Dr Peter Caska - Gynaecologist

 

M.B.,B.S.(SYD),F.R.C.O.G,(LONDON), F.R.A.N.Z.C.O.G.
 

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AS THE MOST EXPERIENCED CONSULTANT GYNAECOLOGIST ON THE CENTRAL COAST
DR PETER CASKA OFFERS
EXCELLENCE AND EXPERTISE
IN ALL GYNAECOLOGY PROCEDURES

 

I offer -

• DIAGNOSIS OF THE PROBLEM - which is extremely important as this then impacts on further tests and treatments. For example - if the diagnosis is not completely accurate it may lead to a line of treatment including surgery, which may not resolve the problem. Some diagnosis is straightforward but some are more subtle and may require repeated review before a firm conclusion is determined and a treatment plan can be made. If surgery is needed - I am in a position to decide which of the available techniques is the best one for you.

• A SECOND OPINION - this may reassure you that what is being proposed is the correct approach, or alternatively in some cases, may result in a completely different approach to a problem - eg an alternative surgical or non-surgical technique may be considered.

Having a second opinion may also prevent unnecessary or inappropriate surgery - this is usually unintentional but can happen if there is not a clear diagnosis and understanding of the condition or an understanding of the non-surgical alternatives.

• CHOICE OF PUBLIC OR PRIVATE HOSPITAL CARE

• I work in the PUBLIC SECTOR at both Gosford Hospital and Wyong Hospital as a senior Consultant Obstetrician / Gynaecologist with Central Coast Area Health Service. This enables me to provide a service for the non-insured patient and also to teach and share my knowledge with the trainees in my specialty.

Please note: being under my care in the public sector does not guarantee that I will personally perform the surgery - often this would be performed under my supervision directly or indirectly.

• In the PRIVATE SECTOR I operate at Gosford Private Hospital at North Gosford and also Brisbane Waters Private Hospital at Woy Woy.

• CONFIDENCE AND REASSURANCE IN YOUR CHOICE OF SPECIALIST In most gynaecological conditions there may be a number of options and the options offered are determined by the experience of the specialist involved. Not all specialists have the same range of solutions. I offer you confidence that whether a surgical or non-surgical solution to your problem is required, it will be performed to the highest level of expertise.


• URINARY INCONTINENCE - DIAGNOSTIC SERVICE / NON-SURGICAL AND SURGICAL MANAGEMENT

I commenced CENTRAL COAST URODYNAMICS FOR WOMEN - the first Practice of its kind on the Central Coast dedicated to helping women with the problem of urinary incontinence and prolapse.

This assists in the diagnosis and enables me to select the correct treatment for patients suffering with urinary incontinence.

Hundreds of patients have benefited from this.

The Urodynamics test is performed in my rooms with a Practice Nurse in attendance.

• VAGINAL AND UTERINE PROLAPSE MANAGEMENT

• Careful assessment is of paramount importance
• Non-surgical management may result in resolution stabilisation of the problem.
• Surgical techniques may involve vaginal or laparoscopic surgery, utilising your tissue or tissue substitutes if the tissues have deteriorated.

When surgery is required there are many different techniques - old and new. Some of these techniques incorporate utilisation of mesh ("tissue substitutes") and the modern super light mesh is an excellent solution when all of the tissues have deteriorated or disappeared. New surgical approaches combined with the new mesh virtually eliminate the problems.

If surgery is indicated, I have performed all the old and new techniques and will help you choose the one which is the most likely to resolve your problem.

• Often the treatment required may not be surgical at all.

• ABNORMAL AND HEAVY VAGINAL BLEEDING MANAGEMENT
After complete analysis of your medical history, clinical examination and other diagnostics tests, I am able to advise you regarding the treatment, which may be surgical or non-surgical.

Non-surgical treatment may involve hormonal treatment, or when appropriate, insertion of an intra-uterine device such as the Mirena. Depending upon the individual, this may be inserted in the rooms or may require a light anaesthetic as a "day surgery" procedure.

If surgery is needed, the techniques I use are "minimally invasive".

SURGICAL TREATMENT -

• HYSTEROSCOPIC whereby an instrument is passed inside the uterus and I operate inside the uterus to treat the problem causing the bleeding. This is performed as a "day surgery" under a light anaesthetic.

• LAPAROSCOPIC - whereby keyhole incisions are made and I operate inside the abdominal cavity to treat the cause of the bleeding. If hysterectomy is the best choice, it can still be performed with the "keyhole" approach.

• Depending upon the procedure, this may be a "day surgery" or an overnight stay under light anaesthetic.

• PAP SMEAR PROBLEMS
A Pap smear is a screening test to check if abnormal changes have occurred in the cells of the cervix. I perform Pap smears in my rooms as part of your consultation if required.

• COLPOSCOPY
A colposcopy, which I perform in my rooms, is a visual microscopic examination of the cervix, or indeed, any part of the female genital tract, to check for pre-cancerous changes. It is performed in the same position as when a Pap smear is performed.

It is usually performed after an abnormal Pap smear or further follow-up after treatment. It may pick up changes that are not done by the Pap smear.

Other reasons for a colposcopy are to diagnose and assist in the treatment of -

• abnormal bleeding
• non-cancerous growths called polpys
• genital warts, a sexually transmitted disease that may suggest infection with human papilloma virus (HPV) which is a risk factor for developing cervical cancer.

• LLETZ PROCEDURE (Large loop electrosurgical excision procedure)

If the results of colposcopy indicate a high grade abnormality (CIN 2 or CIN 3) I may recommend treatment to remove the tissue from which abnormal cells arise. This may involve a LLETZ procedure and excision of the abnormal area, but treatment will depend on the type and severity of the abnormal cells. This is usually performed as "day surgery" in hospital but occasionally I can perform it in my rooms under local anaesthetic.




 

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