A recent consensus statement on endometriosis and infertility indicates that some women may benefit from a combination of assisted reproduction and surgery. Unfortunately the data are limited and somewhat conflicting. This is not uncommon when surgery is involved as there is inevitably a degree of operator (or surgeon) dependence. It is self-evident with diseases such…
It has been well established that oncogenic (cancer causing) strains of HPV are the cause of cancer of the cervix and in fact it could probably be considered a form of sexually transmitted disease. Over the last few years vaccines have become available (Gardasil and Cervarix) for the prevention of HPV related cervical cancer. Gardasil…
Recently one of the largest IVF groups in Australia, IVF Australia, has been sold via private equity interests into a share market floatation (Virtus Health – ASX: VRT). Whilst for many companies this may be a good idea, I have significant reservations about the subsequent quality of this company in the years to come. These…
I was recently asked to complete a survey into the “pain of laparoscopic surgery”. The authors were interested in the pain experienced by surgeons who perform laparoscopic surgery. This started me thinking about a subject that I have often discussed with trainee surgeons under my care; that is the ergonomics of laparoscopic surgery. For those…
Our new paper just published on this topic. Management of deeply infiltrating endometriosis involving the rectum. CE Koh, K Juszczyk, MJ Cooper, and MJ Solomon Dis Colon Rectum, September 1, 2012; 55(9): 925-31. BACKGROUND: Rectal endometriosis can cause debilitating symptoms. Rectal resection in this setting has been shown to improve symptoms; however, there remain…
A recent media report of ovarian transplantation with subsequent infertile women conceiving has raised great interest at a conference in Istanbul. (“Ovary transplant breakthrough lets women gives birth in older age – SMH – 5 July 2012”). 28 babies were born to infertile women who had ovarian tissue transplanted. I have heard the lead surgeon, Dr…
Premenstrual spotting is an important characteristic sign of endometriosis. It usually takes the form of dark or brown staining or spotting lasting more than 12 hours prior to menstruation beginning normally. This association has been known about for some time but has not been well appreciated by doctors or gynaecologists. There appears to be…
Over the last few years I have travelled to Hong Kong and China to operate and run surgical workshops where I have had the honour of teaching and working with other specialist gynaecological surgeons. I am registered as a specialist gynaecologist in Hong Kong and have been accredited to operate as an advanced level laparoscopic…
A reasonable part of my practice involves the use of IVF to assist couples in their quest to conceive. Clearly, however, the underlying issues and reasons why IVF are required should be elucidated and dealt with before proceeding to IVF. Recent times in Australia have seen the proliferation of a large number of IVF units…
A recent report published in Lancet Oncology has raised again the possibility that endometriosis and certain types of ovarian cancer may be closely linked. The authors admit that further analysis is required although suggest that people should consider ongoing surveillance. Unfortunately there are significant problems with the data particularly the patient recollection of a…