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WHO WE ARE
WHAT WE DO
- Listen to the concerns of the individual patient.
- Assess with examination and appropriate investigations to establish a diagnosis (there is often more than one).
- Offer a series of potential solutions with detailed discussion about how each approach might impact positively or negatively if adopted.
- Ultimately, the individual patient, assisted by Dr Onuma, will come to a decision as to how they would like to proceed.
- Providing knowledge, choices and alternatives is an essential part of delivering a first class medical service so as to improve the quality of life and function of each patient seeking help.
- Continue to travel nationally and internationally, teaching others and also learning more along the way.
- Advanced laparoscopic (‘keyhole’) gynaecological surgery.
- Minimal Access Surgery.
- Non surgical laser vaginal treatment.
- Surgical laser vaginal rejuvenation.
- Labiaplasty (minora, majora and prepuce).
- Perineum and perineal body reconstruction.
- Urogynaecology and Female urinary incontinence.
- Urodynamics (Cystometry/Bladder studies).
- Female pelvic organ prolapse: Conservative management and Surgery.
- Sexual function and pelvic reconstructive surgery.
- Female menstrual dysfunction.
- Ovarian cyst management.
- Jurisprudence in the practice of medicine.
Dr Onuma wishes to deliver:
- Personalised care
- Desired outcomes
- World class treatment
- Aesthetics in function
Dr Onuma’s desired outcomes:
- Restore anatomy & function
- Resolution of symptoms
- Improve quality of life
- Restore the sense of femininity
Ageing is inevitable
It is an accumulation of damage to:
Rejuvenation is possible
It is the reversal of ageing and requires:
- Encouraging the formation of new connective tissues
- Repair of the damage that is associated with ageing, or
- Replacement of damaged tissue with an appropriate substitute
A prolapse is a detachment of an organ or tissues from its original position. Any part of the female genital organs can become prolapsed. The aim of surgery is to restore anatomy, functions and, if required, aesthetics.
Most incontinence surgery is performed for stress incontinence. There are some procedures that are available to improve or cure urgency incontinence, problems with bladder emptying and bladder pain.
The vulval structures are most of the external genitalia. These can become damaged through infection, trauma, dermatological conditions, surgery and as part of the ageing process. The aim of surgery is determined by the symptoms described and the outcome desired by the patient.
Laser treatment can be surgical or non-surgical. Surgery is carried out in the operating theatre. Non surgical treatment is done in the office. Lasers improve healing by stimulating collagen formation and also reduce scar tissue.
Vaginal reconstruction is surgery performed to repair damage to vaginal structures with the aim of restoring anatomy, function and, if required, aesthetics.
Fibroids are smooth muscle tumours normally found in the uterus. Surgery can involve removal of the fibroid or removal of the uterus. The nature of surgery is determined by the patient’s particular circumstances, the size, position and symptoms caused the fibroid.
Adhesions are abnormal attachments between parts of the same structure or between different structures. They can cause no symptoms or a variety of symptoms. The most common symptom is pain. Adhesion surgery is primarily aimed at symptom control with restoration of normal function.
Laparoscopic ‘keyhole’ surgery involves the use of very small (2-10mm) incisions to pass special telescopes (‘endoscopes’) and instruments in order to perform surgery that would otherwise require bigger, open incisions. Laparoscopic surgery is associated with a more rapid return to normal activities.
The labia minora can become longer, thicker and change in colour. The main reasons that women request labia minora reduction are because they are uncomfortable during certain activities or because of aesthetic concerns. Often the two co-exist. Surgery that combines attention to function and aesthetics produces optimal outcomes.
The labia majora (‘outer lips’) can become swollen due to excess underlying fat. The skin can sag because of weight loss or ageing and there can be chronic dermatological changes not responding to more conservative treatment. Surgery aims to reduce symptomatology, restore anatomy and aesthetics.
The mons pubis can sometimes remain stubbornly enlarged even when overall weight has been lost. Reduction of the mons pubis requires attention to both the overlying skin and subcutaneous fat in order to achieve a good reduction. Other factors such as abdominoplasty and liposuction may need to be taken into account.
Hymen reconstructive surgery may be appropriate for women who have symptomatic (usually discomfort or painful intercourse) hypertrophy and elongation of the hymenal remnants. Other women may request it for cultural reasons and the aim of surgery is then to create an intact hymen that looks completely ‘normal.’
A hysterectomy refers to removal of the uterus and cervix. Vaginal hysterectomy describes the surgical procedure where the uterus is removed through a vaginal approach to surgery. This is a form of minimally invasive surgery.
Laparoscopic hysterectomy describes the surgical procedure where hysterectomy is facilitated through keyhole surgery. The uterus is then delivered through the vagina. This is a form of minimally invasive surgery.
Oophorectomy is the technical name for removal of the ovary. This can be done as an independent procedure or as an additional surgery when hysterectomy is taking place. The fallopian tubes, if present, are usually removed at the time of oophorectomy.
Ovarian cystectomy involves stripping the lining of the ovarian cyst from the ovary. The ovarian cyst is punctured and drained before cystectomy commences. This operation is usually performed as a laparoscopic day surgery.
Sacrocolpopexy is a surgical technique for suspending the vaginal vault for severe degrees of vaginal vault prolapse. Mesh is placed through an abdominal approach on the front and back parts of the vagina and attached to the sacrum.
Vaginal vault suspension refers to suspension of the top of the vagina using permanent sutures or sometimes mesh. The surgery can be achieved through a vaginal or abdominal (open or keyhole) approach.
The perineal body is, perhaps, the most important structure of the distal (closest to the outside) vaginal structures. Damage is mainly caused by childbirth and can accelerate the rate of prolapse in other genital organs/structures. Surgical reconstruction is paramount in effective pelvic floor reconstructive surgery.
The uterus can become prolapsed and descend into the vagina resulting in a variety of symptoms. The uterus can be elevated through laparoscopic surgery in women who wish to have uterine preserving prolapse surgery.
Urodynamics is an investigation used to assess bladder function in order to guide &/or monitor treatment of bladder problems. This is an office based test involving the passage of 2 small catheters into the bladder, a small catheter into the rectum with all the transducers connected to a computer for analysis.
Endometriosis management involves many strategies including lifestyle changes, attention to diet, counselling, investigative and treatment based surgery. The aim of treatment can be to reduce symptoms, improve quality of life and improve fertility.
Endometrial resection is a method of destroying the lining of the uterus (endometrium). This is done to either reduce menstrual blood loss, remove an endometrial polyp or resect a submucous fibroid.
Tubal occlusion is a permanent method of contraception. Typically, a clip is placed across each fallopian tube. The procedure is done as a day case surgery usually via laparoscopic approach. Tubal removal should be considered instead of occlusion as the failure rate is much lower and it may prevent ovarian cancer.
Cystoscopy is an endoscopic technique for looking inside the bladder using a small telescope (cystoscope). Any abnormal looking areas can be biopsied and the tissue sent for lab analysis.
The urethra can be visualised as the cystoscope is passed through it into the bladder. This procedure of both urethral and bladder inspection is called a cystourethroscopy.
A tissue sample can be obtained, under direct vision, from the bladder urothelium using a special tissue biopsy instrument attached to the cystoscope. This can be valuable in distinguishing a bladder cancer from a non-cancerous (benign) lesion.
Bladder heparin treatment is an effective method of alleviating the bladder pain associated with interstitial cystitis. It is an office procedure and is administered according to a particular protocol and the response of each patient to treatment.
Vaginismus is a complex condition with many different causes and is often multifactorial. Surgery is reserved for patients who have failed conservative treatment where the cause of the problem is thought to be pain invoked by a condition for which surgical correction may resolve the trigger factor. Anti-spasmodic drugs for vaginismus can be injected into the vaginal muscles, usually as a one off treatment.
Hysteroscopy is an endoscopic investigation where a telescope (hysteroscope) is passed through the cervix into the uterus so that the endometrial cavity can be inspected. An endometrial biopsy is usually obtained.
The cause of lichen sclerosus remains undetermined. Symptoms include vulval irritation, itching, discomfort and painful intercourse. The mainstay of treatment is use of topical steroids. Surgery is required only if this does not prove to be effective.
Bartholin’s abscess is a result of blockage of the secretions from the Bartholin’s gland. The accumulated secretions become infected and an abscess results. This is managed by incision, drainage ± marsupialisation.
Anti-spasmodics, injected into the detrusor muscle of the bladder through an operating cystoscope, can be very effective for reducing the symptoms of Overactive Bladder Syndrome. Treatment takes place in a day case surgery unit and needs to be repeated every 6-9 months.
The Mirena intrauterine contraceptive device is used for contraception, reduction of menstrual pain and bleeding, reduction of endometriosis symptoms and protection of the lining of the womb in women having oestrogen hormone replacement therapy. Insertion is done in the office or as a day case procedure in hospital.
Cervical polyps are usually benign (innocent) lesions, however the correct management is for them to be removed and sent to the lab for analysis. In some cases, the origin of the polyp may arise deep within the cervical canal or from the uterus.
Dr Onuma is on the Expert Witness Regress of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists in the areas of general gynaecology and urogynaecology. Dr Onuma has international recognition as an expert in urogynaecology & female pelvic reconstructive surgery.
Payment is required on the day of your consultation. Booking or gap fees for surgery are required prior to surgery (usually 2 weeks beforehand). We accept cash, EFTPOS, VISA and Mastercard.
Your time is valuable and we try to keep to schedule. Please arrive 5 minutes prior to your appointment time. Emergencies and unforeseen circumstances may occasionally cause a delay, for which we apologise and seek your understanding and patience.
Cancellation of appointments
If you are unable to keep your appointment, please notify us as soon as possible. A fee for missed appointments may be charged if we have not been notified.
Attending your consultation
When you attend for consultation kindly bring with you a list of all the medications that you are taking. Please bring your referral letter and the results of any investigations that you have had recently or which may be relevant to your visit. You may find it useful to make a list of the questions you wish to ask or the problems that you wish to have addressed. You may wish to have a support person attend with you.
Patient privacy is taken very seriously. Not only do we adhere to strict confidentiality regulations but we also provide an environment that offers privacy throughout your visit. You can be confident that your consultations are handled with complete discretion, your details are stored securely and your information is not disclosed without your consent.
During your treatment Dr Onuma &/or his staff will:
- Give your a clear explanation of the options for managing your symptoms.
- Obtain consent for any proposed treatment after a discussion about associated risks & benefits.
- Give you a guide as to costs associated with treatment.
- Treat you with courtesy and respect at all times.
- Encourage you to provide feedback on your care and treatment.
- Ensure your personal details including address and telephone numbers recorded are up to date. Please inform our staff of any changes at your earliest convenience.
- Be sure that you are well informed about the proposed treatment, as well as your role in managing your personal health.
- Answer the questions about your health and medical problems honestly as such problems may impact your treatment.
- Inform us of any change in your health, medication or circumstances since your last visit.
- Treat us and other patients with respect and courtesy.
- Conduct yourself in an appropriate way so as not to interfere with the wellbeing of other patients or staff.
Where to find us
4 Robe Terrace, Medindie, South Australia, 5081
Suite 2.01/376 New South Head Road, Double Bay, NSW
Send us a message
We’d love to hear from you!
08 8344 6085
08 8344 6087
4 Robe Terrace, Medindie, SA 5081