Women's Health Clinic
Surgical procedures
Here is information about some of the procedures offered. Patients are often discharged on the same day, but Klíníkin also has complete inpatient facilities where patients are diligently cared for after surgery.
Laparoscopic hysterectomy
Laparoscopy
Jón Ívar has performed over 2000 laparoscopic hysterectomies. He specialises in offering laparoscopic hysterectomy to patients who have been told that the procedure could only be done with a large incision (laparotomy). Laparoscopic hysterectomy leads to less pain, less blood loss, lower risk of adhesions, infection, and blood clots, and is therefore a safer and better option for patients. The average recovery time is about 3 weeks after laparoscopy, compared to 6-8 weeks after laparotomy.
Average recovery time: 3 weeks (ranging from 1-6 weeks)
Time in hospital after surgery: 1 night
What is removed: uterus and fallopian tubes. Usually the cervix and rarely the ovaries. Depends on clinical circumstances.
Jón Ívar has performed over 2000 laparoscopic hysterectomies. He specialises in offering laparoscopic hysterectomy to patients who have been told that the procedure could only be done with a large incision (laparotomy). Laparoscopic hysterectomy leads to less pain, less blood loss, lower risk of adhesions, infection, and blood clots, and is therefore a safer and better option for patients. The average recovery time is about 3 weeks after laparoscopy, compared to 6-8 weeks after laparotomy.
Average recovery time: 3 weeks (ranging from 1-6 weeks)
Time in hospital after surgery: 1 night
What is removed: uterus and fallopian tubes. Usually the cervix and rarely the ovaries. Depends on clinical circumstances.
Laparoscopic removal of uterine fibroids
Laparoscopic removal of uterine fibroids
Uterine fibroids can cause pressure symptoms (frequent urination, pelvic pressure, constipation), abnormal menstrual bleeding, and can reduce fertility in certain cases. In patients who have not completed childbearing and have symptomatic uterine fibroids, laparoscopic surgery is a good option. Laparoscopy has several advantages over open surgery (less bleeding, infections, adhesions), however, many surgeons cannot offer this procedure and recommend a large incision instead. In those cases, we strongly encourage patients to seek a second opinion, as the vast majority of these surgeries can be performed laparoscopically. Jón Ívar has performed around 1000 laparoscopic fibroid removals, some of which involved a uterus reaching far above the navel. It is important to remove all fibroids, and therefore an MRI is recommended before surgery. The average recovery time is about 3 weeks after laparoscopic surgery, compared to 6-8 weeks after open surgery.
Average recovery time: 3 weeks (ranging from 1-6 weeks)
Hospital stay after surgery: 1 night
What is removed: uterine fibroids
Uterine fibroids can cause pressure symptoms (frequent urination, pelvic pressure, constipation), abnormal menstrual bleeding, and can reduce fertility in certain cases. In patients who have not completed childbearing and have symptomatic uterine fibroids, laparoscopic surgery is a good option. Laparoscopy has several advantages over open surgery (less bleeding, infections, adhesions), however, many surgeons cannot offer this procedure and recommend a large incision instead. In those cases, we strongly encourage patients to seek a second opinion, as the vast majority of these surgeries can be performed laparoscopically. Jón Ívar has performed around 1000 laparoscopic fibroid removals, some of which involved a uterus reaching far above the navel. It is important to remove all fibroids, and therefore an MRI is recommended before surgery. The average recovery time is about 3 weeks after laparoscopic surgery, compared to 6-8 weeks after open surgery.
Average recovery time: 3 weeks (ranging from 1-6 weeks)
Hospital stay after surgery: 1 night
What is removed: uterine fibroids
Laparoscopic removal of endometriosis
Laparoscopic removal of endometriosis
Endometriosis is found in approximately 10% of women and can cause severe pain and infertility. It is important to diagnose endo early and start treatment as soon as possible. Hormone therapy is often tried first and can include continuous contraceptive pills, progesterone, a hormonal IUD, and other options. However, if this does not work well, surgery is usually the next step. It is essential to have an experienced surgeon perform the procedure, as endo can be subtle and easily missed in the early stages, and highly challenging to excise completely in the later stages. Generally, the disease begins to form at the onset of menstruation and develops gradually from then on. Endometriosis lesions typically start on the surface of the abdominal peritoneum, but over time they penetrate deeper into the tissues.
If the patient is not adequately diagnosed and treated, endometriosis can begin to invade pelvic organs such as the bowel, bladder, ureters, and nerves, and it can also invade the diaphragm and thoracic cavity. There are two main surgical methods to treat endo: excision and ablation (burning). Ablation basically means burning the endo areas, while excision means cutting away the lesion and removing it. Although both methods can work well for superficial lesions, excision is superior in deeper endo areas and where extensive scar tissue has formed. Excision also has the advantage of obtaining pathological confirmation of what was treated in the patient. Excision is likely better also where endo is on the surface of the peritoneum, as this method allows the surgeon to remove wider surgical margins around visible lesions, thereby reducing the risk of recurrence. Endometriosis can recur, even when surgery is performed in the best possible way, and the risk of recurrence is related to age, i.e., it is more common in young patients. The overall risk of recurrence varies, but a recent study shows that the risk of reoperation in the hands of experienced surgeons is 28% within 10 years. The risk of reoperation is reduced if a hysterectomy is performed, but this is only done in patients who have completed childbearing. This may be because many patients with endo also have a condition called adenomyosis, which is essentially endo in the uterine wall. Adenomyosis is found in all age groups, but is more common in patients in their 30s and 40s. Adenomyosis may not be visible during surgery for endo as it is inside the uterine muscle, but it is generally seen on imaging. Preoperative imaging is very important in patients with suspected endo and adenomyosis, and can include pelvic ultrasound and MRI.
It is important to have realistic expectations regarding surgery for endo and pelvic pain. Pelvic pain can be multifaceted, i.e., not just due to endo, and therefore not all patients recover after surgery. Many improve partially and some are completely better. In a recent study by our physician on women who underwent surgery at Klíníkin, it was found that women had on average a pain score of 9 out of 10 before surgery, but 4 out of 10 after surgery. This means that most patients experienced significant symptom relief, but not all. Patients also missed an average of 3.6 fewer days from work or school after surgery. Their quality of life was also significantly improved. In patients who do not fully recover, it is important to continue looking for reasons and solutions. For example, many women with chronic pelvic pain have pelvic floor hypertonicity, and it is important to treat that. Sometimes collaboration with other specialties such as gastroenterology and urology is also needed.
Average recovery time: 1-2 weeks (range 1-6 weeks)
Time in hospital after surgery: 0-1 night
What is removed: endo, sometimes uterus (in patients who have completed childbearing), rarely ovaries.
Endometriosis is found in approximately 10% of women and can cause severe pain and infertility. It is important to diagnose endo early and start treatment as soon as possible. Hormone therapy is often tried first and can include continuous contraceptive pills, progesterone, a hormonal IUD, and other options. However, if this does not work well, surgery is usually the next step. It is essential to have an experienced surgeon perform the procedure, as endo can be subtle and easily missed in the early stages, and highly challenging to excise completely in the later stages. Generally, the disease begins to form at the onset of menstruation and develops gradually from then on. Endometriosis lesions typically start on the surface of the abdominal peritoneum, but over time they penetrate deeper into the tissues.
If the patient is not adequately diagnosed and treated, endometriosis can begin to invade pelvic organs such as the bowel, bladder, ureters, and nerves, and it can also invade the diaphragm and thoracic cavity. There are two main surgical methods to treat endo: excision and ablation (burning). Ablation basically means burning the endo areas, while excision means cutting away the lesion and removing it. Although both methods can work well for superficial lesions, excision is superior in deeper endo areas and where extensive scar tissue has formed. Excision also has the advantage of obtaining pathological confirmation of what was treated in the patient. Excision is likely better also where endo is on the surface of the peritoneum, as this method allows the surgeon to remove wider surgical margins around visible lesions, thereby reducing the risk of recurrence. Endometriosis can recur, even when surgery is performed in the best possible way, and the risk of recurrence is related to age, i.e., it is more common in young patients. The overall risk of recurrence varies, but a recent study shows that the risk of reoperation in the hands of experienced surgeons is 28% within 10 years. The risk of reoperation is reduced if a hysterectomy is performed, but this is only done in patients who have completed childbearing. This may be because many patients with endo also have a condition called adenomyosis, which is essentially endo in the uterine wall. Adenomyosis is found in all age groups, but is more common in patients in their 30s and 40s. Adenomyosis may not be visible during surgery for endo as it is inside the uterine muscle, but it is generally seen on imaging. Preoperative imaging is very important in patients with suspected endo and adenomyosis, and can include pelvic ultrasound and MRI.
It is important to have realistic expectations regarding surgery for endo and pelvic pain. Pelvic pain can be multifaceted, i.e., not just due to endo, and therefore not all patients recover after surgery. Many improve partially and some are completely better. In a recent study by our physician on women who underwent surgery at Klíníkin, it was found that women had on average a pain score of 9 out of 10 before surgery, but 4 out of 10 after surgery. This means that most patients experienced significant symptom relief, but not all. Patients also missed an average of 3.6 fewer days from work or school after surgery. Their quality of life was also significantly improved. In patients who do not fully recover, it is important to continue looking for reasons and solutions. For example, many women with chronic pelvic pain have pelvic floor hypertonicity, and it is important to treat that. Sometimes collaboration with other specialties such as gastroenterology and urology is also needed.
Average recovery time: 1-2 weeks (range 1-6 weeks)
Time in hospital after surgery: 0-1 night
What is removed: endo, sometimes uterus (in patients who have completed childbearing), rarely ovaries.
Laparoscopic cervical cerclage
Laparoscopic cervical cerclage
Cervical insufficiency is one of the causes of preterm birth and pregnancy loss. In some women, the cervix opens too early, and a typical scenario involves painless dilation of the cervix in the second trimester (often around 16-18 weeks). This then leads to premature rupture of membranes and miscarriage, often before the foetus is viable. A cervical cerclage is basically a stitch tied around the cervix to prevent it from opening too early. A traditional cervical stitch (cerclage) is placed through the vagina, and this is often done at around 12-14 weeks of pregnancy. A transvaginal stitch can be effective, but unfortunately, not always. If a vaginal stitch does not work, a laparoscopic cervical cerclage has been shown to be more effective. Jón Ívar has performed approximately 200 laparoscopic cervical cerclage procedures, which is one of the largest experiences in this operation in the United States. In the latest study of Jón Ívar's team, the success rate of the laparoscopic surgery was about 97%. Many of these patients had suffered multiple losses prior to this procedure. The cervical cerclage is generally placed before pregnancy, but it can also be placed during the first trimester of pregnancy.
It is recommended that patients wait 2 months before becoming pregnant after the procedure, and the delivery method must be a caesarean section. If a miscarriage occurs, a dilation and curettage (D&C) can still be performed with the cerclage in place. Patients require regular follow-up with a high-risk pregnancy specialist during pregnancy. If the cerclage looks good at the time of the caesarean section, it can be left in place to be utilised in a subsequent pregnancy. It is not necessary to remove the stitch even if the patient does not plan to have more children.
Average recovery time: 1 week (ranging from 0-2 weeks)
Time in hospital after surgery: 0 nights
What is removed: nothing. If there are concurrent issues like endo, that will also be removed.
Cervical insufficiency is one of the causes of preterm birth and pregnancy loss. In some women, the cervix opens too early, and a typical scenario involves painless dilation of the cervix in the second trimester (often around 16-18 weeks). This then leads to premature rupture of membranes and miscarriage, often before the foetus is viable. A cervical cerclage is basically a stitch tied around the cervix to prevent it from opening too early. A traditional cervical stitch (cerclage) is placed through the vagina, and this is often done at around 12-14 weeks of pregnancy. A transvaginal stitch can be effective, but unfortunately, not always. If a vaginal stitch does not work, a laparoscopic cervical cerclage has been shown to be more effective. Jón Ívar has performed approximately 200 laparoscopic cervical cerclage procedures, which is one of the largest experiences in this operation in the United States. In the latest study of Jón Ívar's team, the success rate of the laparoscopic surgery was about 97%. Many of these patients had suffered multiple losses prior to this procedure. The cervical cerclage is generally placed before pregnancy, but it can also be placed during the first trimester of pregnancy.
It is recommended that patients wait 2 months before becoming pregnant after the procedure, and the delivery method must be a caesarean section. If a miscarriage occurs, a dilation and curettage (D&C) can still be performed with the cerclage in place. Patients require regular follow-up with a high-risk pregnancy specialist during pregnancy. If the cerclage looks good at the time of the caesarean section, it can be left in place to be utilised in a subsequent pregnancy. It is not necessary to remove the stitch even if the patient does not plan to have more children.
Average recovery time: 1 week (ranging from 0-2 weeks)
Time in hospital after surgery: 0 nights
What is removed: nothing. If there are concurrent issues like endo, that will also be removed.
Nerve procedures in the pelvis (Neuropelveology)
Nerve procedures in the pelvis (Neuropelveology)
Neuropelveology is a relatively new field within gynaecology. This field focuses on the pelvic nerves and the diseases and conditions that affect them, issues which were poorly understood by gynaecologists until recently. Professor Marc Possover is a pioneer in this field, and Jón Ívar has had the privilege of spending time with him in the operating theatre in Zurich. Conditions that fall within this scope include endo in the sciatic nerve and sacral nerve roots, entrapment of the pudendal nerve and sacral nerve roots. Most often, treatment begins with simple advice such as physiotherapy, medication, and lifestyle changes. However, surgery is sometimes required, but it is usually the last resort.
Average recovery time: 3 weeks (range 1-6 weeks). However, it is not uncommon for patients to initially experience complete relief of symptoms, then it is common for pain to recur, which can be worse than before, and then symptoms gradually decline over the next 6-12 months. Patients often require treatment with neuropathic medications during this time, in addition to other complementary therapies.
Hospital stay after surgery: 1 night
What is removed: depends on the situation.
Neuropelveology is a relatively new field within gynaecology. This field focuses on the pelvic nerves and the diseases and conditions that affect them, issues which were poorly understood by gynaecologists until recently. Professor Marc Possover is a pioneer in this field, and Jón Ívar has had the privilege of spending time with him in the operating theatre in Zurich. Conditions that fall within this scope include endo in the sciatic nerve and sacral nerve roots, entrapment of the pudendal nerve and sacral nerve roots. Most often, treatment begins with simple advice such as physiotherapy, medication, and lifestyle changes. However, surgery is sometimes required, but it is usually the last resort.
Average recovery time: 3 weeks (range 1-6 weeks). However, it is not uncommon for patients to initially experience complete relief of symptoms, then it is common for pain to recur, which can be worse than before, and then symptoms gradually decline over the next 6-12 months. Patients often require treatment with neuropathic medications during this time, in addition to other complementary therapies.
Hospital stay after surgery: 1 night
What is removed: depends on the situation.
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Do not hesitate to get in touch.
Do you have any questions?
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Do not hesitate to get in touch.
Klíníkin is a modern medical centre where specialists work together to improve your health. Our goal is to be a leader in the development of safe, high-quality medical services.
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Klíníkin is a modern medical centre where specialists work together to improve your health. Our goal is to be a leader in the development of safe, high-quality medical services.
Our services
Contact us
Klíníkin is a modern medical centre where specialists work together to improve your health. Our goal is to be a leader in the development of safe, high-quality medical services.
Our services
Contact us