Ask the Doctor - October

Sunday 31st October - Hysterectomy

Dr Cameron W Martin is a consultant gynaecologist specialising in Minimal Access Surgery at Spire Murrayfield Hospital. 

In the UK, most hysterectomies are performed through a large cut to the lower tummy wall.  Laparoscopic (keyhole) surgery, however, allows the same operation to be performed through three tiny incisions. Benefits include a short hospital stay (typically 1 or 2 days following hysterectomy), less blood loss, lower risk of infection and much quicker return to normal activity. Treatment of endometriosis, ovarian cysts and fibroids  are also suited to this type of surgery and most patients will go home the same day. A recent advance has allowed us to refine techniques further and we performed the first ever hysterectomy in Scotland through a small single cut in the tummy button. This single incision laparoscopic surgery (sils) in gynaecology further reduces scarring. Keyhole surgery is appropriate for most patients, even for the treatment of certain cancers. It should only ever be undertaken by an surgeon experienced in this highly specialised field.

Sunday 24th October - Bladder Control

Kate Leishman is the Specialist Women and Men’s Health Physiotherapist at the Spire Murrayfield Hospital and Spire Livingston Physiotherapy Clinic.

This is a very common problem following prostate removal.  The surgery involved damages some of the continence mechanism at the base of the bladder and therefore leakage is very common.  However, there is simple solution to this problem.

Pelvic floor exercises can improve this situation considerably and are recommended following this type of surgery.  These can be difficult to do initially and you may need some help from a specialist physiotherapist to find the right muscles.  Once you can do these exercises correctly it is important to continue to do them to maintain the improvement.  You should expect to see some improvement in your symptoms in the first 3-6 months of exercising, but results can take up to one year to achieve. 

You can also use these muscles to prevent leakage when lifting, getting up from a chair, coughing and sneezing etc.  They can also help restore sexual function following this type of surgery.

Sunday 17th October - Weight Loss Surgery

I am a type 2 diabetic on insulin and I am also significantly overweight.  My attempts to lose weight have failed – will weight loss surgery help me? Sam, Linlithgow

Andrew De Beaux is a Consultant Bariatric surgeon at Spire Murrayfield & Shawfair Park hospital.

Diabetes is a common disease which is associated with being overweight.  Current treatments including insulin to improve the control of your blood sugar are recognised to cause weight gain.  It is also recognised that people who are diabetic find it harder to lose weight than non-diabetic people.

Weight loss surgery, in particular, the gastric bypass can ‘cure’ diabetes within 48 hours of surgery.  If you have been on insulin for more than 5 years, you are less likely to be cured, but you will still benefit from other health benefits following weight loss.  Gastric band surgery will also help you with your diabetes but this benefit happens more slowly as you lose weight.  Diabetes can occur in people with normal weight, so surgery may not ‘cure’ your diabetes forever, but delay the onset of the disease.  This is still important, as the longer you suffer from diabetes, the more damage the disease does to your body.  The risks of diabetes needs to be set against the risks of any surgery to help with your weight control.  In general, if you are significantly overweight, the balance of risks are in favour of surgery.

Specialist nurses and surgeons are available to discuss this further at Spire Edinburgh Hospital

Sunday 10th October - Tummy Tuck

I have exercised a lot and lost weight, but just can’t get rid of my tummy bulge. Gillian, Edinburgh

Mr Hilal Bahia a consultant plastic and aesthetic surgeon at spire Murrayfield Hospital.

Abdominoplasty is available for men and women.  It can remove the excess fat, skin, stretch marks and scars below the level of the belly button, while preserving the belly button. The tummy muscles can be brought together and tightened, if they have drifted apart, as can happen during pregnancy. Liposuction may also be incorporated to improve the final contour.

The scars are usually along the lower abdomen and around the belly button and are usually hidden by underwear.

There are a number of potential complications and side effects, all of which would be discussed in detail and the best advice given to you at a clinic consultation with your plastic surgeon.

Recovery is on average, up to six weeks to return to most activities.

The result is a flatter tummy with a much better contour.

Sunday 3rd October - Ovarian Cancer

My mum has recently been diagnosed with ovarian cancer. I’m worried that I could also be affected. Is there anything I can do to find out?

Dr Cameron W Martin is a consultant gynaecologist specialising in Minimal Access Surgery at Spire Murrayfield Hospital.

Over 6000 women are diagnosed with ovarian cancer in the UK every year. It is usually found in the over 50’s and vague symptoms such as bloating can make diagnosis difficult. Women often present with advanced disease and despite developments in surgery and chemotherapy, survival remains poor.  If treated in the early stages, up to 90% of patients will survive and early detection remains the best way to reduce the mortality. The value of current methods to screen the population is however uncertain.

Ovplex, a new test available at Spire Hospitals, measures five proteins in the blood and may improve the detection of early cancers. It can be useful in women who have suspicious symptoms or who are thought to be at risk of ovarian cancer. It is a simple blood test and should be performed after assessment by a health professional with an interest in gynaecological cancer.