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CASE STUDY

Name: Jo Cox

Age: 41

Medical Condition: Polycystic Ovary Syndrome (PCOS)

Since Jo was 14, she had suffered from ovarian cysts, which grew so large they required

surgery. She had also always suffered from crippling period pains. She had been told

her ovaries were otherwise normal, and despite a series of surgeries for cysts, no

gynaecologist offered an explanation, nor cure, apart from the oral contraceptive.

Given her history, Jo was surprised to fall pregnant soon after stopping her

contraception in 2000; however, a few months after the birth, Jo was suffering with

large cysts and pain once again. She was keen to become a mother again, however,

over the following two years, Jo was still in pain and not able to fall pregnant. After

seeking the opinion of two other gynaecologists with no further enlightenment, a friend

recommended Mr Lawrence Mascarenhas, Consultant Obstetrician and Gynaecologist

at London Bridge Hospital. He immediately referred her for a scan with his own trusted

gynaecological team. Jo was sceptical, having had countless scans over the years and

having been told that her ovaries appeared normal. Mr Mascarenhas’ team immediately

diagnosed ‘textbook’ Polycystic Ovary Syndrome – a condition that affects millions

of women in the UK, causing the ovaries to develop cysts, irregularly ovulate, cause

bleeding inside the abdominal cavity, and produce high levels of androgens (the ‘male’

hormones in the body). Suddenly, the years of cripplingly painful periods made sense,

as did the large cysts and present dif culty in getting pregnant. Jo’s ovaries were

scarred, and the eggs were not suitably matured.

Mr Mascarenhas recommended ovarian drilling surgery to allow ovulation, and

a change in diet to alter Jo’s hormonal imbalance. In ovarian drilling, the ovary/

ovaries are treated with heat to destroy the tissue that is producing androgens,

in order to correct the hormone imbalance and restore the normal function of

the ovary/ovaries. It also enables eggs to be released, where thick scar tissue

from years of cyst formation has previously prevented this.

The procedure commonly takes less than one hour. Jo underwent the ovarian

drilling through laparoscopy with success, and within six weeks, she had

conceived her second child. She was delighted to give birth to a baby boy,

Robin, in December 2006; something Jo had been led by other doctors to think

would never be possible. Since this time, Jo has gone on to have another baby,

which Mr Mascarenhas delivered in April 2008.

Women’s Health Services

SEVEN

Women’s Health Services

Women’s Health Services

It is estimated that 1.5 million women

in the UK are living with endometriosis;

a chronic and debilitating condition that

can cause fatigue, bladder and bowel

problems, and even lead to infertility.

London Bridge Hospital is proud to

work with Consultants who specialise in

this condition, and to provide them with

the specialist equipment to allow them

to perform minimally invasive diagnostic

procedures and treatments.

London Bridge Hospital is also pleased

to be able to offer an additional

gynaecology service for women who

have experienced injury during childbirth,

which may have impacted on their sex

life or resulted in incontinence.

Consultant Obstetrician and

Gynaecologist, Mr Lawrence

Mascarenhas, specialises in a range

of gynaecological conditions including

infertility, fibroids, pelvic pain, PCOS,

PMS, laparoscopic and hysteroscopic

surgery, menstrual problems, miscarriage

and prolapse, as well as his work

for women who have experienced a

traumatic childbirth and subsequent

health and lifestyle problems.

London Bridge Hospital

Mr Lawrence

Mascarenhas

MD (Fr) MD (Birm) MRCOG Med (Cantab)

Consultant Obstetrician

& Gynaecologist

Mr Lawrence Mascarenhas is a

Senior Consultant in Obstetrics

and Gynaecology, with 30 years’

experience. He is currently

Regional College Adviser

responsible for patient safety and

hospital accreditation for South

London hospitals.

Mr Mascarenhas’ subspecialty is

in reproductive medicine, focusing

on supporting pregnancies

after recurrent miscarriage and

fertility treatment. He is a highly-

experienced open and keyhole

gynaecological surgeon, and is

an accredited college trainer in

laparoscopic surgery. He also

runs a Perennial Clinic for injuries

sustained during childbirth.