Surgical Procedures

Gynaecological Procedures

  • How quickly can you get me gynaecological surgery?

    Typically, we can get you surgery within 2-3 weeks from the time we receive your diagnostic package.  In certain cases, we can get a client surgery within 24 hours.  Call or e-mail us to get a accurate quote and timeline for your surgery.

  • What does my doctor mean by "pelvic floor" and "prolapse"?

    The term “pelvic floor” describes the group of muscles in the pelvis that support the bladder, bowel, vagina and uterus. When these muscles lose their strength and tone, they are said to “prolapse.” This is extremely common in women – it’s thought that more than half of all women over age 55 have some form of this problem. Heredity, childbirth, obesity and menopause are all contributing factors.

    Your doctor may have mentioned the following terms:

    Prolapsed uterusoccurs when the uterus is significantly lower than its normal position.

    Cystocoeleprolapse of the bladder

    Urethrocoeleprolapse of the urethra (the tube coming from the bladder)

    Rectocoeleprolapse of the back wall of the vagina

    Enterocoeleprolapse of the small intestines into the back wall of the vagina

    It is common for more than one of these conditions to be present at the same time. Women who experience a prolapsed uterus may have the sensation of heaviness or pulling in their pelvis. Some women feel as though something is “falling out” of their vagina. They may also experience low back pain and pain during intercourse.

  • Why do I have to wait so long for my pelvic floor repair?

    Your pelvic surgery will likely be seen as “elective.” As a result of rationing of care by the Canadian public health system and limited operating room times for surgeons, this means your surgery may be delayed and will be subject to being cancelled. Timely Medical Alternatives can help you find a private clinic to expedite your case so you can get the surgery you need as quickly as possible.

  • What happens during a pelvic floor repair or prolapsed uterus repair?

    Pelvic floor repair surgery can use your own tissue, donor tissue or a synthetic mesh material to support the organs in the pelvis. Doctors sometimes prefer to perform this surgery vaginally because this procedure is associated with less pain.

    Another possible lower-pain alternative is laparoscopic surgery. With this technique the surgeon uses a very small telescope/camera to examine the inside of your body while you are asleep under a general anesthetic. He or she then makes the necessary repairs via a very small incision, using specialized instruments.

    If you require a full hysterectomy (removal of the uterus) or have other complications, however, you will require full abdominal surgery. Your surgeon can discuss all your options with you and help you make the best decision.

  • How long will it take me to recover from pelvic surgery?

    Recovery time will depend on your medical condition and the nature of your surgery. Recovery from a laparoscopic surgery will likely be a week to 10 days. Recovery from vaginal or full abdominal surgery will likely be longer. Total recovery time will also depend on your typical activity level and the amount of lifting and carrying you need to for your work or around the home.

Urological Procedures

  • How quickly can you get me urological surgery?

    Typically, we can get you surgery within 2-3 weeks from the time we receive your diagnostic package.  In certain cases, we can get a client surgery within 24 hours.  Call or e-mail us to get a accurate quote and timeline for your surgery.

  • What kinds of urological procedures can you help arrange?

    Timely Medical Alternatives can help get you immediate care for the following urological conditions:

    Benign prostatic hypertrophy (enlarged prostate) The prostate is a gland in the male reproductive system, located inside the body, just below the bladder and in front of the rectum and is about the size of a walnut. It is common for men to find that their prostate has become enlarged as they age. Doctors call this condition benign prostatic hyperplasia or BPH. The symptoms vary, but usually include:

    -the need to urinate more frequently or urgently, especially at night

    -a weak or interrupted stream

    -leaking or dribbling

    (Note: Having BPH does not appear to increase the risk of prostate cancer but many of the symptoms are similar so your doctor will always want to rule out cancer.)

    In treating BPH, doctors will commonly recommend surgical removal of the prostate. The most frequently recommended procedure is called transurethral resection of the prostate (TURP). As the name suggests, the surgery is performed through the urethra, meaning there is no scar. Sometimes, however, when the gland is greatly enlarged or there are other complicating factors, the doctor will recommend what’s called “open surgery.” This means the surgeon makes an incision across the lower abdomen and will result in a longer recovery time. Laser surgery is another, newer, option.

    A growing number of non-surgical options are also available, including HIFU, or high-intensity focused ultrasound. This treatment has been available in Canada since 2005 and so far shows excellent results and lower side effects than surgical procedures. (It is so new that not all physicians are familiar with it and you may have to ask.) Other non-surgical treatments include:

    -microwave treatment (TUMT)

    -needle ablation (TUNA)

    -water-induce thermotherapy.

    Prostate cancer: Prostate cancer occurs when malignant cells form in the tissues of the prostate. There are frequently no symptoms associated with prostate cancer so you should have regular screening with your family doctor via physical exam and blood test (PSA.) This becomes especially important as you age. For those who have symptoms, these might include:

    -the need to urinate more frequently or urgently, especially at night

    -a weak or interrupted stream

    -difficulty urinating

    -pain or burning during urination.

    -blood in the urine or semen.

    -pain in the back, hips, or pelvis that doesn’t go away.

    -painful ejaculation

    To treat prostate cancer, a wide variety of therapies – often used in combination with each other – are available. These include:

    -surgery: including TURP, radical prostatectomy and pelvic -lymphadenectomy

    -radiation: brachytherapy

    -hormone therapy

    -cryosurgery

    -chemotherapy

    -high intensity high-intensity focused ultrasound (HIFU).

    This last treatment has been available in Canada since 2005 and so far shows excellent results and lower side effects than the surgical procedures. (It is so new that not all physicians are familiar with it and you may have to ask.)

    The best choice of treatment for you depends on your age and stage of cancer. You should discuss your options thoroughly with your doctor.

    Kidney stones: Kidney stones are created when minerals and other substances in your urine combine, over time, to form crystals on the inner surfaces of your kidneys. If the crystals remain tiny enough, they will travel through the urinary tract and pass out of the body in the urine, without being noticed. If they become larger, however, they can cause excruciating pain as they go through your system. Doctors do not fully understand why some people form kidney stones and others don’t.

    A primary form treatment for kidney stones is lithotripsy (ESWL) which is a series of shock waves, used to break up the stones and crush them into particles the size of sand. It requires sedation or light anesthesia because of possible pain caused by the shock waves. Other treatments include: percutaneous nephorolithotomy and removal of the stone using a ureteroscope. Some calcium stones are cause by overactive parathyroid glands (in the neck). Most often this is the result of a small benign tumour in one of the glands and, if this is the case, the tumour can be removed surgically.

  • Why do I have to wait so long for my urological surgery or treatment?

    As a result of rationing of care by the Canadian public health system and limited operating room times or access to other facilities, your treatment may be delayed and will be subject to being cancelled. As well, certain newer procedures, such as HIFU are performed by only a small number of clinics. Timely Medical Alternatives can help you find the right private clinic to expedite your case so you can get the treatment you need as quickly as possible.

  • What are the risks of urological procedures?

    The risks associated with prostate surgery include but are not limited to the risk of anesthesia, bleeding, infection, pneumonia, urinary incontinence and impotence. The risks will vary with the different kind of surgery – and with your health. Non-surgical procedures such as HIFU are thought to carry less risk. Your surgeon is the best person to assess your risks and discuss how to minimize them.

    The risks associated with lithotripsy include blood in the urine, bruising, bleeding and discomfort as the pieces of stone pass through the urinary tract. Some people will require a second treatment if the stone doesn’t shatter completely.

  • How long will it take me to recover from urological surgery?

    Depending on the nature of the procedure, and your overall health, recovery may take several months. If you have had surgery for BPH or prostate cancer, you may be sent home with a catheter, which will be removed after several days. During this initial recovery it’s important to avoid any straining or sudden movements that could tear the incision. Here are some guidelines common to recovery from all urological procedures:

     

    -Continue drinking a lot of water to flush the bladder.

    -Avoid straining when having a bowel movement.

    -If constipation occurs, ask your doctor if you can take a laxative.

    -Don’t do any heavy lifting.

Biopsies

  • Why might I require a fine needly biopsy?

    If a breast examination or mammogram shows a cyst or lump or if a lump is found on the thyroid gland (which is near the throat, just under the Adam’s apple), your doctor may request a fine needle biopsy, also known as fine needle aspiration cytology (FNAC).

    During this procedure, a doctor uses a very fine narrow needle to remove fluid from a cyst or clusters of cells from a mass, so they can be examined under a microscope. This technique is considered minimally invasive and allows for very rapid diagnosis. As well, there is no scarring or stitches and no recovery period is required.

  • Why do I have to wait so long for a needle biopsy?

    As a result of rationing of care by the Canadian public health system and the limited availability of doctors, your treatment may be delayed. Because time is so important for cancer diagnosis, and because you shouldn’t have to worry needlessly about a benign condition, Timely Medical Alternatives can help you find a private clinic to expedite your case so you can get the treatment you need as quickly as possible.

  • What happens during a fine needle biopsy?

    This procedure is performed under local anesthetist. The doctor uses a very small hollow needle (smaller than those used to draw blood) that is attached to a syringe to extract fluid from a cyst or cells from a mass. A number of insertions are usually required. The doctor may need to use ultrasound to help locate the mass, in the case of a thyroid biopsy, or ultrasound and mammography in the case of a breast biopsy.

    The cells are then placed on a microscope slide, stained, and examined by a pathologist.

  • What are the risks of needle biopsies?

    Bruising, soreness, bleeding and, vary rarely, infection are all possible risks of fine needle biopsies for the breast and thyroid. Probably the more important risk is that of a “false negative” – that is, that the test will miss the problematic cells because it is so small. For the same reason, there is also a risk that the cells taken do not enable a definitive diagnosis.

    These risks should be weighed against the benefits of a rapid diagnosis leading to faster care with the appropriate specialist.

  • Who interprets the results and how do I get them?

    A pathologist at the clinic will analyze the slides from your fine needle biopsy and send a report with his or her interpretation to your doctor.

Bariatric Surgery

  • Am I a good candidate for bariatric weight loss surgery?

    Bariatric weight loss surgery is reserved for people who are obese and who have repeatedly tried to lose weight but failed. While for many people counting calories or increasing exercise is enough to lose weight, for others these methods just don’t work, for reasons doctors still don’t fully understand.

    Generally speaking, surgeons reserve bariatric weight loss surgery for people who have a Body Mass Index (BMI) of 40 or more. (You can use a calculator to determine your BMI.) Surgeons will also consider the procedure if you suffer from a serious obesity-related illness such as life-threatening heart disease or severe sleep apnea.

    Bariatric weight loss surgery should not be undertaken lightly or considered the “easy” way out because it carries the pain and risks of a major gastrointestinal surgery. But it is a proven procedure for highly motivated individuals who have a serious weight problem and have failed at other methods of losing weight.

  • What are the benefits of bariatric weight loss surgery?

    Bariatric weight loss surgery has many benefits for the right candidates. It can improve:

     

    -Quality of life by improving your ability to be active, to relate socially with others and to feel good about yourself

    -Sleep apnea

    -Gastroesophageal reflux disease (acid reflux or GERD)

    -High blood pressure

    -High cholesterol

    -Type 2 diabetes

  • Why do I have to wait so long for bariatric weight loss surgery?

    As a result of rationing of care by the Canadian public health system, a shortage of trained surgeons in this highly specialized procedure and restricted access to operating room times, there are currently very long waits for bariatric weight loss surgery. If the required wait is unacceptable to you, Timely Medical Alternatives can help you find a private clinic to expedite the surgery you need.

  • What will happen during bariatric weight loss surgery?

    There are two main types of bariatric weight loss surgery: Bypass and Lap-Band.

    With the bypass procedure, the surgeon “staples” part of your stomach to make a smaller stomach pouch. This pouch is then directly connected to a lower portion of the small intestine, bypassing the duodenum. By making the stomach smaller and by bypassing the top section of the small intestine, the surgery will help you feel “full” faster and your body will be prevented from absorbing as many calories.

    The most common type of bariatric bypass surgery is known as the roux-en-Y and it can be done via traditional or “open” surgery or by a laparoscope (a special and very small telescope used to examine the inside of the body.) Laparoscopic surgery usually means a shorter hospital stay and a faster recovery, but not everyone is a candidate for this technique. As well, another less common bypass option is the biliopancreatic diversion bypass. In this procedure, a portion of the stomach is removed. This is less commonly performed today. Your doctor will discuss all the surgical options with you.

    Another alternative for bariatric weight loss surgery is the Lap-Band. This is a band or belt of silicone rubber that’s gathered around near the top of the stomach in order to reduce the amount of food it can hold. It effectively divides the stomach into two parts – somewhat like an hourglass, but with the top portion much smaller. It is adjustable and reversible although for some weight loss patients, it is not as effective as bypass surgery. Again, you should discuss your options with your doctor.

  • What are the possible complications of a bariatric weight loss surgery?

    Bariatric weight loss surgery is considered a relatively high-risk procedure and there are a number of potential complications. For this reason, doctors rigorously screen potential candidates. They want to know that the risks of the surgery will be outweighed by the benefits you can expect. Risks include but are not limited to: blood clots in the legs; leaking at one of the staple lines in the stomach; pneumonia; narrowing of the opening between the stomach and small intestine; dumping syndrome (which leads to nausea, vomiting, diarrhea, dizziness and sweating.) and vitamin and mineral deficiencies. A risk of death has also been associated with the surgery.

    At the same time, you should note that severe obesity in itself is considered a life-threatening disease. Your risk profile is unique. To get a true picture of what is best for you, it’s essential to talk to your surgeon in detail.

  • What happens after bariatric weight loss surgery?

    Your recovery time will vary greatly, depending on your health and weight going into the surgery and on the type of surgery you have. Typically, you will not be allowed to eat for several days following the surgery, so that your stomach can heal. Then you will gradually add food into your diet in a controlled way for the following 12 weeks. You will be required to monitor your food intake for the rest of your life. As with any major surgery, you will be tired and may find moving difficult for the first six weeks. You should experience rapid weight loss in the first three to six months and, with proper attention to diet and exercise, should have lost about half of your excess weight within the first two years.

     

  • What are my expectations for success with bariatric weight loss surgery?

    Some patients will lose as much as 200 pounds, but most others will have a more modest weight loss*. Some will reach a normal weight while others will remain overweight – but less so than before. Some will regain the weight.

    In order to maintain your weight loss, it’s essential to follow the diet and exercise plan that the surgeon will give you and to be psychologically prepared for the challenge. Many people also find joining a support group very helpful. As well, following the surgery, many patients will want plastic surgery to remove excess skin.

    *Disclaimer: Surgical results vary from patient to patient, depending on factors such as age, physical fitness, or other complicating medical conditions. For this reason, prospective clients should not necessarily assume that they will have comparable surgical outcomes.

Nerve Blocks

  • What can be done to control my pain?

    If you are suffering from pain and the source of this pain has been carefully diagnosed by the appropriate doctor, and there is no other treatment available for you, a nerve block may be able to free you from pain. Nerve blocks can help those who suffer from:

     

    -Neck and back pain (especially from herniated discs)

    -Shoulder pain

    -Face pain

    -Jaw pain

    -Arm, hand, elbow and wrist pain

    -Abdominal pain

    -Cancer pain

    -Shingles pain

     

    Nerve blocks may also be useful to control pain if the source of the pain is known to be temporary or while you are waiting for other forms of treatment.

  • How do nerve blocks work?

    Nerve blocks literally block or disrupt the pain signal that is sent from your brain to your body. Some forms of nerve blocks use local anesthetic to achieve this. This is similar to the same way that “freezing” in your dentist’s office helps numb your mouth so you do not feel the pain of the drill.

    In addition to local anesthetic, nerve blocks also use other drugs and methods including cortiscosteroids, opiods, alcohol, cryoanalgesia (freezing) and radiofrequency (heat).

  • Why do I have to wait so long for a nerve block?

    As a result of rationing of care by the Canadian public health system and the limited availability of doctors specializing in pain management, your treatment may be delayed and will be subject to being cancelled. Timely Medical Alternatives can help you find a private clinic to expedite your case so you can get the treatment you need as quickly as possible.

  • What are the risks of a nerve block?

    The risks will very with the type of nerve block performed but may include soreness at the site of injection, elevated blood sugars, rash, itching, weight gain, bleeding, infection or allergic reaction. The more serious of these side effects are rare.

    Patients who are on anti-coagulant therapy such as Heparin or Coumadin may not be eligible for nerve blocks because of the risk of bleeding. Be sure to discuss any medications you are taking with your doctor.

  • How effective are nerve blocks and how long does the pain relief last?

    Nerve blocks may work for anywhere from several hours to several months. They can be delivered by a single injection or a continuous infusion. In some cases, they might even involve deliberately destroying the nerve. Nerve blocks are generally most successful if they are part of a total pain management program that also includes rehabilitation and training in other pain control measures such as self-hypnosis or relaxation exercises.