Gynecology & Obstetrics

(1) Overview

• Obstetrics and gynecology care covers a wide range of services—from childbirth, the beginning of life, to the treatment of benign conditions such as uterine fibroids and ovarian cysts, as well as malignant conditions including cervical, endometrial, and ovarian cancers.
• In January 2023, we established a dedicated women’s ward staffed exclusively by female personnel and serving only female patients. Gynecology patients admitted here receive attentive care tailored to the unique and sensitive issues that may arise during hospitalization and post-operative recovery, with the utmost respect for patient privacy.
• We also offer ovarian tissue cryopreservation in collaboration with specialized institutions. This procedure enables young women to undergo surgery while preserving ovarian tissue for future pregnancy.

Reference: Japan Society of Obstetrics and Gynecology: Gynecologic Diseases
https://www.jsog.or.jp/modules/diseases/index.php?content_id=17

Aiming for Safe Surgery: Cervical, Endometrial, and Ovarian Cancer

We provide comprehensive care for diagnosis, surgery, chemotherapy, and radiation therapy for major gynecologic cancers. Surgeries are performed by gynecologic oncologists certified by the Japan Society of Gynecologic Oncology, ensuring safe and reliable procedures.

Minimally Invasive Surgery: Uterine Fibroids and Adenomyosis

For benign conditions such as uterine fibroids and adenomyosis, we recommend minimally invasive procedures. These surgeries reduce scarring, minimize pain, shorten hospital stays, and enable a quicker return to daily life.

Surgery for the Future: Ovarian Tissue Cryopreservation

Ovarian tissue freezing involves surgically removing healthy ovarian tissue, carefully preparing it, and then freezing it to preserve fertility for future pregnancy.
There are two main reasons for this procedure:
Medical reason: For cancer patients scheduled to undergo radiation or chemotherapy, this procedure is done before treatment to protect ovarian function.
Social reason: For healthy women who wish to preserve their fertility while their reproductive potential is still high.
The surgical procedure is the same in both cases. Note that it is not covered by insurance and aims to remove healthy ovarian tissue.

(2) Policy

Gynecology: Minimally Invasive Gynecologic Surgery

A specialized team—including certified gynecologic oncologists—oversees the diagnosis and treatment of gynecologic cancers such as cervical and ovarian cancer.
We actively incorporate laparoscopic surgery to reduce pain and hospital stays, while maintaining surgical safety.
We also emphasize the appropriate use of chemotherapy and management of side effects through close collaboration between physicians, nurses, and pharmacists. Palliative care specialists oversee pain management, and radiation therapy is provided by board-certified radiologists.
As a Designated Regional Cancer Care Hospital, we offer a Cancer Consultation Support Center where patients can seek advice not only on cancer treatment but also on work and financial concerns.

Obstetrics: Aiming for a Safe and Comfortable Pregnancy and Delivery

Our maternity care policy prioritizes “not placing undue stress on expectant and new mothers.” We avoid rigid rules or forcing unnecessary interventions. Instead, we respect each woman’s wishes and values, striving to minimize physical and emotional strain.
After childbirth, our top priority is to allow mothers to rest and recover without pressure, especially regarding breastfeeding.
Responding to growing demand, since March 2025 we have offered epidural (pain-relief) delivery under specific conditions. We are committed to alleviating anxiety and supporting birth plans tailored to each woman’s preferences.
A dedicated page is available for those interested in giving birth at our facility.

(3) Features

Minimally invasive surgery to reduce pain, with safe procedures guided by accurate diagnosis

　　
• Accurate diagnosis is essential for gynecologic cancers such as uterine and ovarian cancer. When abnormalities are detected during cancer screening at other facilities, patients are referred to us with a referral letter. Upon consultation, our doctors perform thorough examinations including ultrasound and colposcopy, along with blood tests and imaging such as CT and MRI, to make a precise diagnosis.
• Surgery is not taken lightly, especially for benign conditions like fibroids or ovarian cysts. For those choosing surgery to relieve symptoms such as pain or anemia, we are committed to minimally invasive techniques that reduce discomfort and shorten recovery time.
• Our hospital has a well-established system unique to general hospitals, with access to intensive care units, blood transfusions, the ability to conduct tests at night, and options to consult with specialists in surgery or urology when necessary.
• For patients undergoing cancer treatment in other departments or those wishing to preserve fertility despite a busy lifestyle, we offer fertility preservation options. This involves a minimally invasive laparoscopic procedure to remove and freeze healthy ovarian tissue, which can later be thawed and re-implanted to help restore fertility.

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Safe Surgeries: Cervical, Endometrial, and Ovarian Cancer

（1）Policy

Cervical Cancer

Most of our patients are referred here by their local ward screening center following abnormal results. To make an accurate diagnosis, we use a colposcope—a device that magnifies the cervix—allowing us to collect tissue samples for detailed analysis. Based on results, we determine appropriate next steps, which may include monitoring, cauterization, partial removal of the cervix, or, in some cases, recommending hysterectomy. We discuss findings and treatment options thoroughly with each patient to decide the best course of action together. For patients planning pregnancy, less invasive treatments including watchful waiting are considered whenever possible.

Endometrial Cancer

Often detected during evaluation for abnormal bleeding rather than routine screening, the primary treatment is abdominal hysterectomy.

Ovarian Cancer

Currently, no effective screening method exists for ovarian cancer. Tumors are often large by the time of diagnosis, either due to rapid growth or incidental discovery during exams. Patients are referred to us for detailed examination and surgery, serving both diagnostic and therapeutic purposes.
Referrals come from gynecologists and general practitioners alike—for example, patients may notice abdominal swelling or pain that prompts further evaluation. We use ultrasound, blood tests, and imaging like CT or MRI to assess the condition, though definitive diagnosis typically requires surgery.
Endometriosis, which causes menstrual pain and infertility, can affect the ovaries and lead to cysts called “chocolate cysts” (endometriomas). Studies show about 3.4% of surgeries for endometriomas reveal ovarian cancer. Rapidly growing cysts or those larger than 10 cm are especially concerning. Because imaging may not always detect malignancy, we strongly recommend surgery if there is cause for concern.

Reference: Japan Society of Gynecologic Oncology: Endometriosis & Ovarian Cancer
https://jsgo.or.jp/public/naimaku.html

（2）Features

For cervical intraepithelial neoplasia (a precancerous condition), minimally invasive surgeries like conization are often recommended for patients wishing to preserve fertility. If uterine fibroids or other conditions coexist, endoscopic surgery may be an option.
For uterine cancer, surgery may be followed by chemotherapy or radiation therapy as needed.
Ovarian tumors cannot be definitively diagnosed without surgery. Patients who strongly wish to preserve fertility undergo surgery first to confirm diagnosis. Treatment plans then focus on preserving the uterus and ovaries as much as possible, based on final pathology.

（3）For Patients

If further tests are recommended, feeling worried is natural, but completing them is important. While some cancer diagnoses can be made through examination alone, surgery may be necessary for confirmation.
You may have concerns about pregnancy, family, work, or other personal matters. Cancer-specialized nurses and our Cancer Consultation Office are available to assist with questions about treatment, work, finances, or any other concerns. Please do not hesitate to reach out.
If you have diabetes or heart disease, we work closely with specialists here to develop the best treatment plan for you.

Minimally Invasive Surgery: Uterine Fibroids and Adenomyosis

（1）Policy

Uterine fibroids are among the most common gynecological conditions, affecting 20–30% of women of reproductive age. Symptoms vary depending on the size and location of fibroids, and we recommend treatment tailored to each patient.

（2）Features

There are two main surgical options:

• Uterus-preserving surgery, such as myomectomy or hysteroscopic myomectomy, aims to relieve symptoms during menstruation and improve fertility.
• Total hysterectomy, the removal of the entire uterus, is typically chosen by women who do not wish to become pregnant and want to avoid potential recurrence and further surgeries.

The surgical approach—open, laparoscopic, or vaginal—is selected based on factors like uterine size, childbirth history, and previous surgeries.
For patients who do not want surgery but wish to preserve their uterus, uterine artery embolization (UAE) is also available as a non-surgical alternative.

（3）For Patients

Most patients referred for surgery have experienced worsening symptoms despite hormone treatment or have been advised surgery after infertility evaluation. Many patients feel reluctant about surgery or removing their uterus.
If fibroids or adenomyosis cause no or mild symptoms, monitoring without immediate intervention is possible. Surgery is recommended if symptoms worsen, such as increased menstrual bleeding or severe pain, or if infertility is attributed to the condition. The patient’s wishes are always prioritized.

• For submucosal fibroids, hysteroscopic surgery with a short hospital stay (2-3 days) is recommended.
• For patients with abnormal cervical cancer screening but no uterine enlargement, vaginal surgery is a good option.
• UAE is available for those who prefer to avoid surgery or preserve the uterus.

Surgery for the Future: Ovarian Tissue Cryopreservation

（1）Policy

Ovarian tissue freezing is performed for two main reasons:

• Medical purpose: To preserve ovarian tissue in cancer patients before radiation or chemotherapy, which can damage ovarian function.
• Social purpose: For healthy women who wish to preserve fertility while reproductive potential is still high, in preparation for future pregnancy.

In both cases, normal ovarian tissue is surgically removed. This procedure is self-funded, and the surgical techniques are identical.
More than 200 pregnancies worldwide have resulted from ovarian tissue that was frozen, thawed, and transplanted. In Japan, three births using this method were reported in 2022.
In Tokyo, financial assistance is provided to cancer patients for fertility preservation and pregnancy-related treatments. From fiscal year 2023, support extends to unmarried healthy women to help preserve future pregnancy chances. Starting next fiscal year, approximately 300,000 yen per person will be subsidized for egg freezing, with an estimated 200 people benefiting annually.

（2）Features

• We perform ovarian tissue freezing, thawing, and transplantation in collaboration with the Japan Ovarian Tissue Cryopreservation Center, which has extensive experience. Our hospital provides a well-prepared surgical environment, safely removing healthy ovarian tissue. The tissue is transported (approximately 15 minutes) to the preservation center for careful freezing.

（3）For Patients

• If you are a cancer patient requiring urgent fertility preservation, please have your primary doctor contact our Medical Coordination Office directly at 03-3448-6192 for prompt consultation and arrangement.
• For women considering ovarian tissue freezing for non-medical (social) reasons, there is ample time to discuss your options. Please schedule an initial consultation to talk about timing and the procedure in detail.