Women Wellbeing
Mr Mark Malak. Consultant Gynaecologist & Urogynaecologist. MSc, DFFP, PhD FRCOG. Eastbourne and East Sussex Hospitals
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  Procedures
 
 
Latex Allergy : "National Library of Medicine"

Colposcopy:To look with a magnifying lens at the neck of the womb  : "National Library of Medicine"


Cystoscopy: To look with a camera inside the bladder : "National Library of Medicine"


Cystoscopy: To look with a camera inside the bladder : "Harvard Medical School"


Hysteroscopy: To look with a camera inside the womb : "Harvard Medical School"


Laparoscopy:To look with a camera inside the tummy : "National Library of Medicine"



HYSTERECTOMY
 

Hysterectomy: To remove the womb : "National Library of Medicine"


Hysterectomy: General Information and Outcome after Total (to remove neck of womb) versus Subtotal (to leave neck of womb) procedures : "Cochrane Systemic Reviews"

Editorial group: Cochrane Menstrual Disorders and Subfertility Group.
Publication status and date: Edited (no change to conclusions), published in Issue 1, 2009.
Review content assessed as up-to-date: 2 February 2006.

Citation: Lethaby A, Ivanova V, Johnson N. Total versus subtotal hysterectomy for benign gynaecological conditions. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD004993. DOI: 10.1002/14651858.CD004993.pub2.

Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Abstract

Background
Hysterectomy using an abdominal approach removes either the uterus alone (subtotal hysterectomy) or both the uterus and the cervix (total hysterectomy). The latter is more common but outcomes have not been systematically compared.

Objectives
To assess and compare outcomes with subtotal hysterectomy versus total abdominal hysterectomy for benign gynaecological conditions.


Authors' conclusions
This review has not confirmed the perception that subtotal hysterectomy offers improved outcomes for sexual, urinary or bowel function when compared with total abdominal hysterectomy. Surgery is shorter and intraoperative blood loss and fever are reduced but women are more likely to experience ongoing cyclical bleeding up to a year after surgery with subtotal hysterectomy compared to total hysterectomy.


Plain language summary
Total versus subtotal hysterectomy for benign gynaecological conditions
When abdominal hysterectomy is required for non cancerous conditions, either the uterus alone (subtotal hysterectomy) or the uterus and the cervix (total hysterectomy) are removed. Some people have suggested that not removing the cervix (subtotal hysterectomy) would reduce the chance of sexual difficulties and/or problems with passing urine or solids. This review has found no evidence of a difference between these 2 types of surgery for these outcomes. Surgery is faster with subtotal hysterectomy and there is less blood loss and fever during or just after surgery but women are more likely to have long term ongoing menstrual bleeding, when compared with total hysterectomy.
 
 

Would we remove normal ovaries during hysterectomy in women with no risk for cancer?

It has been shown that the risks outweight the benefits. Estrogen and other drugs mitigate the risks associated with removal of normal ovaries—but many women avoid or discontinue these medications:

Removal of normal ovaries may cause more harm than good in many women undergoing hysterectomy for benign disease


Laparoscopic Hysterectomy: "NICE"

Laparoscopic techniques for hysterectomy:"NICE"


Incision Care : "National Library of Medicine"




Hysteroscopy - Hysteroscopy - Health A-Z Hysteroscopy illustration key … A hysteroscopy is a procedure where a doctor can look at the inside of the uterus (or womb) using a … you to have a …


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  • Complications - Laparoscopy - Health A-Z

    Complications of a laparoscopy  … After a laparoscopy, you may have some minor bleeding or bruising around the cuts in the skin of you … during a laparoscopy there is a small …

  • and my appendix was taken out as a safety measure.

  • Advantages - Laparoscopy - Health A-Z

    Laparoscopy … As laparoscopy is a form of keyhole surgery, it allows the surgeon to look inside the body in a way … scars following laparoscopy are smaller than in …

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  • How it is performed - Laparoscopy - Health A-Z

    How laparoscopy is performed  … A laparoscopy is usually a fairly short procedure. … The laparoscopy procedure

  • Introduction - Hysterectomy - Health A-Z

    A hysterectomy is an operation to remove your womb (uterus). After the operation you will no longer be able to have children. If you haven't yet gone through the menopause, you will no longer have periods. It's estimated that one in five …


 

Mr Mark Malak

Consultant Gynaecologist & Urogynaecologist

MB BCh, MSC, DFFP, MRCOG, PhD, FRCOG

 

Professional Profile

 

Mr Malak is a consultant Obstetrician, Gynaecologist and Urogynaecologist. He is currently the Lead Clinician at East Sussex NHS Hospitals Trust and has worked at Eastbourne since 1995.

Mr Malak has a special interest in urogynaecology, colposcopy and minimally invasive laparoscopic & hysteroscopic gynaecological surgery (for abnormal bleeding, pelvic masses and pelvic pain).

Mr Malak is the East Sussex Hospitals Lead Urogynaecologist. He established the first integrated, multidisciplinary urogynaecology team in Eastbourne in 1996. His team was awarded the 2nd place in the prestigious “Hospital Doctor” award for the best urinary continence team in United Kingdom.

He has extensive clinical and surgical expertise to manage urinary incontinence, frequency, urgency & recurrent cystitis and to perform pelvic reconstructive surgery for incontinence & uterovaginal prolapse. A subjective retrospective audit of his continence surgery showed a success rate of 97% (complete cure rate of 94%).He also is interested in the management of sexual dysfunction, including vaginal corrective surgery.

He is the Eastbourne Lead Colposcopist and is responsible for management of cervical abnormal cytology (smears).

Mr Malak was awarded the Department of Health Clinical Excellence Awards in 2005, 06, 07, 08 and 2009.

He was awarded the Doctor of Philosophy degree (Ph D) and the “Ernest Frizelle Prize” from University of Leicester for his important clinical research (45 publications). In 2008, Mr Malak was elected to the membership of the publication Committee of the International Urogynaecology Association.

Mr Malak publishes regular educational “Gynaecology Update” for GPs since 1997. He has also established educational internet sites for medical professions (markmalak.com) and for patients (mrmalak.com).

Mr Malak's achievements were featured in many national and local media (newspapers and TV news) regarding the introduction of minimally invasive surgery for heavy periods, impact of his clinical research and when his team won the 2nd place in the prestigious “Hospital Doctor” award. Patients' feedback

He is keen to ensure that patients are fully informed and involved in all aspects of their care.


For more information please visit the Author section

Professional memberships

  • British society of Urogynaecology (BSUG)
  • Internatioal Urogynaecology Association (IUGA)
  • British Society of Colposcopy and Cervical Pathology (BSCCP)
  • Royal College of Obstetricians and Gynaecologists
  • General Medical Council (GMC)
  • Medical Protection Society (MPS)

Clinical interests

 

Urogynaecology Management of urinary incontinence & urinary frequency and urgency Pelvic reconstructive surgery for urianry incontinence and uterovaginal prolapse Management of sexual dysfunction including vaginal corrective surgery Management of recurrent cystitis

 

Abnormal bleeding Medical and surgical management of heavy periods, bleeding between periods, bleeding related to intercourse, fibroids, endometriosis

 

Minimal invasive surgery Laparoscopic surgeryfor pelvic pain, pelvic masses and hysterectomy Hysteroscopic surgery for uterine bleeding (e.g ablation)

 

Colposcopy Management of cervical abnormal smears Management of vulval abnormalities

 

Gynaecological Endocrinology Management of menopause Management of polycystic ovarian disease

 

Gynaecology Cancer Unit core member Early diagnosis of gyanecological malignancy Management of pre-invasive and early invasive uterine cancer

 

NHS hospital


 

East Sussex NHS Hospitals Trust

(Eastbourne District General Hospital), King's Drive, Eastbourne BN21 2UD

East Sussex NHS Hospitals Trust

 

 

Private Rooms and Hospital


 

The Esperance House

The Esperance Private Hospital, Hartington Place, Eastbourne BN21 3BG

Tel: 01323 414816/410717/411188

http://www.bmihealthcare.co.uk/

The Esperance Private Hospital

Websites

http://www.mrmalak.com

http://www.markmalak.com

 




  • Introduction - Laparoscopy - Health A-Z

    Laparoscopy is a procedure doctors use to look inside the abdomen. It can help to identify and diagnose a range of conditions, including appendicitis and ovarian cysts. A small cut (incision) is made in the abdominal wall, and a …

  • Laparoscopy - Laparoscopy - Health A-Z

    Laparoscopy is a procedure doctors use to look inside the abdomen. … may need to have a laparoscopy to investigate symptoms such as abdominal pain, pelvic pain or swell … Sometimes a …

 


  • What it is used for - Laparoscopy - Health A-Z

    … a diagnosis, and a laparoscopy may be recommended to allow doctors to look directly at the organs w … The most common conditions diagnosed through laparoscopy include: …

  • Recovery - Laparoscopy - Health A-Z

    Recovering from a laparoscopy  … After a laparoscopy, it is normal to feel some pain and discomfort around the cuts in your abdomen. … or two after the laparoscopy, which can …







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