Videos - Dr. Swar Shah

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Not every ovarian-area cyst affects fertility.But that doesn't always mean it can be ignored.A paraovarian cyst develops next to the ovary, not inside it.Because it doesn't arise from the ovary itself, it usually doesn't interfere with egg production, ovulation, or ovarian reserve.In many women, a small, simple paraovarian cyst causes no symptoms and is discovered incidentally during an ultrasound.In these cases, regular follow-up is often all that's needed.So when does surgery become necessary?The concern is usually not fertility—it's torsion.As a paraovarian cyst grows larger, especially beyond 5 cm, it can twist along with the ovary or fallopian tube.This is called adnexal torsion, a surgical emergency that cuts off the blood supply to these organs.Symptoms typically include:
• sudden, severe pelvic pain
• nausea or vomiting
• pain that doesn't settleIf diagnosed early, laparoscopic surgery can often untwist the ovary (detorsion), restore its blood supply, remove the cyst, and, in selected cases, fix the ovary in position to reduce the risk of recurrence.But if treatment is delayed and the blood supply has been cut off for too long, the ovary and fallopian tube may no longer be viable.In that situation, removing the affected ovary, fallopian tube, and cyst may become unavoidable.The key message is simple:A paraovarian cyst doesn't usually threaten fertility by itself.The danger comes from waiting too long when complications develop.Sudden, severe pelvic pain is never something to ignore.#ParaovarianCyst #OvarianTorsion #WomensHealth #Gynecology #Laparoscopy[paraovarian cyst, ovarian torsion, pelvic pain, laparoscopic surgery, ovarian cyst, fertility preservation, women's health India, gynecology, adnexal torsion, emergency gynecology]

Paraovarian Cyst Explained: When Does It Need Surgery?

Many women are told they have a bulky uterus.What they are often not told is why.One common cause is adenomyosis.Adenomyosis occurs when tissue similar to the lining of the uterus grows into the muscle of the uterus itself.Unlike fibroids, adenomyosis doesn’t form a single, well-defined lump.Instead, it spreads through the uterine muscle, making the uterus enlarged, tender, and less able to contract normally.This is why women with adenomyosis may experience:
• heavy menstrual bleeding
• severe period cramps
• chronic pelvic pain
• prolonged periods
• pain during intimacy
• anemia from excessive blood lossBecause the disease is spread throughout the uterine muscle, there is often no single portion that can simply be removed while preserving the uterus.That’s why treatment usually begins with medicines and hormone-based therapies to reduce bleeding and control pain.However, if symptoms remain severe despite treatment—and you have completed your family—a hysterectomy is considered the most definitive treatment.Today, in suitable patients, hysterectomy is commonly performed using laparoscopic (keyhole) surgery.Through a few small incisions and a high-definition 3D 4K camera, the uterus is carefully separated from the surrounding organs with excellent visualization and precision.Whenever appropriate, the ovaries are preserved so they can continue producing important hormones, helping avoid early surgical menopause.A hysterectomy is never performed simply because a woman has heavy periods.It is considered only after careful evaluation, when the benefits clearly outweigh the risks and other treatments are no longer effective.The goal is always the same:
To help women live without pain, excessive bleeding, and the constant disruption of adenomyosis.#Adenomyosis #Hysterectomy #WomensHealth #Gynecology #Laparoscopy[adenomyosis, bulky uterus, heavy periods, hysterectomy, laparoscopic hysterectomy, pelvic pain, painful periods, women’s health India, gynecology, minimally invasive surgery]

HEAVY PERIODS? IT COULD BE ADENOMYOSIS

Many women with PCOS believe that if fertility medicines don’t work, IVF is the only option.But for some women, there is another step before that.It’s called laparoscopic ovarian drilling (LOD).This procedure is not recommended for every woman with PCOS.It is usually considered for women who are trying to conceive and have not ovulated despite treatment with ovulation-inducing medicines, particularly those who are resistant to medications like letrozole or clomiphene.During this minimally invasive keyhole procedure, a few tiny, carefully controlled punctures are made on the surface of the ovary.The goal is to reduce the excess hormone-producing tissue that contributes to hormone imbalance in PCOS.As hormone levels improve, the ovary may become more responsive to ovulation medicines—and in some women, it may even begin releasing eggs naturally.Potential benefits include:
• Improved ovulation
• Lower doses of fertility medication
• Reduced need for repeated hormone injections
• Better chances of natural conception or IUI in selected patientsLike every treatment, ovarian drilling is not suitable for everyone.Its success depends on factors such as age, ovarian reserve, duration of infertility, your partner’s fertility, and other underlying conditions.When performed for the right patient and at the right time, it can be an effective option before moving to more advanced fertility treatments.The most important step is choosing the treatment that matches the cause of infertility—not simply the next treatment on the list.#PCOS #Infertility #Laparoscopy #Fertility #Gynecology[PCOS, ovarian drilling, laparoscopic ovarian drilling, PCOS infertility, ovulation induction, fertility treatment, women’s health India, gynecology, IUI, PCOS treatment]

PCOS Medicines Not Working? Ovarian Drilling Could Be the Next Step Before IVF

Many people think endometriosis surgery is simply about “removing a few spots.”In reality, endometriosis excision surgery is one of the most meticulous procedures in gynecology.The operation begins with laparoscopic (keyhole) surgery, where a tiny camera is inserted through small incisions to provide a magnified view of the pelvis.The first step is inspection.Every area where endometriosis commonly occurs is carefully examined, including the:
• ovaries
• uterus
• fallopian tubes
• pelvic lining
• bladder
• bowel
• pelvic side walls
• spaces between these organsThis is important because endometriosis is often more extensive than it appears on scans.Once the disease is identified, each lesion is assessed for its size, depth, and relationship to nearby organs.The next step is excision.Unlike simply burning the surface of the disease, excision involves carefully cutting out the endometriosis while preserving as much healthy tissue as possible.If scar tissue (adhesions) has caused organs to stick together, they are gently separated to restore their normal anatomy and movement.This step is especially important because adhesions themselves can be a major source of pain and infertility.The removed tissue is then sent to a laboratory for histopathological examination to help confirm the diagnosis.Before completing the surgery, the pelvis is inspected again to ensure all visible disease has been treated safely and that nearby organs remain healthy.The goal is not just to remove what is obvious.It is to understand the full extent of the disease and remove it as completely and safely as possible while preserving fertility and protecting surrounding organs whenever feasible.#Endometriosis #Laparoscopy #Gynecology #PelvicPain #WomensHealth[endometriosis surgery, endometriosis excision, laparoscopic surgery, keyhole surgery, pelvic pain, fertility preservation, endometriosis treatment, women’s health India, gynecology, minimally invasive surgery]

What Happens During Endometriosis Surgery? Step-by-Step Excision Explained

One of the biggest misconceptions about endometriosis is that it is “like cancer.”It isn’t.Endometriosis is a benign (non-cancerous) disease.So why do researchers sometimes compare it to cancer?Not because endometriosis is cancer.But because certain biological behaviors are surprisingly similar.Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus.These lesions can:
• invade nearby tissues
• develop their own blood supply (angiogenesis)
• survive outside their normal location
• recur after treatmentThese are all characteristics that scientists also study in cancer biology.But this is where the similarities end.Cancer cells grow uncontrollably, destroy surrounding tissue, and can spread throughout the body in a life-threatening way.Endometriosis does not behave like that.Its growth is usually much slower, it remains a benign condition, and it does not have the same uncontrolled, metastatic potential seen in cancer.So why is this comparison important?Because studying these shared biological mechanisms has helped researchers better understand why endometriosis persists, why it recurs in some women, and why it can be so difficult to treat.It has also opened new areas of research into inflammation, blood vessel formation, hormones, genetics, and immune system function.Understanding these similarities doesn’t mean endometriosis is cancer.It means medicine is learning from one disease to better understand another.And the more we understand how endometriosis behaves, the closer we get to earlier diagnosis and better treatments.#Endometriosis #WomensHealth #Gynecology #MedicalResearch #ChronicPain[endometriosis, endometriosis research, endometriosis vs cancer, chronic pelvic pain, angiogenesis, women’s health India, gynecology, endometriosis treatment, medical research, inflammation]

Why Scientists Compare Endometriosis to Cancer (Without Calling It Cancer)

One of the biggest myths about endometriosis is that pregnancy cures it.It doesn’t.So why has this belief existed for so many years?Endometriosis is influenced by hormones, particularly estrogen.During a normal menstrual cycle, hormonal changes stimulate endometriosis lesions, leading to inflammation that can cause pelvic pain and other symptoms.During pregnancy, ovulation and menstrual cycles stop.Without these monthly hormonal fluctuations, endometriosis lesions often become less active and inflammation may decrease.This is why many women notice that their symptoms improve during pregnancy.But symptom relief is not the same as a cure.The endometriosis lesions usually do not disappear.Scar tissue, adhesions, and ovarian cysts (endometriomas) also generally remain.After pregnancy, when menstrual cycles eventually return, the lesions can become hormonally active again.Some women notice symptoms returning within months, while others remain symptom-free for longer. Every woman’s experience is different.It is also important to remember that not every woman with endometriosis feels better during pregnancy. Some continue to have pain throughout pregnancy, while others experience recurrence soon after delivery.This is why pregnancy should never be recommended as a treatment for endometriosis.The decision to have a baby should be based on personal choice—not as a way to manage a chronic disease.Pregnancy may temporarily suppress the activity of endometriosis.It does not eliminate the disease.If symptoms persist before pregnancy or return afterward, they deserve proper evaluation and treatment.#Endometriosis #PregnancyMyths #WomensHealth #Gynecology #PelvicPain[endometriosis, pregnancy and endometriosis, endometriosis myths, pelvic pain, endometriosis treatment, infertility, women’s health India, gynecology, endometriosis symptoms, chronic pelvic pain]

Can Pregnancy Cure Endometriosis? The Truth Every Woman Should Know

Endometriosis takes an average of 7–10 years to diagnose.Not because the disease is rare.But because many women don’t realize how many different symptoms it can cause—and many of those symptoms are mistaken for separate conditions.Pelvic pain is treated as a gynecology issue.Bloating is blamed on digestion.Back pain is blamed on posture.Fatigue is blamed on a busy lifestyle.When these symptoms are looked at individually, the diagnosis is often missed.The most common symptoms of endometriosis include:1️⃣ Severe period pain that interferes with daily life
2️⃣ Chronic pelvic pain, even between periods
3️⃣ Pain during or after intimacy
4️⃣ Difficulty conceiving or infertility
5️⃣ Painful bowel movements, especially during periods
6️⃣ Bloating (“Endo belly”)
7️⃣ Constipation, diarrhea, or bowel symptoms that worsen during menstruation
8️⃣ Persistent fatigue
9️⃣ Lower back pain
🔟 Pain while passing urine during periods
1️⃣1️⃣ Pain radiating to the hips, buttocks, thighs, or legs
1️⃣2️⃣ Heavy menstrual bleeding (not present in every woman)Less common—but important—symptoms include blood in the urine or stool during periods, shoulder pain, or even chest pain and breathlessness that occur cyclically.One important thing to remember:Having one of these symptoms does not automatically mean you have endometriosis.But when several of these symptoms occur together and repeatedly worsen around your menstrual cycle, they deserve proper evaluation.The menstrual cycle is often the biggest clue.Your body follows patterns.Learning to recognize them is often the first step toward diagnosis.#Endometriosis #PelvicPain #PeriodPain #WomensHealth #Gynecology[endometriosis symptoms, severe period pain, chronic pelvic pain, endo belly, painful periods, infertility, women’s health India, gynecology, endometriosis diagnosis, painful periods]

15 Symptoms of Endometriosis Every Woman Should Know | Why Diagnosis Takes 7–10 Years

A recent study linked endometriosis with 661 different medical conditions.That does not mean endometriosis causes 661 diseases.It means researchers found important associations that may help us better understand how this condition affects the body.For years, women with endometriosis were often treated symptom by symptom.Pelvic pain went to the gynecologist.Migraines to the neurologist.Bowel problems to the gastroenterologist.Fatigue was often dismissed altogether.But this research suggests we may need to think differently.Along with expected conditions like chronic pelvic pain, infertility, adenomyosis, and ovarian cysts, researchers also found higher rates of migraines, irritable bowel disorders, thyroid disease, fatigue, and several immune-related conditions.Why does this matter?Because endometriosis may be more than a disease confined to the pelvis.It is increasingly being recognized as a complex chronic inflammatory condition involving hormones, immunity, genetics, nerves, and multiple organ systems.This could explain why some women experience symptoms far beyond painful periods.It may also help doctors recognize endometriosis earlier, especially in women who have multiple seemingly unrelated symptoms.One important point:Association does not prove that one condition causes another.More research is still needed to understand exactly how these conditions are connected.But studies like this are changing the conversation.Instead of asking,
“Which symptom should we treat?”Medicine is beginning to ask,
“Could all of these symptoms be part of the same disease process?”That shift could transform how endometriosis is diagnosed, researched, and treated in the future.#Endometriosis #WomensHealth #ChronicInflammation #Gynecology #MedicalResearch[endometriosis, endometriosis research, chronic pelvic pain, women’s health India, inflammation, infertility, adenomyosis, ovarian cysts, autoimmune diseases, gynecology]

Endometriosis Is Linked to 661 Medical Conditions | The Research That Could Change Everything

Why is no one able to agree on what endometriosis actually is?Because endometriosis doesn’t fit neatly into a single medical category.Some call it a hormonal disease.Others compare it to an immune disorder.Some researchers even compare certain aspects of its behavior to cancer.And surprisingly, all of them are partly right.Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus.But that simple definition doesn’t explain why it can cause such different symptoms in different women.It is a gynecological disease because it commonly affects the ovaries, fallopian tubes, pelvic lining, bowel, and bladder.It is hormonal because estrogen helps drive the growth and activity of endometriosis lesions.It is compared to immune disorders because the body often fails to clear this tissue from places where it doesn’t belong, allowing chronic inflammation to continue.And it is sometimes compared to cancer because these lesions can invade nearby tissues, develop their own blood supply, and return after treatment.But endometriosis is NOT cancer.Unlike cancer, it does not spread uncontrollably throughout the body.What makes endometriosis especially challenging is that symptoms often don’t match the severity of disease.Some women have extensive endometriosis with minimal symptoms.Others have debilitating pain despite relatively small lesions.Symptoms may include:
• severe period pain
• painful intimacy
• infertility
• bloating
• bowel symptoms
• back pain
• fatigueOr sometimes almost no symptoms at all.The best way to think about endometriosis is as a chronic inflammatory disease involving hormones, immunity, genetics, nerves, and abnormal tissue growth.And that complexity is exactly why there is no single explanation that fully defines it.#Endometriosis #WomensHealth #PelvicPain #Gynecology #Fertility[endometriosis, chronic pelvic pain, infertility, painful periods, endometriosis symptoms, women’s health India, gynecology, hormonal disease, immune system, laparoscopic surgery]

Why Endometriosis Confuses Even Doctors | The Disease That Doesn’t Fit Any Category

Laparoscopic Excision of Cervical Fibroid-Mimicking as BroadLigament Fibroid

Retroperitoneal Dissection-Tackling Uterine Artery at Origin Using Harmonic

Retroperitoneal Dissection-Tackling Uterine Artery at Origin-Using Bipolar Shearer

Total Laparoscopic Hysterectomy with Bilateral Salpingo-Oophorectomy