While many marketers have written off Internet Yellow Pages as dead, the recent Google Pigeon update may have made them relevant once more.
The recent Google Pigeon update appears to have provided a bit of a traffic upswing for Internet Yellow Pages (IYPs) and other online business directories, at the cost of individual local businesses’ site rankings in many cases. Search engines and the internet have put some serious dents in old local media powerhouses like yellow pages, newspapers, classifieds, etc. As a number of us noted, the recent Pigeon update improved the ranking and visibility of IYPs and directories, and SEMrush and other competitive analytics services are already showing a real upswing in those sites’ visits as a result. Top Internet Yellow Pages sites, and even some of the second-tier yellow pages sites, have seen increases in traffic over the past year, particularly after late spring and going into the summer. It’s pretty simple math to figure out that in many business categories, if the local directory sites have risen some in rankings, then other stuff was equally displaced. If you’re a business that lost its visibility when the tide shifted, then you need to seriously consider beefing up your presence and visibility within the directory sites where the consumers are now going.
Even if your website or local pack listing did not lose its first-page-of-search-results placement, you should still consider strengthening your directory game in order to increase your visibility and maximize your presence where consumers are looking.
First, do a few searches for your type of business in your area and then see which directory sites are ranking well in search results. Once you have your list of local directory sites, visit the pages from them that are showing up for your keyword searches in order to assess what you may need to do with each. Questions you should ask are: Does my business listing appear on the first page of results from the directory webpage that is ranking for my local business keyword searches?
In some cases, adjusting your listing might help it pop up onto Page 1 for free, but in many cases you may want to seriously consider advertising since ads are typically going to be in the upper portion of a directory page.
Above all, for the directory page to benefit you, your business must appear on Page 1 of that directory site. With many of these sites, simply purchasing the least-expensive ad option might be the minimum necessary to enable you to appear in the ad section of their first page of listings – so, that might be all you would need.
IYPs may offer bundled advertising deals that would combine print with internet and mobile advertising – I think that in most cases you don’t need the print (there are undoubtedly exceptions to this – small towns and locations in the Midwest of the U.S. I think the main goal for you will be to get on Page 1 of the directory page in question, and closer to the top of it. In the past, there was some anecdotal evidence that IYP ads might provide actual SEO benefits – but, most of these links will be identified and discounted as ad links by search engines, or they’re nofollowed on those sites – so, this probably should not be considered to be an SEO stratagem. A number of directory sites employ call tracking so that they can show more of their sites’ value to advertisers, but these numbers can be detrimental to the rankings of your business in local search, and if the tracking number displays a nonlocal area code, it might have an impact on your conversion rates when consumers are choosing a business.
Business listings pages from online directory sites are often a type of local search results pages.
In most cases, you would likely have to file for a name change or apply for a “Doing Business As” name, and then supply the government approved paperwork to the directory to ask them to change how they list you.
In yet other cases, the businesses are displayed in order of proximity to the center of the search area – in order to optimize for this, you’d have to alter your address, which might not be worth it for the potential added exposure benefit. I’ve written about those before, although I was focusing more on search optimization benefits then.
Obviously, your overall customer service needs to be excellent already – if it is less than what it could be, beef it up by studying companies at the top of the customer service game, like Zappos.
But, there are also things you can do to improve your presence in reviews sites online, such as encouraging happy customers to post reviews, responding capably to feedback, and more. Be sure to connect your directory listings with your social media accounts wherever possible! I’ve also seen a lot of instances where businesses have made errors when adding their social media URLs to directory sites, so be sure to check all your links when you look at your listings and directory profile pages. Did you know you can see how many visitors were referred from directory sites to your site’s pages in web analytics systems like Google Analytics? Many businesses have hyper-focused on how they rank and appear in Google and Bing search results, and your presence in that top tier of search is definitely valuable and important. Some opinions expressed in this article may be those of a guest author and not necessarily Search Engine Land. Chris Smith is President of Argent Media, and serves on advisory boards for Universal Business Listing and FindLaw.
SMX Advanced, the only conference designed for experienced search marketers, returns to Seattle June 22-23. MarTech: The Marketing Tech Conference is for marketers responsible for selecting marketing technologies and developing marketing technologists. The state health and family welfare department has come up with the 'Shishu Sathi Prokolpo' - a new scheme by which 3,000 children all over the state till the age of 12, with congenital cardiac defects will be treated free-of-cost at all government hospitals having pediatric facilities and at three private hospitals with which the government have tied up.
Minister of state for health Chandrima Bhattacharya said that the chief minister has given special attention to child health care. Bhattacharya said that there will be district level committees that will scrutinise all such applications tat will come in for such surgery.
Diagnostic laparoscopy is a surgical procedure doctors use to view a woman's reproductive organs. Laparoscopy is often recommended when other diagnostic tests, such as ultrasound and X-ray, cannot confirm the cause of a condition. The procedure is performed while you are lying down in a slightly tilted position, with your head lower than your feet.
Patients are asked to return to their doctors for follow-up checkups within two to eight weeks.
Gas in the abdomen might cause discomfort in the neck, shoulders, and chest for 24 to 72 hours after surgery. Wait two to three menstrual cycles before determining if laparoscopy has helped to relieve your condition. Irregular menstrual bleeding or heavy menstrual bleeding or a combination of both may characterize abnormal menstruation.
World wide up to 20% of women will suffer from heavy menstrual bleeding (HMB) at some point in their lives.
Historically up to 60% of women would end up with a hysterectomy within 5 years of referral but there are now a number of effective alternative ways to manage HMB without recourse to hysterectomy. The holistic approach to the management of HMB is important as it depends on a woman’s symptoms as well as her circumstance, whether her family is complete or whether fertility is still desired. In the absence of any overt pathology it is possible to manage HMB with medication in some cases hormones will not be required. Even when surgery is required hysterectomy is not the starting point measures to remove or destroy the lining of the womb are effective treatments in up to 70% of women.
For women who do require hysterectomy tradition open surgery should not be and is no longer the norm.
The questions women should always ask her gynaecologist should always include: whether she is able to have her hysterectomy by minimal access techniques and if not why?
No one knows what causes cervical cancer but there are associations with the human papilloma virus and cigarette smoking. Recent advances in the screening and management process include screening for HPV types that have been linked with increased risk of developing cervical cancer and the use of Vaccines for prevention. Where treatment is required it is usually done by large loop excision of the transformation zone (LLETZ), with a local anaesthetic to numb the cervix.
Over 90% of women will need no further intervention after the first treatment for others however follow-up may be required.
Miscarriage presents with pain and or bleeding in early pregnancy, after missing a menstrual period.
From the early 1990s the management of miscarriage has changed in the United Kingdom with all units that care for women with complications of early pregnancy having dedicated areas and dedicated staff, who are experienced and versed in the management of complications of early pregnancy (Early pregnancy assessment units).
Once a woman experiences pain and bleeding in early pregnancy she will be referred to one of these units in her local area.
Threatened: where there has been pain and or bleeding but the pregnancy is still ongoing.
On arrival at the EPAU the objective would be to try and determine what type of miscarriage is taking place.
Traditionally surgical management was the only therapy offered but depending on a woman’s symptoms and her preference she may be offered expectant or medical management. Whatever management is offered women are offered counseling for the emotional implications of miscarriage and how if necessary to manage future pregnancy.
Endometriosis is a chronic condition where endometrium (this is the lining of the inside of the womb) is found outside the womb. Though it is possible to diagnose some forms endometriosis with non- invasive techniques like ultrasound, the gold standard for diagnosis is a laparoscopy.
The management of endometriosis requires a holistic and multidisciplinary approach as endometriosis not only affects the woman but may also affect indirectly other family members. Management should be undertaken by experts who are not only familiar with the symptoms of the disease but also its natural history as endometriosis however treated has a recurrence risk and most women depending on the stage of endometriosis may require more than one surgery. Initial management of endometriosis may be by the use of medicines or pain management therapy depending on the desire for immediate fertility.
Management multidisciplinary teams usually include a gynaecologist, a colorectal surgeon, urologists and pain management specialists as well as dedicated endometriosis nurses and support from counselors, physiotherapists and in some cases alternative medicine specialists. Women are also encouraged to join support groups to share experiences as in some cases a problem shared is a problem halved. Common symptoms are abdominal pain and bleeding after missing a menstrual period, with a positive pregnancy test. Risk factors for ectopic pregnancy include: previous ectopic pregnancy, previous tubal surgery, previous pelvic infection, current IUCD use. Ectopic pregnancies are usually diagnosed on the basis of symptoms and a blood test which measures the amount of Beta-HCG which is a pregnancy related hormone, and an ultrasound scan. For the majority of women it is possible to make a diagnosis after initial investigation but in some women the results of investigations may be inconclusive and follow up scans and blood tests may be necessary. Once the diagnosis is established women may be given a choice of how they would prefer their ectopic pregnancy to be managed.
For optimal chances of success the HCG level usually chosen is less than 3000IU, and there should be no fetal heart seen on ultrasound scan. Even for the rarer ectopic pregnancies Dasmahapatra has demonstrated that laparoscopic surgery is feasible. Uterine fibroids are the commonest benign tumour (growth) of the female reproductive tract. No one knows for sure what causes fibroids but they develop from a single muscle cell in the uterus and are hormone dependent. Fibroids can be responsible for heavy periods leading to anaemia, pressure symptoms on the bowel where they may cause constipation.
Fibroids can also be responsible for fertility problems depending on their location, particularly those within or distorting the cavity of the womb. It must be said however that most women that have fibroids will have no problems with fertility and when they do get pregnant they will have no problems.


Some of the problems associated with fibroids in the pregnant women include: increased risk of miscarriage, increased risk of degeneration which may lead to pain, increased risk of premature delivery and increased risk of bleeding once the baby has been delivered. To this end a woman who suffers with symptoms relating to the presence of fibroids needs to seek out a gynaecologist with experience in the management of all aspects of care relating to fibroids and not a gynaecologist who is an expert in only one aspect of management.
The objective of management should be to treat the symptoms, to facilitate or increase chances of fertility if this is what is desired, and while achieving these objectives ensure the best quality of life for the patient. Hormonal preparations: these may reduce heavy menstrual loss and in some cases reduce the size of fibroids. There are two ways of achieving pregnancy after sterilization: either assisted conception methods like IVF or reversal of sterilization. Historically reversal of sterilization used to be undertaken by conventional open surgery using microsurgical principles. The success rates for reversal vary from 47-80% the success rates sometimes depend on the type of sterilization that was performed, the extent of the tube that was removed or damaged or if it was carried out at caesarean section. Other factors that affect success would be the age of the woman seeking reversal (as fertility declines naturally after the age of 35) of sterilization and the presence of any other pathology. It is also important to ensure that the male partner has a semen sample that is adequate for pregnancy.
The operation itself is carried out laparoscopically with additional incisions on each side of the pelvis just above the pubic hair line, the procedure is usually completed in an hour or 90 minutes and patients are able to go home the same day or after an overnight stay. The main thing to be aware of after the reversal procedure is the risk of ectopic pregnancy.
The majority of pathological ovarian cysts are benign particularly in the reproductive years. Because of complications that can occur with ovarian cysts they are the 4th most common reason for acute gynaecological admission, by the age of 65 years 4% of women would have been admitted to hospital for this reason.
Ovarian torsion: this is where the ovary twists on itself, deprives itself of blood supply and causes acute onset of abdominal pain.
Risk of Cancer: the risk of ovarian cancer is rare and to help differentiate between this and benign disease, gynaecologists rely on history, scan findings and special blood tests. The diagnosis of ovarian cysts and most often their nature is determined by pre-operative investigations which include a pelvic ultrasound scan, which  is most often performed vaginally. Cysts less than 5cm are often treated conservatively without operation and a follow-up scan organized for 6 weeks after the first. The main worry in the management of ovarian cysts is to make sure that cancer is not missed and accurate diagnosis is made before surgery.
Chronic pelvic pain is defined as intermittent or constant pain in the pelvis or lower abdomen of at least 6 months duration. Pain by definition is a sensory and emotional experience associated with actual or potential tissue damage, it is an individual experience and can be affected by physical, psychological and social factors. The aim of management of pelvic pain is to effect diagnosis in a short a time as possible and institute treatment to improve quality of life. Because of the number of organs in the pelvis the origin of pain my be in the gynaecological organs, or the bladder or bowel or may be as a result of irritation or damage of bones, muscles or nerves. One of the most important requirements for diagnosis is the gynaecologists ability to listen and examine as taking a full history may take time, symptoms should not just be put down to psychological issues in the first instance and symptoms should not be dismissed. Investigations will depend on the history and examination and what system of the body is thought to be involved. For others it may be that once the history is taken an ultrasound scan is arranged (this is often transvaginal) to assess the thickness of the lining of the womb.
The next investigation would be a hysteroscopy where as small camera is put into the womb and a sample taken from the lining, once again it is possible to do this in an outpatient setting without the need for general anaesthesia. PMS is a collection of physical and behavior and emotional symptoms related to a woman's menstrual cycle, in the absence of any physical or psychiatric illness. Lifestyle alteration, both diet and exercise help as does stress management and cognitive behavioural therapy. Second line treatment includes the use of the Mirena intrauterine contraceptive device and other forms of hormonal manipulation. If this doesn’t work hormone implants may be of benefit to suppress the function of the ovaries.
This is a female disorder, though the exact cause is unknown it is thought to be due to hormonal imbalance.
Not all women will have all symptoms, the severity and the type of symptoms vary greatly among affected individuals. Consultation usually involves a detailed history looking at menstrual patterns, abnormal hair growth and body mass index (weight and height).
Other investigations are usually blood tests looking at various hormone levels on certain days of the menstrual cycle. For the overweight woman, diet coupled with exercise is first tried and if weight is lost and the BMI is improved periods can regularise themselves spontaneously. Medication centers on improving insulin resistance by means of a drug called Metformin, in some cases the oral contraceptive pill is given to regulate periods particularly if fertility is not an immediate issue. When fertility is the main issue treatment is concentrated on weight loss, improving insulin resistance with Metformin and induction of ovulation. In extreme cases laparoscopy may be necessary if medication fails and a procedure called laparoscopic ovarian drilling.
PCOS can be transient and in those individuals in whom symptoms improve they should actually adopt life-styles that will prevent the development of diabetes. Incontinence of urine unfortunately is under reported probably due to the embarrassment it causes the sufferer. For women who seek medical help it is once again important to take a detailed history and examination, trying to differentiate between the types of incontinence. If this doesn’t work then medication may be necessary this is usually in the form of an anticholinergic agent.
For women with pure stress incontinence treatment is initially conservative in the form of pelvic floor exercises supervised by an incontinence advisor or physiotherapist. Complications include needing to go to the toilet more often in about 10% of women who have the procedure, difficulty in voiding in about 10% of women. The best approach to the management of incontinence is a multi-disciplinary approach and best managed in a caring environment within the woman’s own community only needing to see a specialist if conservative measures fail. Pelvic floor disorders include prolapse of the womb or parts of the vagina, incontinence of urine and sometimes incontinence of faeces. Factors that can influence the development of prolapse include: childbearing, the menopause, occupational stresses that put pressure on the pelvic floor, constipation, chronic cough as well as surgery on the pelvic floor, particularly hysterectomy.
As with all conditions in gynaecology it is important to have a holistic approach to management. Before surgery is offered it may be possible to adopt a conservative approach with pelvic floor exercises or the use of pessaries (devices that are able to support the pelvic floor when inserted into the vagina). Surgery for pelvic floor prolapse has evolved overtime and there are numerous operations some of which have not stood the test of time. Sacrospinous fixations are operations performed vaginally for the same prolapse but failure rates are higher. Unlike the use of meshes for vaginal repair, for urinary incontinence the use of mesh is the way forward and has replaced conventional surgery for most women who suffer from stress incontinence. Laparoscopic surgery also known as keyhole surgery is one of the greatest modern advances of gynaecological surgery and today most gynaecological procedures can be performed with key hole surgery.
It involves passing a small camera through the belly button to visualise  and operate on pelvic and abdominal contents using very small incisions with the surgeon looking at a monitor.
Laparoscopy can now be used to manage fibroids (in some cases large and multiple fibroids), Endometriosis, ovarian cysts, ectopic pregnancy, adhesions, chronic pelvic pain and a range of other illnesses it can also be used to reverse sterilisation.
Surgeons need to be highly skilled to perform effective and complication free minimal access surgery, particularly for advanced and complicated procedures. Dr Dasmahapatra is a highly skilled and formally trained advanced minimal access surgeon who is able to provide minimal access surgery for most  routine and complicated gynaecological complaints.
Though it is now possible to manage menstrual and other gynaecological pathologies conservatively some women will still be advised to have a hysterectomy.
Hysterectomy is one of the commonest major gynaecological operations performed with over 600,000 procedures performed in the USA. For women who require hysterectomy the questions now asked are how should the hysterectomy be performed? NICE and other regulatory bodies advocate that the first choice for a hysterectomy should be vaginal, followed by laparoscopic and the last choice should be traditional open surgery. For specialized surgeons with extra training these are not limitations as most of these excuses can be overcome by the use of minimal access techniques. If women have had normal cervical smears and are in a cervical screening program there is no absolute need for the cervix to be removed. When you have endometriosis, the implants of tissue outside your uterus act just like the tissue lining your uterus. I’ve frequently mentioned in the past how Google and other local search engines were edging out IYPs as the local business information provider-of-choice for consumers. Local business reviews sites seem to have benefited in many cases, including Angie’s List, the Better Business Bureau (BBB), HomeAdvisor and probably Yelp (even though SEMrush shows a slight dip downwards for Yelp after June).
It’s likely that some local businesses’ websites are not as visible in each of the search markets where this occurred. Determine whether you merely wish to optimize your business profiles there at their free levels, or whether you’ll wish to purchase advertising.
And, if your listing is already on Page 1 there, is it ranking higher on the page – such as in the first half to first third of the page? It helps further for it to rank near the top, but that’s not as important as simply being there. I’ll say that in general, it may not be worthwhile to advertise in the print yellow pages books in many cases, but IYP and online directory sites often have much more cost-effective advertising options compared with the heyday of print.
There can be other value-add options that you may want to consider, such as add-ons that would make the listing more visible and more attention-getting for consumers. If you choose to advertise, I recommend that you continue to avoid using call-tracking numbers for the sake of your overall local SEO healthiness. As such, there are optimization techniques that can enable your business to rise up in their rankings, just as with the local results in the major search engines!
Businesses have actually done this to attempt to improve their rankings in search engines, so why not in directory sites, too? There are frequently a number of elements of business directory profiles that may be optimized beyond merely checking to see if your name, address and phone number are correct: business categories, lists of products and services, written descriptions, hours of operations, website link, photos, logos, social media links, and more.
Your optimization in this instance should be more focused upon making you as visible and attractive within the directory site as possible.
For business reviews sites, your promotional value is naturally going to be heavily affected by your overall reviews and ratings. I’m seeing many instances where a business’s Facebook page is ranking well in the new search results, and consumers may like businesses that appear more open to interacting with them online, so enhance the chances of this happening.


I recommend that you compare these referrals before and after you’ve performed optimizations on your listings — if you were successful in your efforts, I would imagine you’ll likely see the referral numbers rise! However, using these tips can further optimize your presence in the second tier of search,  thereby increasing your potential customer referrals and associated sales.
The treatment cost will be absolutely free and the state government will bear the entire treatment expenses. A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen.
You will be given a general anesthetic to relax your muscles and prevent pain during surgery. The laparoscope is inserted through this incision, and the abdomen is inflated to make the organs easier to view.
This incision provides an additional opening for instruments needed for completing minor surgical procedures. Many women do not have their next normal menstrual cycle for four to six weeks after surgery. Dasmahapatra is personally familiar with many of the concerns and issues women and couples face. It is now possible to carry out most hysterectomies though minimal access techniques, sometimes irrespective of the size of the uterus. Whether she needs to have her cervix removed during the hysterectomy and whether she needs to have her ovaries removed.
This is an investigation where the neck of the womb ( the cervix) is examined under magnification  (using an instrument akin to binoculars) to identify whether the abnormal cells found on the smear truly exist. They are advised to return or make contact if they have bleeding that is heavier than a heavy period, as bleeding is a potential complication of the procedure. These allow women continuity of care, provide counseling and support, and allow all tests and therapies to be carried out in dedicated areas, and avoid unnecessary and repeated internal examinations. A pregnancy test is usually organised and depending on how many weeks pregnant the woman is an ultrasound scan is then arranged. There are certain criteria that need to be met for safety and efficacy of the first 2 methods of management. It can be responsible for pelvic pain, pain during intercourse and in some women infertility. If fertility is not immediately desired then the pain symptoms can be managed with pain killers or in some cases the oral contraceptive pill.
Traditionally surgery used to be by conventional open surgery but now it is possible to manage nearly if not all ectopic pregnancies by means of laparoscopic surgery. Under his direction  all (100%) women who are haemodynamically stable have laparoscopic surgery for the management of ectopic pregnancy when this is required. The effect on the bladder can either be going to the toilet to pass urine more often or in some cases they can cause retention of urine. Dasmahamahapatra of kolkata is familiar with all aspects of management of uterine fibroids and applies minimal access techniques where it is the responsible thing to do. At the time of sterilization women are warned of the potential irreversibility of the procedure, however life circumstances change and women may desire more children. The difference between the two is that women would have to pay for each conception cycle whereas if the reversal of sterilization is successful it is possible to use it more than once.
And if surgery is required, as most women are in their reproductive years fertility sparing procedures are carried out and herein lies the beauty of laparoscopic surgery in the management of ovarian cysts.
The source can be difficult to find on occasion as sometimes even when the provoking factor is removed the pain still occurs.
The woman should also understand that because of the nature of chronic pelvic pain actual diagnosis may take a while and the source of pain may never be found.
For some women it is possible to take a sample of the endometrium (the lining of the womb) with a small tube at the index consultation. The ultimate treatment is removal of the ovaries coupled with hormone replacement therapy.
Here during the laparoscopy little holes are made in the ovary to reduce the number of follicles.
If the diagnosis cannot be reached on the basis of history alone it may be necessary for the woman to keep a urinary diary for a few days to help in the analysis.
This is usually in the form of bladder re-education carried out either by a physiotherapist of an incontinence advisor.
The efficacy of anticholinergic agents is sometimes limited by their side effects, which include blurred vision, constipation and dry mouth.
During this test a catheter (a little tube) is inserted into the bladder and the bladder if filled with fluid and recordings are taken on a computer looking at how the bladder reacts to filling. There are also come devices that can be inserted into the vagina to prevent incontinence (this may be helpful for athletes or when a woman needs to undertake strenuous activity for a short period of time). The cumulative risk of development of prolapse after hysterectomy is 1% at 3 years and 5% at 15 years the risk is 5.5% higher if hysterectomy is performed for prolapse. A detailed history and examination need to be carried out taking into account the patients circumstance and whether family is complete or not.
These can be particularly useful for women who have not completed their families and for those due to medical complaints are not able to have surgery. Before surgery is undertaken depending on the part of  the vagina that has prolapsed it may be necessary to carry out investigations such as urodynamics to see how the bladder functions and how it may be affected by surgery. The theory behind their use is because of the high recurrence risk with vaginal surgery for prolapse repair. It is associated with less tissue trauma thus less scarring, less pain, less blood loss, quicker discharge from hospital, earlier recovery and quicker return to normal activity. It means that a type of tissue that lines your uterus is also growing outside your uterus. They usually grow on the ovaries, the fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. Some women have heavy periods, spotting or bleeding between periods, bleeding after sex, or blood in their urine or stool. Some women don't know that they have it until they go to see a doctor because they can't get pregnant or have a procedure for another problem.
So, there is potential you could apply these in order to pop up into the first page of the directory site without incurring advertising or membership fees, if you’re not already there. Using the laparoscope, the doctor can look directly at the outside of the uterus, ovaries, fallopian tubes, and nearby organs. The laparoscope might also be equipped with surgical devices for taking tissue samples or removing scar tissue.
When your normal cycle returns, you might notice heavier bleeding and more discomfort than usual. His years of clinical experience, both in the india and abroad, have deepened his understanding further and have also allowed him insight into other cultures and customs. This course of management is underpinned by NICE (National Institute of Clinical Excellence) guidelines in the UK.
If abnormality is found a biopsy may be taken and this will dictate whether further treatment is necessary. Long term complications are uncommon; they include cervical stenosis( where the cervix becomes too tight) or cervical incompetence (where the cervix is unable to stay closed during pregnancy) this may result in miscarriage. If the fetal heart is seen beating on the ultrasound scan she is reassured and in most cases sent home.
It is particularly common during the reproductive years and is more common in women of colour than Caucasians. Not all fibroids can or should be managed by minimal access means but where possible the size of the fibroid is not sole the limitation for minimal access management. If the latter were the case then it would be a matter of managing the pain symptoms in the absence of an actual diagnosis. It occurs in 3-30% of women it is more prevalent in obese women and those who do not undertake exercise. Low dose antidepressants are also used on the days when symptoms are severe leading up to the menstrual cycle. This should only be done as a last resort and in women whose family is complete and after all other treatments fail.
Alterations in life style may also be advised: avoidance of coffee and other stimulants may be helpful. Some women may need to switch from one drug to another till they find the one that suits them. Other complications include bladder injury, painful intercourse for the woman and painful intercourse for the partner if the mesh used erodes (His-pareunia). And more women will develop prolapse as life expectancy is increased, but not all will require intervention. This is because there is a failure risk with surgery and the risk of recurrence can be as high as 30% in some cases.
Vaginal mesh surgery needs to be approached with caution because of the risk of Mesh erosion and other complications.
This is another very effective technique which is, once again, less traumatic than conventional surgery. The chief minister has declared of a new scheme - 'Sishu Sathi Prokolpo' - in which 3,000 children upto the age of 12 will be able to have cardiac surgery absolutely free of cost every year," Bhattacharya said. Possible complications include injury to nearby organs, bleeding, or a problem related to the anesthesia. He fervently believes that each one of his patients is an individual with individual circumstances and treatment needs, and these he aims to address with a sympathetic ear and an open mind in his practice.
Once a woman has a positive pregnancy test within the first 3 months there is a 20% chance that she might miscarry. Black woman tend to present with symptoms relating to fibroids earlier than Caucasians and they are more likely to present with problems relating to fertility. Sometimes women are advised to have a trial with hormone therapy to suppress the ovaries before surgery to ascertain whether they would benefit from the procedure.
The commonest procedure performed today for urinary incontinence is the tension free transvaginal tape either suprapubic or trans-obturator. The advice is that most women will not require mesh for a first vaginal prolapse operation and should only need it if prolapse recurs after surgery.
In other women, the pain and bleeding are so bad that they aren't able to work or go to school.
Between 6 and 9 weeks the risk falls to about 4% and after 9 weeks to 3% in the first trimester.



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