Office Procedures

Surgery can be a very frightening prospect for anyone. We believe that by understanding the options available to you, knowing what to expect and following the right steps upon recovery will help you to choose an option that is right for you.

Dr Groenewald’s aim is to provide a gynaecological service that offers patients a top class, minimally invasive (keyhole) option for their gynaecological surgeries. Traditionally, all gynaecological surgeries were performed through a large abdominal incision, which renders the patient unable to work for six weeks. Keyhole surgery offers the advantage of major abdominal surgery being performed through three or four 1cm incisions. This allows a shorter hospital stay with far less pain and a recovery period of ten days instead of two weeks.

It is the way the western world performs surgeries and I hope to bring South African practices in line with this or at least provide patients with a safe and effective minimally invasive option. The surgery requires a lot of skill and is traditionally very hard to perform and thus there are only a couple of surgeons in SA who are able to perform good major laparoscopic surgeries.

Intrauterine device insertion

The IUD (intrauterine device) can be placed in the office. Currently, two devices are available in the US, Mirena (levonorgestrel-releasing intrauterine system) and the Copper T. Prior to placement, it is important that you discuss risks, benefits, and alternatives with our health care professionals to ensure that the IUD is appropriate for you.

How long does it take and what to expect

Insertion typically takes only take a few minutes which may be associated with mild cramping and spotting. These symptoms often resolve within hours of placement. You may have an a typical discharge after placement. This too should resolve within a few days of placement. We anticipate you being able to resume routine activity the day of placement, but if you develop a fever, severe pain, or heavy vaginal bleeding, please notify the office immediately. You should return to the office for evaluation approximately one month after placement.

In addition, please notify our office if you are scheduled for IUD placement and suspect that you may be pregnant, develop fever, abdominal pain, evidence of systemic, urinary tract, or vaginal infection, as these must be investigated prior to insertion of the device. If having regular periods, the placement should take place within 7 days of the start of your period to ensue that you are protected from pregnancy on the day you receive the IUD. Please make sure the provider is aware if you are breastfeeding as you may be offered a medicine to help relax the cervix to facilitate placement.

Colposcopy

Colposcopy is a way of looking at the cervix through a special magnifying device called a colposcope. It shines a light into the vagina and onto the cervix. A colposcopy can greatly enlarge the normal view. This exam allows the doctor to find problems that cannot be seen by the eye alone. Read more

Colposcopy is done when results of cervical cancer screening tests show abnormal changes in the cells of the cervix. Colposcopy provides more information about the abnormal cells and may be used further to asses other problems.

  • Genital warts on the cervix
  • Cervicitis (an inflamed cervix)
  • Benign (not cancer) growths, such as polyps
  • Pain
  • Bleeding
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Gynaecological Ultrasound

Ultrasound creates pictures of the internal organs of the body from sound waves. There is no radiation involved. The sound waves are directed into a specific area of the body through a transducer. The sound waves hit tissues, body fluids, and bones. Waves then bounce back, like echoes, and are converted into pictures of the internal organs. The images appear on a screen similar to a computer monitor. Dark areas show liquid. Gray or light areas show denser material, like tissue or bone.

Types of Ultrasound

There are many different types of ultrasound exams. The type of ultrasound you have will depend on what types of images your health care provider needs and why the exam is being done. Types of ultrasound are listed as follows:

  • Transabdominal – The transducer is placed on the abdomen.
  • Transvaginal – The transducer is placed in the vagina.
  • Doppler ultrasound – For this exam, high-intensity sound waves are used to study the movement of blood.
  • Sonohysterography – For sonohysterography, you first will have a transvaginal ultrasound exam. A catheter (a small tube) then will be inserted through the cervix, and a saline solution (salt water) will be injected through the catheter. The saline solution fills the uterus so abnormal findings can be seen inside the uterus. It also acts as a contrast material, which makes it easier to see anything abnormal.

Uses in Gynaecology

Ultrasound is used in gynaecology to examine the pelvic organs. An ultrasound exam can help:

  • identify a pelvic mass
  • find causes of pelvic pain
  • find causes of abnormal bleeding or other menstrual problems
  • find the position of an intrauterine device
  • diagnose and treat infertility

Preparation for transabdominal ultrasound

Here’s how to make the most of your appointment and get the most accurate ultrasound results.

  • If you are having a transabdominal ultrasound, wear loose-fitting clothes. This will allow your abdomen to be exposed easily.
  • You may need to drink up to six glasses of water during the 2 hours before your exam. This will make your bladder full. A full bladder is necessary because it pushes loops of the bowel up and out of the way, making the uterus easier to see.