Gynaecology in Niš: gynaecological examination, ultrasound and procedures

A cone biopsy (conisation) is a procedure that removes a cone-shaped part of the cervix when colposcopy and biopsy show a change that needs to be removed and examined in detail. Depending on the method and the doctor's assessment, it is done under local or general anaesthetic. After the procedure there is usually discharge and light bleeding, which can last for several weeks, and the bleeding may briefly become heavier around the second week. The doctor advises how long to avoid strenuous activity, baths, tampons and sex, usually around four weeks. Bleeding heavier than a period, a temperature or foul-smelling discharge are reasons to contact the doctor sooner. If you are planning a pregnancy, tell the gynaecologist before the procedure, because a cone biopsy can affect future pregnancies. A follow-up with a Pap smear or HPV test usually takes place after a few months.

The Bartholin's glands are located on both sides of the vaginal opening. When the gland's duct becomes blocked, a cyst can form, and when the cyst becomes infected, an abscess. A small cyst that causes no symptoms often needs no treatment, only monitoring. For an abscess or a larger cyst, the doctor usually suggests an incision, which drains the contents. When a cyst keeps coming back, the gynaecologist may suggest a different procedure, and one of the options is excision, which removes the gland. Excision is a bigger procedure and is done under anaesthetic. Recovery usually takes from a few days to a few weeks, depending on the type of procedure.

Curettage is usually done under a short intravenous anaesthetic, so the patient is asleep during the procedure. The type of anaesthetic is decided by the gynaecologist and the anaesthetist after the examination and tests. After the procedure the patient stays under observation until she has recovered from the anaesthetic. Light bleeding and period-like pain usually last a few days, sometimes up to two weeks. Bleeding heavier than a period, a temperature or foul-smelling discharge are reasons to contact the doctor before the follow-up. The tissue sample is usually sent for histopathological analysis.

An IUD is usually fitted during a period or just after it, but it can also be fitted on other days of the cycle when the doctor judges that pregnancy is not possible. Before fitting, the gynaecologist carries out an examination and, if needed, an ultrasound scan and swabs. The procedure itself takes a few minutes, and for a few days afterwards there may be cramps and light bleeding. According to a note in the Maja Hospital price list, the device is not included in the price of fitting, so when booking, check the price of the IUD and whether you need to obtain it yourself. You choose the type of IUD together with the gynaecologist, and the first check-up is usually booked after your next period.

Colporrhaphy is an operation that strengthens the front or back wall of the vagina when it has dropped (prolapsed). Anterior repair is usually done when the bladder has dropped together with the vaginal wall, and posterior repair when the last part of the bowel has dropped. For milder prolapse, the gynaecologist may first suggest pelvic floor exercises or a pessary (a ring placed in the vagina to support the organs). The operation is done under anaesthetic, the type of which is decided by the gynaecologist and the anaesthetist. The length of the hospital stay and the course of recovery are explained by the gynaecologist at the examination, according to the findings and the type of operation.

The time it takes to get a histopathology result depends on the type and number of samples and on the laboratory doing the analysis. At the time of the procedure, the gynaecologist tells you when to expect the result and books a follow-up appointment at which it is interpreted. Histopathological analysis has separate items in the gynaecology price list, and the gynaecologist tells you before the procedure whether it is included in the price of the procedure.