Surgery that has changed my life

A Yorkshire surgeon has developed a pioneering way to end pain for thousands of women. Catherine Scott reports.
Ashwini TrehanAshwini Trehan
Ashwini Trehan

For years following a hysterectomy Linda Thipthorp suffered from such debilitating pain that she couldn’t walk, work or sit for long periods.

Now, thanks to a West Yorkshire surgeon, that has all changed and Linda feels like a new woman.

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Ashwini Trehan, consultant gynaecologist at the Spire Elland Hospital in West Yorkshire, has pioneered a keyhole operation to renew the internal hysterectomy scar – which he believes is often the cause of women’s pain after hysterectomy.

Mr Trehan, has helped around 50 women to date by re-cutting their old hysterectomy scars and re-stitching the area to offer relief from ongoing pain and discomfort.

Linda, 57, travelled 350 miles from her home in Truro, Cornwall, to visit Mr Trehan in Elland after the constant pain eventually became too much.

“I was a complete mess but he has given me my life back.”

Linda had suffered heavy and painful periods from the age of 11. She had two children, when she was 19 and 24. Then, at the age of 39, she was diagnosed with a prolapsed womb and advised to have a hysterectomy.

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During the operation, it was discovered she was also suffering from endometriosis – a condition where cells that usually line the inside of the womb grow outside the uterus and into the lining of the pelvis. The condition can also affect the organs within the pelvic cavity including the ovaries, fallopian tubes, bladder and bowel.

Linda’s surgeon was only able to remove 50 per cent of the endometriosis at the time. After experiencing continuing problems, she underwent further surgery to remove her ovaries 18 months later. But her pains still continued.

“I just didn’t have the energy. I suffered from bloating, nausea, bowel and pelvic pains. The pain radiated down to my 
knees and caused backache too. I was an absolute mess since my hysterectomy. I couldn’t go anywhere and I felt so ill, it was that debilitating. I was always off work.”

Linda, a hospital theatre receptionist, eventually grew so tired of her health problems she decided to do some research and discovered Mr Trehan.

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Linda underwent keyhole surgery to renew and re-stitch her old hysterectomy scar which had a cyst and fibrosis with chronic inflammation. During the procedure, Mr Trehan also scraped further scar tissue from her bowel and lining of the pelvis containing endometriosis.

She was in surgery for a total of six hours and, although a little sore, was able to travel home to Cornwall the next day.

“Since the day after that operation, I have never had pain in my stomach again. I cried with relief when I realised the pain, bloating and sickness had gone. I just thank him from the bottom of my heart. There are many women out there who have hysterectomies but if the endometriosis is still there, they could still suffer problems.

“I can now go away and don’t have to plan it around the calendar. I used to 
drag myself to work at my part-time job. Now I work 
full-time and do lots of different sports including skating! I just couldn’t have done a quarter of what I do now. It has changed my life.”

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The keyhole operation focuses on the top of the vaginal area, where the 
womb was attached before it was removed by hysterectomy.

Mr Trehan – a consultant for more than 20 years – came up with the specialised technique after seeing many women in clinic who continued to suffer chronic pelvic pain after hysterectomy. Many had also given up having sexual intercourse because of excruciating pain.

“Around 60,000 hysterectomies are performed in the UK every year and figures show 10-15 per cent of those who had hysterectomies to ease pain will continue to suffer pain afterwards. The research also suggests 2.5 per cent of those women who had their hysterectomies for other reasons, and were not in any pain before surgery, will end up with chronic pain or experiencing painful intercourse after the operation,” says Mr Trehan, from Gomersal.

“Now, it’s possible these patients do not have to suffer for the rest of their lives.”

Pioneering procedure

Hysterectomy is a surgical procedure to remove the womb.

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About 60,000 hysterectomies are carried out in the UK each year.

A fifth of women will have the operation during their lives.

Mr Ashwini Trehan’s keyhole technique uses a tiny camera and keyhole instruments to re-cut the old internal hysterectomy scar at the top of the vagina, where the uterus had been removed, to make a better line of stitches. He is also able to view the entire pelvic cavity at the same time to remove other problems including endometriotic tissue, cysts or adhesions.

As the surgery is performed laparoscopically, it can be done without an abdominal scar, and as a result the patient usually returns home the day after surgery and is soon back 
to their normal daily activities.