Gynaecology

Helping you be the best you.

Caring Skilled Gynaecological Care

As a skilled gynaecologist I will take care of your gynaecological concerns in a sensitive and respectful manner. I believe in clear open communication and encourage you to raise all concerns during our consultation. I understand that many gynaecological problems can cause pain, discomfort and impact on fertility. I will listen with warmth and empathy aiming to provide the most appropriate, evidence-based treatment options that meet your needs. There may be a variety of treatment options to be considered depending on your stage in life and future plans. I will listen to your individual needs and situation and give a sensitive and respectful assessment.

I treat all typical and atypical gynaecological presentations

Routine cervical screening tests are an important preventative measure in women’s health preventing hundreds of cases of cervical cancer each year in Australia. I perform routine cervical screening tests (the new version of the old pap smear) as part of routine preventative screening or as part of your care for a gynaecological condition that you have been referred to see me for.

Contraception advice may include hormonal therapies such as the oral contraceptive pill, Depot Provera, Implanon, Mirena and non-hormonal intrauterine devices. Laparoscopic sterilisation is also offered.

Abnormal cervical screening test results may require further investigation and management including colposcopy (a detailed examination of the cervix) to diagnose pre-cancerous changes called dysplasia that without treatment can lead to cervical cancer.I can perform colposcopy in my rooms and if treatment is required arrange for you to undergo the appropriate procedure.

The causes of abnormal menstrual bleeding are numerous and range from hormonal disturbances to uterine problems such as fibroids and polyps. Investigation usually involves a combination of clinical assessment, measurement of hormonal levels and ultrasound. Management may include hormonal therapies (contraceptive pill, Mirena), hysteroscopic surgery (removal of fibroids/polyps or endometrial ablation and laparoscopic/open surgery (removal of fibroids or hysterectomy).

Endocrine disorders such as Poly Cystic Ovarian Syndrome (PCOS) present in a variety of ways such as irregular cycles, excessive hair growth and weight gain. These chronic disorders are often distressing to patients and require thorough investigation, explanation and a holistic management approach
Menopausal symptoms are varied and can be distressing for some women. The topic of hormone replacement therapy has become controversial and confusing. I aim to advise and inform in an unbiased manner in order to empower you to make the right decision for you in regards to symptom management.
Pelvic floor weakness, particularly after childbirth may result in prolapse and/or urinary incontinence. The symptoms are often distressing but can be addressed through a wide range of therapies ranging from physiotherapy through to surgery.
The causes of pelvic pain include endometriosis, pelvic infection, ovarian cysts and non-gynaecological causes. Investigation usually involves a combination of clinical assessment and specialised ultrasound. Management may include hormonal therapies, antibiotics and laparoscopy.

IF REQUIRED AS PART OF YOUR CARE, I AM SKILLED IN THE FOLLOWING PROCEURES

Hysteroscopy is a minor day surgery procedure where the inside of the uterus is visualised using a fine camera inserted through the cervix. Saline solution is then run into the uterus to allow a good image to be obtained. It does not involve any incision on the abdomen and normally has a quick recovery time. It is performed for a variety of reasons but most commonly for the investigation of infertility or abnormal uterine bleeding. In this case a small biopsy of the lining is also performed (commonly described as a D&C or Dilatation and Curettage). When fibroids and polyps are seen within the uterus these can be removed or resected if necessary.
Laparoscopic (keyhole) surgery is where the abdomen is entered through small incisions (typically 5mm). A tiny camera is introduced and the inside of the abdomen is inflated with carbon dioxide to allow a clear view of all abdominal and pelvic organs so surgery can be performed. Laparoscopy is often performed to investigate infertility, removal of endemetriosis, fibroids or ovarian cysts and hysterectomy. Laparoscopy is normally a day surgery but patents will subsequently require a few days of rest.

Endometrial Ablation involves ablating or surgically destroying the lining of the womb usually with a device such as a Novasure endometrial ablation system which uses microwave energy to achieve this. It is an excellent treatment for women with heavy menstrual bleeding and is less invasive than a hysterectomy.

Myomectomy is the surgical removal of fibroids from the uterus. The recommended procedure will depend on the size and position of the fibroid(s). If the fibroids are within the uterus then they can be removed by a type of keyhole surgery called a hysteroscopic myomectomy without the need for an incision on the abdomen and this usually means a quick recovery. Other fibroids may need either laparoscopy or open surgery.

Hysterectomy is surgery to remove the uterus. It can be necessary for a variety of reasons such as: management of severe endometriosis and to remove uterine fibroids when fertility is no longer desired; management of pre-cancerous or early cancer cells in the lining of the uterus; management of abnormal periods where other less invasive attempts at management have not worked. Hysterectomy can be performed vaginally, laparoscopically or at open surgery. The reason for the hysterectomy will dictate which type of surgery should be undertaken. A common misconception is that the ovaries must be removed at the time of a hysterectomy. Most of the time this is not necessary and for women before the age of menopause it is unusual to remove the ovaries as they are important for the maintenance of healthy hormone levels.

Open surgery involves an incision through the skin and then entry into the abdomen (laparotomy). The incision is either low transverse (bikini line) or in the midline from the umbilicus (belly button) down towards the pubic bone. Open surgery is sometimes necessary for difficult ovarian surgery, hysterectomy or fibroid removal when the size of the uterus is very large. Open surgery usually requires a longer stay in hospital and around 4 weeks off work.

DR Adam Mackie

Obstetrician & Gynaecologist

I offer exceptional, personalised healthcare for women and their families in a calm supportive setting. I would love to hear from you.