Many of the midwives will be transferring up to Joondalup, so we will see familiar faces up there.

We’ve delivered a few babies up there already – all went very smoothly. We’re confident that patients will be happy with the service at Joondalup.

Additionally, there is a safety advantage: with a blood bank, HDU, ICU & NICU on-site for when things get interesting. Fortunately they will be used very infrequently with our patients.

It will mean some mild logistical issues need to be solved. We’ll need to use telehealth more, and there will be some occasional cross-covering needed with the other obstetric consultants.

We’re still doing all our consulting from our Duncraig rooms – so no changes there at all.

The post Move to Joondalup Private Maternity appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

We’re still very close to Glengarry Hospital, but now we have more space, more parking & a nicer environment.

The address is:

Glengarry Cottage,
31 Arnisdale Road,
Duncraig,
WA 2063

Unfortunately we have not been able to port out out old phone & fax number from the Ramsey corporate network. Too complex according to both Telstra & Optus.

Our new details:

Phone number: (08) 6119 9160
Fax numner; (08) 6119 9161

The building is the white house on the corner opposite Glengarry Park.

The post New premises appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Following the announcement of the projected closure of Attadale Private Hospital for obstetrics & gynaecological surgery, we can announce we’re moving our main base to Glengarry Hospital, Duncraig, Perth.

Glengarry is a friendly hospital with many similar attributes to Attadale: human scale, friendly staff, consistent familar faces, nice rooms with double beds, good food, easy free parking, easy accessibility from the freeway & coast road. The hospital is a 10 minute drive North of the city and is very accessible from all of the Western suburbs via the West Coast Highway.

Our rooms will be up & running soon, and we’re booking obstetric and gynaecology patients already. All operating will be at Glengarry in their excellent theatres.

The post New obstetrician & gynaecologist at Glengarry Hospital, Duncraig, Perth appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Hysteroscopy

in this type of operation, a narrow telescope is passed into the womb. Problems inside the womb are therefore able to be treated without any cuts on the outside at all.

Typical operations include:

• exploratory operations
• biopsies
• removal of polyps (small growths)
• removal of small fibroids
• reshaping the interior shape of the womb; which improves fertility
• sterilisation procedures.

Recovery is very rapid, and potential complications are few. They will be discussed with you at the the time of booking during the informed consent process.

Laparoscopy

In this type of operation, a small camera is passed, usually through the tummy button. This allows us to see inside the abdomen and pelvis. This scar usually heals very well – often becoming invisible with time.

Additional small 5 mm incisions are made in the lower part of the abdomen – normally between one and three. These additional incisions allow operations to be performed using a variety of sophisticated technologies, and remove any specimens that may be needed.

Keyhole surgery is more difficult to perform than traditional open surgery but, because of the magnification, things are much clearer and the surgery is more precise. Recovery is much faster, and it’s very common for women to walk out of the hospital after a few hours after quite significant procedures, with only a week to fully recover.

Common operations performed at laparoscopy include:

• hysterectomies
• removal of ovarian cysts
• removal of the fallopian tubes
• removal of fibroids
• treatment of endometriosis
• removal of adhesions and scar tissue
• infertility surgery

Overall, 95% of Dr Sillender’s surgeries are performed using keyhole methods. There are some conditions which require traditional techniques with bikini-line or midline abdominal incisions, but the default technique is nearly always a minimal access or keyhole surgery method.

The risks of this type of keyhole surgery are important to mention. Fortunately serious complications are extremely uncommon. The most important risk is that of damage to bowel or a major blood vessel at the time the laparoscope is inserted at the start of the operation. This is said to occur in about 1:1000 cases. Other risks are infection, bruising, bleeding, and specific complications of the particular operation. For instance, removal of fibroids can lead to bleeding, scar tissue forming afterwards and slight weakening of the womb during pregnancy. Possible complications will all be discussed at the time of taking informed consent before booking the operation.

Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful.

The post The advantages of keyhole surgery appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

1. Having a trusted obstetrician

Confidence in the care-giver, by having continuity of care and a good relationship, is very important to reduce anxiety and encourage healthy labour.

2. Training for the labour

It has been traditional for women to go to birth classes and learn breathing exercises and other techniques to prepare for labour and birth. These techniques provide some help coping with contractions but they don’t actually help with the pushing.

The second stage of labour (the pushing stage) needs 2 things from your muscles:

1) A lot of physical exertion for 30-60 minutes.
2) Relaxing your pelvic floor at the right time as the baby’s head comes down, while still pushing.

The human body performs better in any activity when the person has trained and prepared.

You can prepare your body for birth using a new trainer called the EPI-NO. This helps the pelvic floor muscles get ready for stretching during birth and also trains the pushing muscles. When a woman prepares for birth using the EPI-NO, the following benefits have been seen in several research studies.

• Significant reductions in the rate of episiotomy & the rate of tears (reduced from 50% to 10-20%).
• Reductions in urinary incontinence, prolapse, problems with sex, and faecal incontinence (due to fewer third degree tears).
• Significantly reduced chance of forceps or vacuum delivery.
• The second stage of labour is significantly reduced in length putting less strain on you and your baby.
• Fewer painkillers are needed, during and after.
• Babies have better APGAR scores after birth and are less distressed. This improves bonding, breast feeding & reduces crying.
• Anxiety is reduced.
• Confidence in birth is much increased.

There are no downsides. 98% of women using the EPI-NO would recommend it.

We strongly recommend this birth trainer, which costs $179, and is bought online or from pharmacies.

3. Perineal massage

Regular, frequent massage with olive oil reduces tears during birth by about 4% but is not as good as the EPI-NO.

4. Being well rested

This is really important but is overlooked by just about everyone! Pregnant women have often had poor sleep leading up to their birth for multiple reasons. Read our guide to sleep and try to optimise this as much as possible. If you have young children, can someone else look after them if they wake during the night? Can someone else get them ready in the morning? Can you get a good afternoon nap after lunch? Don’t watch TV or surf the net after 8pm. Get the pets out the bedroom. If the other half snores send him to the spare room until after the birth! Go to bed and wake at the same time every day. Have a warm milky drink before bed. Have a tepid bath a couple of hours before bedtime. If hot, use air-con if you have it, fans if not. If you have heartburn try some antacids from the pharmacist, or even some over-the-counter Zantac – it’s safe in pregnancy. Try an antihistamine like Piriton at night for its drowsy effects – it’s safe in pregnancy.

5. Having a birth supporter

There is evidence that having the support of an additional trusted person in labour is important in birth and reduces anxiety & the length of the labour. A mum, sister, or a good friend (as well as your partner) can be a great help – as long as they don’t get stressed by it all!

6. Inducing labour

You will hear more opinions on induction than just about anything else in childbirth! Some are opposed to induction because they think it increases the chance of problems. The opposite is actually true; this is now supported by Level 1 evidence.

It is very clear that induction reduces the chance of emergency Caesarean section, having a bad third degree tear, baby getting distressed, and stillbirth. Yes, it’s “not natural”. For the evidence, go here.

• Chance of death of the baby is reduced by 2/3
• 50% reduction in meconium (“baby poo”) aspiration into the lungs
• 11% reduction in emergency Caesarean section
• 25% reduction in very large babies

The optimum time for induction to get these benefits is between 39-40 weeks of pregnancy. If you decide to have an induction, we go slow and mimic natural labour as much as possible, and allow plenty of rest during the process.

7. Upright positions in labour

In early labour, walking around helps reduce discomfort and encourages baby’s head to move down. In active labour, upright positions encourage good labour. Even if you have an epidural, stay upright as much as possible. Upright positions during pushing can also be helpful for many women.

8. Having some nourishment in labour

It’s important to keep your energy levels up. If it’s looking like you’ll need a Caesarean we’ll ask you to be nil by mouth. But if not, it’s important to keep eating – nothing too “heavy” but have easily digestible high energy food.

9. Having a special injection to relax the cervix and shorten the labour

This single injection of hyoscine is well proven, has been used in pregnancy for decades, has no downsides, and will shorten labour by 2-3 hours without increasing contractions or pain at all. The baby is completely unaffected.

10. A word on epidurals

An epidural does increase the chance of a longer labour and assisted delivery. It does not increase the risk of a Caesarean however, despite what many people think. The techniques listed above will help, but not entirely as some babies are more likely to remain “back-to-back” with an epidural.
A new technique for reducing forceps and vacuum delivery rates is where we turn the baby from back-to-back to the correct way with a hand. This is called a manual rotation. It is performed when you reach full dilatation, and only if baby is healthy and it is safe.

The steps involved are
• “Topping up” the epidural
• Scanning to check baby’s position
• Making a judgement that a vaginal birth is realistic, even if the baby is turned
• Placing a hand on baby’s head inside the vagina and a hand on the abdomen
• Whilst you push, turning the baby by rotating the head and shoulder to an anterior position
• Monitoring the baby while this is happening.
• It takes up to 3 contractions to do this.
• You then push the baby out yourself as normal

It is quite successful a lot of the time and reduces the length of the pushing stage and the chance of forceps or vacuum.

11. If it’s your first birth and you have an epidural

An oxytocin drip started when you’re fully dilated, even if you’re already contracting, reduces the forceps or vacuum rate significantly.

The post Maximising the chances of an uncomplicated birth appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Colposcopy is an examination of the cervix using a special microscope called a colposcope. The microscope allows the doctor to see the cervix and other areas in detail. Dr Sillender can find abnormal areas and take samples if needed.

Why do I need a colposcopy test?

You may have been referred for the test for any of the following reasons

• an abnormal Pap test result
• an abnormal area appearing on the cervix, vagina or vulva
• bleeding from the cervix

Dr Sillender will discuss with you why you are being referred.

What does having an abnormal Pap smear test result mean?

When the pathologist in the lab viewed your test on a slide he/she saw cells that looked “different” from normal cells. An abnormal test result may indicate the presence of

• HPV (Human Papillomavirus)
• low- or high-grade dysplasia(pre-cancer changes)
• bacterial infection
• pregnancy
• aging
• normal inflammation

Does this mean I have cancer of the cervix?

No. An abnormal Pap test result or referral for a colposcopy examination does not mean you have cancer.

Very few women with abnormal smear test results have cancer. A smear test helps detect abnormal cell changes before cancer develops.

How is a colposcopy done?

It is very similar to the Pap smear test. We place a speculum into the vagina to look at the cervix. A smear may be taken. A solution is applied to the cervix and vagina. You may feel a tingling sensation. Any abnormal areas turn white. Dr Sillender looks at the cervix through the colposcope – the colposcope does not enter your body. This usually takes about 10 minutes.

Tip: Empty your bladder just before the test – you’ll feel less pressure.

Will a biopsy be done?

If any abnormal areas are seen, a biopsy or small tissue sample will be taken. You may feel a pinch when the biopsy is taken or you may not feel any discomfort. Silver is applied to the biopsy site to help stop any bleeding.

What happens after a biopsy?

• You may have mild abdominal cramping
• Use ibuprofen or panadeine before your appointment to prevent this discomfort
• You may have a small amount of bleeding or dark coloured discharge. This may last a few days. The nurse will give you a sanitary pad.
• You can bathe, shower, and resume yourusual activities
• You should avoid intercourse for a few days at least

If you have any problems, call the PEARL office or ring Attadale hospital out of hours.

Will I need treatment?

You may or may not need treatment based on your colposcopy and test results. Dr Sillender will recommend the best treatment for you. Treatments are often arranged within 2-3 weeks of your visit.

Commonly used management plans include: observation with more regular PAP smears or LLETZ. Most treatments can be done awake, but general anaesthesia is available.

If you have genital warts or polyps they may be treated on this first visit.

Your colposcopy test results

Dr Sillender may discuss the colposcopy findings with you immediately after the test. In other cases a follow-up visit may be arranged to discuss your test results and possible treatment. A follow-up appointment may or may not be needed. If recommended, it is important to keep all follow-up visits.

Dr Sillender will send a letter to your GP or sexual health specialist about your findings and follow-up care. If you have any questions or concerns, please call us for more information.

Can I come for colposcopy if I am menstruating?

Yes, if your flow is not too heavy and you are comfortable coming for your test. You may wish to rebook your appointment. Please call us to rebook if needed.

Should I have a colposcopy examination if I am pregnant?

If you are pregnant, keep your appointment. Observation is usually all that is needed. Treatments are usually done 6 weeks after the birth.

Why is there a screen in your examination room?

Our colposcope is state of the art and is equipped with a video camera and TV monitor. You can see on the monitor what we are seeing through the colposcope. This may give you a better understanding of what is happening. Many of our patients choose not to watch the monitor!

Will there be more than one person in the room?

There will be a nurse in the room to assist.

The post Colposcopy with a specialist gynaecologist near Fremantle, Applecross, Attadale, Cottesloe, Mosman Park and the other Western suburbs appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

Dr Mark Sillender is a specialist Obstetrician and Gynaecologist with a strong interest and extensive experience in the management of both uncomplicated and complicated pregnancy. We strive to offer friendly, accessible maternity care that is responsive to all your needs.

Location

We are located at Attadale Private Hospital, a friendly small hospital by the banks of the River Swan. We’re conveniently located for anywhere south of the Swan river from Fremantle to Applecross, South Perth and beyond. It’s also easy to reach us from the Western suburbs north of the river. Cottesloe, Mosman Park and Claremont are within a 15 minute drive.

The birth suites are spacious with self-contained private gardens. Rooms have easy access to adjacent parkland. Parking is free and generally easy.

Our obstetric services include – but aren’t limited to:

Preconception assessment | advice
Optimisation of medical problems and general health prior to embarking upon pregnancy. Dr Sillender has been published in academic journals on vitamin supplementation around conception.

All aspects of miscarriage care
Including the assessment and management of recurrent miscarriages. We understand the anxiety that women can have after miscarriage. We can support you and see you as often as you need. Scans can be used liberally.

General pregnancy care
We are happy to provide you with all reasonable birthing options from low-intervention birthing to Caesarean section (C-section). We are comfortable discussing all your wishes for your birth. We have our obstetrician & midwives working collaboratively – our two PEARL midwifery colleagues and the Attadale Hospital midwives help optimise your antenatal and birth experience without compromising safety. Research has shown that undergoing continuous care is the safest option for all women who are pregnant. Integrated care with both a specialist obstetrician and a midwife provides holistic care that covers all the bases.

Pregnancy care for women with medical problems
Including high blood pressure, heart problems, asthma, kidney and bladder disorders, anaemia and thalassaemia, thyroid and other endocrine problems, liver and gastrointestinal problems, inflammatory conditions such as SLE and arthritis

Pregnancy care for women with reproductive problems

• Fertility problems or those who have conceived with IVF or other reproductive technologies
• Recurrent miscarriages
• Previous cervical surgery
• Polycystic Ovarian Syndrome (PCOS)
• An increased BMI
• Previous preterm births
• Previous significant pregnancy problems eg. haemorrhage, severe pre-eclampsia, deaths
• Previous difficult or traumatic births
• Pregnancy care for women with psychological or psychiatric conditions
• Pregnancy and birth care for women with previous caesarean sections
• Pregnancy and birth care for women with multiple pregnancies. Dr Sillender has lots of experience in managing twin pregnancies – including those with monochorionic twins, and his own twin boys!
• Pregnancy and birth care for the over 40s, who often have specific relevant issues.

We believe that, even in the presence of significant complications, it is our role to make the pregnancy and birth experience as positive as possible.

The post Having a baby with a specialist obstetrician with PEARL obstetrics gynaecology at Glengarry hospital appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

There are two main ways of performing sterilisation at laparoscopy (a type of keyhole surgery).

The first, more common, method is to place specially designed clips on the tubes. These clips crush the tubes causing a small portion to be blocked. The clips remain in the body. Sometimes they migrate but this rarely causes problems. Sometimes the clips may be thought to cause pain afterwards – the so-called sterilisation syndrome. An attempt at reversal may be used with this type of sterilisation, but reversal is unreliable.

The second method is to remove both Fallopian tubes completely using special instruments. This is a more involved procedure, more costly, but has the advantage of leaving no foreign body behind. This sterilisation can not be reversed, which may or may be an advantage.

What happens at surgery?

A general anaesthetic is used. A camera is placed through an incision in your tummy button. With the clip method, another 1cm incision is made above the pubic bone, an instrument is passed through and the Fallopian tubes are clipped. Any pelvic abnormalities found may be treated at the same time eg. endometriosis and adhesions. The operation usually takes less than an hour. If you wish the second more complex operation ie. removal of the tubes, this requires 2 smaller incisions on each side instead of the 1cm middle one. This operation takes longer.

Important points

It’s an “irreversible” procedure

This operation should be regarded as permanent. Most women who change their minds end up having to have IVF. Reversal is only occasionally successful when clips are used and very expensive.

Failure rate

Women occasionally get pregnant after this operation. The pregnancy rate after clips is reported to be 1 | 200-500 depending upon age – the tubes rejoin together and become open again. Even if you have the tubes completely removed, pregnancy can still occasionally occur! If you did become pregnant, the pregnancy might be ectopic, so you would need to see a doctor if you were pregnant.

Laparoscopy risks

Generally very safe surgery. Serious bleeding or damage to the bowel or bladder are the most important complications, which is said to occur in 1 | 500 cases. Special techniques are used to minimise these risks. Minor infections or bruises are common and settle with time and | or antibiotics.

Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful.

After the operation

Normally a day-case operation. You’ll come in having had no food or drink for 6 hours. Afterwards you’ll probably feel drowsy and perhaps slightly sick, which will wear off quickly. You’ll need someone to take you home and be with you overnight.

Will it be painful?

It’s usually not too bad. There may be some pain or discomfort for usually up to a week, but you’ll have pain relief. Sometimes the pain is in your shoulders – this is normal and will settle. Rest up for a few days and have the rest of the week off work.

Incisions

Keep them clean and uncovered. Bathe & dry thoroughly but gently. If they become red, get some antibiotics – the earlier the better. It may be a minor infection (that 1 | 20 women get despite us giving antibiotics during the surgery). The stitches will dissolve and come away themselves.

When can I drive?

Usually after a few days when you feel ready and the pain has settled.

When can I go back to work?

Have the rest of the week off. Ask us for a sickness certificate if needed.

When can I have sex?

When you feel ready. Continue your usual contraception until your next period (unless you’re on your period at the time of the operation).

The post How straightforward is a sterilisation procedure? appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

HRT is beneficial when started at the time of the menopause. The research that showed problems with HRT was in women in their 60s who already had medical problems. When started at the correct time, hormone replacement therapy cut deaths by 25% according to the research – people are afraid to use it because this wasn’t reported! Patches may be even better than tablets.

HRT is good for treating flushes, sweats and vaginal dryness. It prevents fractures and helps the discs in the spine. Oestrogen without or with testosterone helps some reproductive depression, energy and libido. There is evidence that it reduces heart attacks. HRT improves the texture of the skin & nails. There is a 1% extra lifetime risk of breast cancer. This should be balanced against the fewer heart attacks, fewer deaths and serious fractures in those who start HRT below the age of 60.

HRT will stop your hot flushes and sweats

Troublesome hot flushes, severe night sweats and headaches causing chronic insomnia are characteristic symptoms of the menopause. These symptoms may last for many years. Apart from being socially embarrassing they result in tiredness and depression because of lack of sleep. These symptoms can be cut by at least 75% with HRT. No other teatment is as good.

Oestrogens will treat vaginal dryness, painful intercourse and lack of libido

Thinning, vaginal dryness, and occasionally bleeding occurs after the menopause. This also can be successfully treated with HRT, or local oestrogen cream which is very mild.

HRT increases bone density and prevents fractures

HRT is the most effective way of increasing bone strength and preventing osteoporotic fractures even in low-risk women. Younger women with weak bones due to premature menopause, early removal of the ovaries or anorexia benefit even more from HRT.

HRT protects the intervertebral discs

HRT prevents collagen being lost from the intervertebral discs, thus maintaining their strength and function. These discs act as cushions of the spine, preventing a bending of the spine and a hump.

HRT reduces heart attacks

The 2002 WHI Study, showed an increase in heart attacks but looked at patients of the wrong age using HRT ie over 60s. Women below the age of 60 have fewer heart attacks. A Mirena used with oestrogen makes HRT even safer.

Oestrogens help depression in many women

There is no doubt that depression is helped in postmenopausal women who have been suffering from night sweats, insomnia or vaginal dryness, painful intercourse and marital problems in that most of these problems can be effectively treated and removed. Some younger perimenopausal women with depression that is hormone sensitive in the 2–3 years before menopause can do very well with HRT.

HRT improves libido

HRT improves libido by curing vaginal dryness, painful intercourse and improving sexual desire. Testosterone can also be helpful, but must be used carefully.

HRT improves the texture of the skin

After the menopause, women lose about 25% of their collagen – thin inelastic skin, brittle nails, loss of hair. Oestrogen therapy replaces the lost collagen in the skin and the bone. Its effect on the facial skin is a very obvious useful cosmetic effect.

‘Better person to live with’
Many women say that when estrogen therapy stops their depression, their loss of libido and their irritability, they become more agreeable people to live with. The depression, irritability, grumpiness and loss of energy and disinterest in sex can usually be improved considerably HRT.

HRT is safe

In women who started HRT below the age of 60 there were fewer heart attacks, fewer deaths & fewer fractures. The additional risk of breast cancer of 1% is no more than the breast cancer risk of being overweight or drinking wine.

We are experienced in all menopausal matters

Dr Sillender has a huge amount of experience in menopause medicine, having worked with and stood in for one of world’s foremost authority’s on HRT in his quaternary referral clinic in a London teaching hospital. You will need a referral from your GP if you would like a Medicare rebate, otherwise unsubsidised private fees apply. Our clinic is located near Fremantle & Applecross, a short drive from the Western Suburbs, so come and see us.

The post The benefits of HRT appeared first on Obstetrican & gynaecologist, Glengarry Private, Perth.

The removal of abnormal cells, detected on a smear, from the cervix with a heated loop. It’s also called a LEEP procedure.

Why do I need would I need a LLETZ?

Following an abnormal smear test, colposcopy & biopsies, it becomes clear that the abnormal cells present on the cervix aren’t mild and likely to go away by themselves. Therefore, it’s important to have them removed in a simple way before they develop, over the course of several years, into cancer of the cervix.

Duration

The procedure itself takes about 10 minutes, and is very straightforward.

How is it performed?

It’s very similar to a coloposcopy.

1. You will be asked to lie on the examination bed with your legs supported by stirrups.
2. A speculum will be placed like when you have a Pap smear.
3. The colposcope – a special kind of microscope – will be set up for viewing the cervical area.
4. A staining solution will be applied to your cervix. This highlights the abnormal cells.
5. Your cervix is anaesthetised with local anaesthetic. This may be slightly uncomfortable.
6. The abnormal cells are then removed by an heated wire loop. This does not hurt.
7. The treated area is then sealed using heat to prevent bleeding.
8. The removed cells are sent for testing by pathology.

Very important

Let us know if you’re having a heavy period | have an infection | are travelling | are getting married | or have an important event in the month after your appointment. We can easily rearrange your appointment for another time.

After the procedure

• You might get a little cramping pain afterwards, although many patients do not. Take paracetamol, ibuprofen or panadeine if you want
• You will get a blood-stained discharge initially. This may be pink, red or brown/black
• It will then become watery and continue for up to four weeks after treatment while healing takes place
• Use panty liners NOT TAMPONS

Seek medical advice from your GP or an emergency department or give us a call if you experience any of the following

• Offensive & smelly vaginal discharge
• Heavy vaginal bleeding up to 14 days after treatment
• Severe abdominal cramps | pain

Afterwards, avoid

• Heavy or vigorous exercise for 2 weeks.
• Tampons, until the discharge has settled, usually about 4 weeks.
• Sexual intercourse, until the discharge has settled, usually about 4 weeks.
• Long baths. Short baths are OK.

Results

• We are unable to give the results out over the phone.
• As soon as we get results, a letter will be posted to you with the results & planned follow up.

Follow up

• A follow-up smear & colposcopy is nearly always required 4 months after treatment.
• This is to make absolutely sure all cells have been removed.
• We’ll automatically book this appointment for you. Call us to change it if it’s inconvenient.
• You will then need a smear every year until you’ve had two negatives. Then you can return to normal screening

Smoking

Stopping smoking is an important way of reducing chances of the cells coming back. It allows your body’s own defences to fight the pre-cancerous cells. If you smoke we’d strongly advise you to stop.

PEARL obstetrics | gynaecology

The clinic is situated in Attadale Private Hospital, and is easily accessible from South of the river suburbs like Fremantle, Bicton, Applecross, Melville and Mount Pleasant. The Western suburbs of Cottesloe, Mosman Park, Claremont, City Beach and Swanbourne are all within easy reach.

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