspect you have endometriosis, or a problem conceiving, call Oxford Women's Health on 03 379 0555. 

 

Non-invasive prenatal genetic testing now available to South Island women

2 July 2015

Pregnant women in the South Island now have access to the fastest, most accurate, non-invasive prenatal genetic testing in New Zealand.

GeneSyte is a simple blood test that offers a 99 per cent detection rate for Down syndrome without the risk of miscarriage involved in more invasive prenatal tests.

Available exclusively at Genea Oxford Fertility in Christchurch and at consultations at the Mornington Health Centre in Dunedin, the test also picks up many other chromosomal abnormalities*. Because samples are sent to Australia rather than the US or Asia, results are available within 10 working days.

GeneSyte is the latest in prenatal chromosomal testing and comes without the need for invasive procedures such as amniocentesis. It's fantastic to be able to provide the test here in Christchurch to give pregnant women and couples faster, safer and more accurate peace of mind, Genea Oxford Fertility Clinical Director Richard Dover said.

One of the many other advantages of this test is that parents-to-be receive definitive yes and no answers rather than information on a sliding scale, Mr Dover said.

The test, also known as Non-Invasive Prenatal Screening (NIPS), involves taking a blood sample from a woman, who is between 10 and 20 weeks pregnant. The fetal DNA in the blood is then analysed using advanced molecular biology techniques.

Because of the important implications of the results, Genea Oxford Fertility offers a clinical consultation as part of the $775 fee for the test.

Recently established at Forté Health in Christchurch, Genea Oxford Fertility is a partnership between Australian fertility specialists Genea and the local, experienced team of health professionals at Oxford Women's Health. Genea is a pioneer in prenatal screening with more than 28 years' experience in the field.

To find out more about GeneSyte call Genea Oxford Fertility on 0800 377 894 or talk to your family doctor.

* GeneSyte can detect abnormalities relating to chromosomes 21, 18 and 13, and the X and Y chromosomes. Down syndrome, Edwards syndrome, Patau syndrome and Turner syndrome are among the conditions that can be detected through the test.

 

Christchurch specialist, a leading light in women's health

25 June 2015

A Christchurch gynaecologist is taking a leading role in improving the lives of women with incontinence and prolapse across Australasia.

John Short, a gynaecologist at Oxford Women's Health, Christchurch, has recently been elected to the prestigious Executive Board of the UroGynaecological Society of Australasia (UGSA). He is the only New Zealand representative on the committee, joining five specialists from Australia.

It is the first time a Christchurch specialist has served on the Board and Short says it's an honour to be involved in helping to set standards for health care and advance the science of urogynaecology.

Urogynaecology is a branch of gynaecology, focusing on incontinence, prolapse and associated problems. UGSA members include gynaecologists and specialists in fields such as urology and physiotherapy.

Short says about 25 per cent of New Zealand women suffer from incontinence (loss of bladder control) and vaginal prolapse (bulging). The costs to the New Zealand economy have been estimated at $8 billion per year in direct health care, lost productivity, carer support and other costs.

While they are not fatal conditions, they can make life miserable, Short says. "Unfortunately many women do not seek treatment. There has been a tendency to accept these problems as a normal consequence of childbirth and ageing and many women persevere with their symptoms thinking there is no help available."

At Oxford Women's Health, Short provides a range of non-surgical and surgical treatments for his patients.* He says it's important all women experiencing incontinence or prolapse are thoroughly assessed and treatments are tailored to their needs.

"Whilst obviously not the most glamorous area of medicine, this work is hugely satisfying," Short says. "These problems can severely affect all aspects of life, from work to recreational activities to interactions with friends and family. The sense of satisfaction from fixing someone's problems and helping them get back to enjoying life is enormous."

Short is also a consultant obstetrician and gynaecologist at Christchurch Women's Hospital. He is a RANZCOG training supervisor and an advisor to the Health and Disability Commissioner.

*O&G Magazine recently published an article by John Short, summarising the non-surgical management of prolapse. The link is https://www.ranzcog.edu.au/editions/cat_view/38-publications/409-o-g-magazine/410-o-g-magazine-issues/719-vol-16-no-1-autumn-2014.html