Procedures / Operations


Adhesions are abnormal connections between structures in the body, usually following open surgery or infection. They present with pain and may cause infertility. Laparoscopy (keyhole surgery) has the advantage of minimizing adhesion formation in the first place compared to open (abdominal) surgery and being very suitable to correct them once they are present...

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Endometriosis is a painful disease caused by growth of menstrual tissue inside the abdominal cavity. It causes severe period pain, heavy or irregular periods, infertility, pain passing motions or with intercourse and can often keep a woman confined to bed for 1- 2 days per month. It is best diagnosed by a laparoscopy to allow a full and detailed view of all surfaces within the pelvis, and skilled surgeons can remove all disease via keyhole incisions...

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Early gynaecological cancers and family risks

Gynaecological cancer can affect any pelvic organ. Gynaecologists are the primary specialists involved in the investigation and early management of many of these problems including pre-cancerous changes of the cervix, abnormal uterine bleeding and ovarian changes. In addition, laparoscopic surgeons are skilled at risk reducing surgery for women who carry the BRCA1 or 2 genes...

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Fibroids are abnormal balls of uterine muscle that grow within or around the uterus. They cause heavy menstrual bleeding or pressure symptoms like urinary frequency, depending on where they are situated within the uterus. Rarely they may undergo malignant or cancerous change. Fibroids were traditionally removed via a large abdominal incision however most if not all can now be removed via minimal access (keyhole) techniques thus reducing hospital stay, pain, adhesion formation, time off work and increasing future fertility options...

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Removal of the uterus is a major decision for a woman and one that can only be made once your family is complete. Whilst many other options exist, hysterectomy is 100% successful in ending menstrual periods and removing cyclical pain associated with a number of conditions such as fibroids, adenomyosis and endometriosis. A common misconception is that hysterectomy causes the menopause – this is not so. Removal of the uterus does not affect the ovarian function (where hormones are made) unless the ovaries themselves are removed. All it does is remove the womb and cervix, the ovaries are usually left...

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Pap smear problems

The Human Papilloma Virus (HPV) is responsible for the vast majority of pre-cancerous changes in the female cervix (the neck of the womb) causing abnormalities detected by a regular pap smear. These changes are classified as Low-grade or High grade depending on the cellular changes seen by the lab, and at that stage referral to a specialist is often warranted to confirm the diagnosis and plan further treatment if appropriate...

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Ovarian cysts

The ovary is a constantly changing organ providing a follicle (egg) every month during a womans fertile years. Unfortunately this activity makes the ovaries prone to develop cysts or growths that may be exaggerations of normal physiological structures (functional cysts) or tumours, abnormal growths in the ovary both benign and malignant. Such cysts can be;

  • Silent – no symptoms at all
  • Painful – from twisting or bleeding into the cyst as fragile new vessels grow
  • Rupture causing pain or leading to adhesion formation
  • Cause problems with fertility
  • Press on the bowel or bladder causing urinary frequency or constipation
  • In rare case, can be malignant (cancerous)

Ovarian cysts may be diagnosed during a routine pelvic examination or found by ultrasound. They are well suited to removal by laparoscopy...

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Urinary incontinence is a common problem for women following pregnancies or after the menopause . It can present with a number of different symptoms;

  • Stress incontinence – the loss of urine with coughing, sneezing, laughing or exercise limiting normal lifestyle activities and often causing embarrassment. It is commonly associated with pelvic organ prolapse as well.
  • Urgency – the need to rush to the toilet because of a sensation of needing to pass water, often when running the tap or putting the key in the front door!
  • Voiding dysfunction – difficulty coordinating the relaxation of the pelvic muscles with the contraction of the bladder causing urinary difficulties.

If this seems like you problem,

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Pelvic floor prolapse affects an increasing number of women due to damage cause to the pelvic floor during childbirth, loss of oestrogen after the menopause or inheritance of weak connective tissue. It can be felt as;

  • Urinary problems such as incontinence
  • A bulge felt vaginally especially on straining
  • Dragging or back pain
  • Discomfort with intercourse
  • Difficulty passing a bowel motion

Prolapse is rarely if ever life threatening however it can affect lifestyle and at the very least, one should be aware of the options available for correction...

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Female sterilization procedures

For those women who are satisfied their family is complete and who no longer wish to use alternative forms of contraception such as the pill, permanent sterilization is a good option. It can be performed as a laparoscopic sterilization placing clips over the fallopian tubes, or via the new advanced techniques of hysteroscopic sterilization (Essure or Adiana) using a tiny camera placed via the cervix to insert small devices into the fallopian tubes to minimize discomfort and make return to normal activity much faster. Dr Rosen was a leading figure in the introduction of the Essure technique to Australia and is happy to discuss any of these options with you...

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Reversal of Sterlization

Many women call the practice to enquire about reversal of sterilization. In theory this is possible and Dr Rosen can certainly perform the procedure laparoscopically with minimal risk and speedy return to work. There are however, some issues to consider...

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