GYNAECOLOGY
Advanced laparoscopic procedures, including
* Hysterectomy
* Removal of appendix
* Removal of ovarian cysts
* Treatment of ectopic pregnancies
* Treatment of endometriosis
Operative hysteroscopy, including
* Endometrial ablation
* Removal of polyps
* Removal of fibroids
Treatment of irregular, heavy or painful bleeding
Evaluation of pelvic pain and other problems and treatment
Microsurgery of infertility and tubal reanastomosis
Treatment of stress incontinence of urine
Treatment of prolapse including insertion of polymer material for recurrent prolapse
Hormone problems and menopause
Investigation and treatment of vulval disorders
Infertility due to not ovulating, tubal adhesions and endometriosis
Abdominoplasty (apronectomy) at time of other surgery e.g. hysterectomy
Office procedures
* Colposcopy and office treatment of cervical dysplasia (CIN)
* Evaluation and treatment of vulval disorders
* Insertion of hormone implants
* Hysteroscopy (diagnostic, not operative)
Contraception including
* ESSURE pbc hysteroscopic sterilization under local anaesthesia
* Laparoscopic sterilization including under general local or regional anaesthesia
* Mirena (IUCD containing hormone)
* Implanon hormone implants
Males
* Microsurgical vasectomy reversal
Infertile patients who require IVF are referred to IVF subspecialists
Patients found to have advanced cancer are referred to gynaecology cancer subspecialists
These referrals to subspecialists give the best outcomes in selected cases.
OBSTETRICS
Management of all obstetric problems, including
* Recurrent miscarriage
* Patients of any age
* Diabetes, including diabetes before pregnancy and gestational diabetes
* Dr Howland has a special interest in managing gestational diabetes including those patients who require insulin.
* Patients with high blood pressure
* Low placenta (placenta preavia)
* Medical problems including lupus, multiple sclerosis, spinal disease and epilepsy
* Premature labour
* Placental dysfunction including small babies and bleeding during pregnancy
Patient treatment preferences can be accommodated including
Amniocentesis
Elective epidural anaesthesia during labour
Elective induction when medically safe
Elective caesarian delivery
Birth plans are encouraged but should be realistic. Problems may arise during labour that are unexpected and which may require urgent intervention.
The plan for all women in labour is for no intervention, no drugs and no stitches. These are often achieved. But, these may not be safe options at the time. Labour management is always considerate of the mothers wishes but must ultimately be guided by the safety of the baby and the mother. Any intervention will be explained to the mother at the time and her permission obtained.
