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Gynecology

Women Health issues are often overlooked and under treated. Many women are either too embarrassed to talk to their doctor about such problems or they are not aware that simple, effective remedies are readily available. Dr. Ammar Shammaa takes great pride in his ability to help these women achieving satisfactory results by careful listening, meticulous assessment, comprehensive discussion and precise execution of the planned treatment.

Common Women Health issues include:

Da Vinci Hysterectomy

Until recently, surgery for most gynecologic conditions was performed using a large abdominal incision. This is because while conventional laparoscopic surgery is effective for many routine procedures, the long-handled, rigid instruments used in laparoscopy are not usually considered effective for delicate or complex operations.
Fortunately, there is a minimally invasive option for treating gynecologic conditions designed to overcome the limitations of traditional surgery - Da Vinci Surgery.
If your doctor recommends a hysterectomy to treat your condition, you may be a candidate for Da Vinci Surgery. Using state-of-the-art technology, a Da Vinci® Hysterectomy requires only a few tiny incisions, so you can get back to your life faster.
The Da Vinci System enables your doctor to perform a minimally invasive hysterectomy even for complex conditions with enhanced vision, precision, dexterity and control. Da Vinci offers women many potential benefits over traditional surgery, including:

The Da Vinci System is a state-of-the-art surgical platform with 3D, high-definition vision and miniaturized, wristed surgical instruments designed to help doctors take surgery beyond the limits of the human hand. By helping doctors to overcome the challenges of traditional open and laparoscopic surgery, Da Vinci is changing the experience of surgery for women around the world.

Fertility Care

The advantage of continuation of care can not be overemphasized. Dr. Ammar Shammaa provides antenatal and obstetrics care after successful conception.  Our office offers counseling and assessment for couples with fertility issues.
Comprehensive investigations include:

Management options include:

Urodynamic Study    

What is urodynamics?

Urodynamics is a study to assess the ability of the bladder to store urine, and to empty effectively.
Urodynamics is an aid to the examination which your doctor has performed. It is often used to assist in determining the cause of your bladder problems such as an unstable bladder and incontinence.
Your urodynamic studies should take approximately between half and three quarters of an hour to complete (that is if your bladder is full when you arrive). Urodynamic studies include a bladder ultrasound scan and flow rate, urethral pressure profile and cystometry. These studies are conducted as an outpatient procedure so unless otherwise told you will be able to leave when your procedure is completed.

Who performs the procedure?

Urodynamic studies are performed by personnel who have been trained in the use of the equipment and procedures; they usually consist of a friendly female registered nurse and a gynecologist. The tests are interpreted by a specialized gynecologist.

Do i need to do anything special before my procedure?

For the first part of the test we require that you drink one (1) liter of water one (1) hour prior to your appointment. Should you feel that you are unable to travel with a full bladder, we ask that you arrive one (1) hour prior to your appointment so we can give you the water when you arrive.
Although you will be able to drive it is recommended that you have someone else to drive you home.

What happens to me during the procedure?

The procedure itself should not be painful but some people find it uncomfortable. Relaxation techniques such as slow deep breathing or relaxing music may assist you to feel less apprehensive about the procedure.
The staff will endeavor to assist you to relax.
When you feel that your bladder is full it will be scanned using a low frequency hand held ultrasound probe.
Once we know how much urine is in your bladder you will be asked to urinate in a special toilet that measures how much urine you produced and how fast or slow the bladder emptied.
A small catheter will be inserted into your bladder through the urethra (water passage) to allow the staff to fill your bladder with sterile water. And a very fine transducer or probe, (about as fine as a match stick) will also be inserted, this will allow a computer to measure the pressures within your bladder.
A second very fine transducer needs to be inserted into your vagina. This transducer is important in the pressure measurement. The urethral pressure point is measured using the same transducers which were inserted for the cystometry. We can measure the ability of your sphincter muscles (valves) to hold urine in your bladder, by slowly withdrawing the catheter through the urethra (water passage).
Throughout the cystometry part of the procedure the staff will ask you some questions such as when you need to pass urine.
As the bladder fills, you will be asked to cough or bear down to assess if there is any accidental leakage of urine. At the end of this test, you will be asked to pass urine into the flow meter again, while the pressure measurement continues.

What information is obtained form the procedure?

A bladder ultrasound is used in conjunction with a flow rate to interpret the amount of fluid within your bladder. When you feel that your bladder is full it will be scanned using a low frequency hand held ultrasound probe.
A flow rate is the most basic of all urodynamic investigations; it is a graphical representation of your urinary flow and measures the volume of urine that passes, and how fast or slow the bladder empties.
The urethral pressure point measures the ability of your sphincter muscles (valves) to hold urine in your bladder.
Cystometry assists the doctor to identify how much fluid is needed in your bladder before you feel any sensation, and how much fluid your bladder can hold.

What about when I go home?

Most people have no problems immediately after the procedure is performed. You should drink plenty of fluids during the remainder of the day so as to dilute your urine.
Should you experience any fevers or feel ill, please contact Dr. Ammar Shammaa for advice as soon as possible.