Patient Information:

Cervical Cancer Prevention

What is Pap Smear Test?
This is a quick, simple and painless test done in the clinic by which few cells are collected from cervix (neck of the womb). These
collected cells are then further examined under microscope in the laboratory to make sure that there is no risk of development
of cervical cancer in the future.  For most women the test result is normal indicating healthy cervix.  For a few, however it picks up
abnormal cells which if treated promptly can prevent cancer in later life.
Why Do I Need Cervical Pap Smear Test?
Cervical cancer is one of the commonest causes of female death in our country. A simple smear test can catch the disease in very
early stage even before it turns into cancer.  It is very important to remember that most women who die of the disease have never
had a smear test in their life.
Who Needs the Test?
Although most of the cervical cancer is diagnosed around 40 years of age, the process begins much earlier in early twenties by
some germs called Human Papilloma Virus (HPV). Therefore all women aged between 20 and 64 years are advised to have this
test at regular interval.
What will happen if the Test is Abnormal?
Abnormal test result does not always mean that you have cancer.  You would then be advised to have an examination called
Colposcopy (examination of cervix under magnifying glass) and if necessary with a biopsy (examination of a piece of tissue).
This test is again a clinic procedure and does not need any general anaesthesia.
What is HPV?
HPV (Human Papilloma Virus, is a virus which commonly infects birth passage and if not cleared from the body can develops cancer
of the cervix in later life. It is commonly found in women in their early twenties. Four (16, 18, 31 and 45) out of about one hundred subtypes cause most of the cervical cancer.
What is HPV Vaccine?
Vaccines have been developed and are now available in India that specifically prevents the main cancer causing HPV infection and
as a result, almost 80% of the cervical cancer risk reduced.
Who can get the Vaccine?
Any woman between 9 to 45 years of age can have this vaccine.  However it is contraindicated in pregnancy.  Three doses of intramuscular injections are required in six months to complete the vaccine course.
Is there any side effect of the Vaccine?
Apart from local pain or redness and very rarely mild fever, this injection is not found to be associated any serious side effects.
However it is advised that you should get the injection by a qualified doctor only.
Do I still need to have Cervical Smear once I get the Vaccine?
Yes, HPV vaccine is not the replacement of cervical smear test.  You would still need to have Pap smear test at regular interval.

Laparoscopic Hysterectomy

What is a Laparoscopic Hysterectomy?
Laparoscopic hysterectomy is removal of the uterus (womb) using key-hole surgery through tiny cuts in your abdomen (Minimal
Access Surgery)
What are the advantages of a laparoscopic hysterectomy surgery?
A laparoscopic hysterectomy requires only a few small incisions, compared to a traditional abdominal hysterectomy which is done through a 3-6 inch incision. As a result, there is less blood loss, less scarring and less post-operative pain. A laparoscopic hystere
ctomy usually requires about 2 days hospital stays whereas that is 4-5 days in open abdominal hysterectomy. The recovery period
for this laparoscopic procedure is 1-2 weeks, compared to 4-6 weeks after an abdominal hysterectomy.The risks of blood loss and infection are lower with laparoscopic hysterectomy than with an abdominal hysterectomy. In experienced hands, laparoscopic hysterectomy takes about the same length of time as an abdominal hysterectomy and involves no greater risk.
Who should have laparoscopic hysterectomy surgery?
Most patients who are having a hysterectomy to treat abnormal uterine bleeding or fibroids can have a laparoscopic hysterectomy.
What type of anaesthesia will be required?
Patients are put to sleep under general anaesthesia.
What will happen during surgery?
After you have had your anaesthetic a telescope and other instruments are passed through small cuts inside your abdomen which
will be inflated with Carbon Dioxide gas to enable the surgeons to see and perform the procedure. The incisions will be sutured with dissolvable stitches and covered by dressings.
Are there any complications?
Anaesthetic complications are generally very rare. Potential complications of the procedure are generally rare and include bleeding,
injury to the bladder or ureter, bowel injury, infection, blood clots in the legs. Very rarely open surgery may be required to repair some
of these complications. Precautions are routinely taken to avoid these risks.
What kind of recovery can be expected?
Patients are usually up and about on the first post operative day.  Patients are encouraged NOT to stay in bed and are advised to
move around the house and resume normal activities as soon as they feel up to it when they are at home. They are advised to take
pain killer pills for a few days post-operatively. Some women are well enough to return to work one week after surgery. Women who
have more physically demanding work should stay home for 2-3 weeks. Women can resume exercise and sex within a few weeks of
the surgery. Laparoscopic patients can expect to suffer less post-operative pain than traditional hysterectomy or cesarean section patients.

Antenatal Screening for Down’s Syndrome

What is Down’s Syndrome?
Down’s Syndrome is a form of mental handicap caused by the presence of an extra chromosome (no. 21) in the cell. It is manifested
by significant learning difficulties along with other physical challenges. In fact, two out of five such babies are found to have different
kind of heart problems.  Most people with Down’s will need special help throughout their lives. The risk of having a baby with Down’s
Syndrome increases with mother’s age especially if she is above 37 yrs of age during pregnancy.
How is it screened?
The screening test will tell us whether your baby is in the low risk or high risk category for Down’s Syndrome. It involves a blood
test and an Ultrasonography (USG) of the mother that can be done between 11 and 14 weeks of pregnancy called First Trimester Screening (FTS). In case you miss this test a combination of blood tests only can be done between 15 to18 weeks (Triple or Quadruple Test).
What happens if the result is in the “HIGH RISK”?
A test called Amniocentesis (Testing a sample of fluid around the baby) can tell you for certain if your baby has Down’s Syndrome.
It can also give the diagnosis of any other rare form of chromosomal abnormality of the baby.A new noninvasive but expensive test
called NIPT is also available for screen positive high risk patients which has got very good pick up rate for Down’s syndrome. This is
done by a simple blood test from the pregnant mother.