Obstetrics and Gynecology

If a malignant tumor is suspected, examinations (pelvic examination, rectal examination, ultrasound, CT/MRI, tumor markers, etc.) are performed, the stage is estimated, and treatment is selected. Cancer treatments include surgery, radiation, and chemotherapy.

It is a cancer that occurs in the lower part of the uterus and is common among young women in their 20s and 30s. At our hospital, we perform treatment with an appropriate combination of surgery, radiotherapy, and chemotherapy.

What is cervical cancer

It is a cancer that develops from the part called the uterine cervix at the entrance of the uterus, and about 10,900 people are affected annually nationwide, and about 2,900 people die from cervical cancer every year. The average age of onset of cervical cancer is around 50 years old, but in recent years, the incidence and mortality of cervical cancer among young people in their 20s and 30s have been increasing in Japan. In addition, cervical cancer has a precancerous lesion called cervical dysplasia, and its onset is said to peak in the 30s. Cervical cancer is a cancer that has been scientifically proven that the implementation of cancer screening can reduce the mortality rate, so regular cancer screening is recommended even at a young age.

symptoms

Cervical dysplasia and early cervical cancer have no symptoms at all. Abnormal cells in the uterine cervix can be detected by cytological examination, so it is possible to detect them at an early stage through gynecological examinations and group screenings, even when there are no symptoms. Also, if you are not menstruating, have bleeding during sexual intercourse, or have unusual vaginal discharge, don't hesitate to see a doctor for early detection.

Examination/Diagnosis

Cytology is usually performed in cancer screening. A procedure in which cells are removed from the cervix and viewed under a microscope, and the procedure is usually not very painful.

If abnormalities are found in the cytology, colposcopy is performed to observe the mucosal surface of the cervix with a magnifying glass, and then a biopsy is performed by removing a small piece of tissue from a suspected cancerous area. The test may be painful and may bleed. If the normal histology is insufficient for evaluation, a histological examination by cervical conization may be performed (see separate section).

If cervical cancer is diagnosed by histological examination, pelvic examination, ultrasonography, CT examination, and MRI examination are performed to check the extent of the cancer. Cystoscopy and rectoscopy may be added in some cases.

treatment

Treatment for cervical cancer is roughly divided into surgery, radiotherapy, and chemotherapy with anticancer agents. The treatment policy is selected according to each medical condition, such as the degree of cancer progression, the patient's age, and the presence or absence of complications.

In principle, if the cancer is relatively early and can be completely resected, surgery is performed. The surgical method is determined by the size of the lesion, and if the lesion is small, surgical methods such as cervical conization, simple hysterectomy, semi-radical hysterectomy, and radical hysterectomy are listed. increase. The latter provides satisfactory treatment results even for larger lesions, but the operation time is longer and the frequency of postoperative complications such as dysuria and intestinal obstruction is higher. At our hospital, we use nerve-sparing surgery to the extent that it does not interfere with cancer treatment, so that dysuria does not occur as much as possible. In addition, if a total hysterectomy is performed, depending on the situation, laparoscopic surgery (details are also explained in the section "Laparoscopic surgery for malignant tumors") can be selected at our hospital, so please consult with your doctor. .

Radiation therapy includes external radiation, which is radiation from outside the body, and intracavity radiation, which is radiation to the cervix through the vagina. Radiation therapy may be used to control cancer when surgery is not possible, or as an adjuvant therapy after surgery. For cervical cancer, it is known that simultaneous chemoradiotherapy combined with chemotherapy is more effective than radiotherapy alone, and at our hospital, treatment is performed in cooperation with the Department of Radiation Oncology of Chemotherapy. going.

Chemotherapy for cervical cancer is mainly performed in cases with distant metastasis or recurrent cases. At our hospital, chemotherapy is mainly performed in the outpatient chemotherapy department, and various methods are taken to reduce the pain caused by the side effects of anticancer drugs so that patients can live their daily lives at home with peace of mind.

Cancer of the uterus is divided into cervical cancer and endometrial cancer. Endometrial cancer is cancer that arises from the lining of the uterus, the lining of the uterus.

symptoms

A common symptom is irregular vaginal bleeding.
If you continue to have a small amount of vaginal bleeding that is different from menstruation, please consult a gynecologist as soon as possible.
Even if you say that you are okay because you have undergone cervical cancer screening, you should be careful because cervical cancer screening may refer to cervical cancer screening.
Other symptoms include pain in the lower abdomen, pain during urination, difficulty urinating, and pain during sexual intercourse.

test

If endometrial cancer is suspected, in addition to pelvic examination and transvaginal ultrasonography, endometrial cytology, which collects and confirms cells from the inside of the uterus, is performed.

If endometrial cytology is suspected of cancer, hysteroscopy, in which the inside of the uterus is observed with an endoscope, and endometrial biopsy, in which biopsy is performed from the endometrium, are performed.

If cancer is diagnosed as a result of endometrial biopsy, the spread of the lesion (advanced stage) is predicted by MRI or CT.

treatment

Cancer treatment generally includes (1) surgery, (2) anticancer drugs, and (3) radiation therapy, but the treatment method differs depending on the type of cancer.

The most common treatment for endometrial cancer is surgery.

The surgical procedure differs depending on the advanced stage, but the uterus and both ovaries are removed. Additional lymphadenectomy and omentectomy may be done.

Surgery is basically open surgery, but at our hospital, we perform less invasive laparoscopic surgery in the case of so-called early-stage cancer, where the lesion has not spread much (see "Laparoscopic surgery for malignant tumors" for details). section).

We will remove the lesion by surgery, determine the exact stage of progression, and consider additional postoperative treatment. Additional treatments include anticancer drugs.

If the preoperative examination predicts that the lesion has spread to the extent that surgery is difficult, anticancer drug treatment may be performed without surgery.

In addition, if you are young and strongly wish to become pregnant, hormone therapy may be performed only if the advanced stage is early.

Regardless of which treatment method you choose, you will have regular check-ups after treatment to make sure there is no recurrence.

Ovarian cancer is a cancer that occurs in a wide range of age groups from infants to the elderly. It is a cancer that develops slowly and is often advanced by the time it is discovered.

What is ovarian cancer

The ovaries are thumb-sized organs on either side of the uterus. It is the organ in which eggs mature and are released, and it also secretes female hormones periodically. Ovarian tumors are classified according to the tissue from which they originate, and include epithelial tumors, germ cell tumors, and sex cord-stromal tumors. In addition, there are benign, borderline (less malignant), and malignant tumors.

Ovarian cancer is often asymptomatic until it becomes quite large, and it is said that there are few subjective symptoms. As a result, more than half of the cases are often found in the state of advanced cancer at the time of diagnosis. Symptoms that appear as the tumor grows include a feeling of mass and pressure in the lower abdomen, and frequent urination due to pressure on the bladder. It is not uncommon for people not to notice anything abnormal until ascites builds up in their stomachs, causing them to feel bloated and lose their appetite, or to have shortness of breath due to fluids in their chest.

test

Interview, pelvic examination (gynecological examination), rectal examination, ultrasonic tomographic examination, blood test (tumor marker), imaging examination (CT examination, MRI examination, PET examination, etc.) will be performed.

diagnose

Surgery is the mainstay of treatment for ovarian tumors. Whether it is a benign tumor or a malignant tumor is diagnosed by surgery, and the subsequent treatment policy is decided.

treatment

Treatments for ovarian cancer include surgery, chemotherapy, and radiation therapy. Basically, we determine the diagnosis and advanced stage by surgery, and consider whether to combine chemotherapy based on the results of the advanced stage. Depending on the advanced stage, treatment may begin with chemotherapy.

surgical therapy

The choice is made according to the patient's condition, such as the advanced stage of cancer, age, and the presence or absence of complications.

• Removal of ovaries and uterus
• omentectomy
• Retroperitoneal lymph node dissection (pelvic lymph nodes, para-aortic lymph nodes)
• If the cancer has metastasized, we aim for complete resection if resectable.

If it cannot be completely removed, cytoreductive surgery is done to remove as much of the cancer as possible.

Drug therapy-chemotherapy

Ovarian cancer is one of the cancers for which anticancer drugs are relatively effective, and multiple anticancer drugs are used in combination. Because anticancer drugs affect not only cancer cells but also normal cells, their side effects are a problem. Side effects vary from person to person, so we will monitor the effects and side effects of anticancer drugs.

radiotherapy

Radiation therapy uses high-energy X-rays to irradiate the affected area and has the effect of shrinking the cancer. Rather than using it for ovarian cancer, it is now sometimes used to alleviate the symptoms of metastasis to the brain and bones.

We actively perform laparoscopic surgery for benign diseases (ovarian cysts, uterine fibroids, uterine fibroids) and early malignant tumors.

At our hospital, we perform laparoscopic surgery for many benign diseases.

The abdominal cavity is the so-called "space in the stomach", where the stomach, intestines, liver, etc. are contained. Mirror means "camera". In other words, it is a surgery performed by inserting a “camera” into the “space in the stomach”.

First, an incision of about 5 mm is made in the umbilicus, and a tube called a trocar is punctured through the same site to reach the abdominal cavity. Then, pneumoperitoneum with carbon dioxide is performed to create a space in the abdominal cavity. In addition, 2 to 3 incisions of 5 mm to 1 cm are made in the lower abdomen, and trocars are similarly punctured and placed in place. Surgery is performed by inserting tools such as forceps through the tube. The advantage is that the wound is small and the burden during surgery is light, but if adhesions (tissues sticking together) are severe or unexpected bleeding occurs, the surgical method will be changed to laparotomy. You may.

What is a focal cyst

An ovarian cyst is a benign disease that causes the ovaries to swell. An ovarian cyst is called an ovarian cyst. Abdominal bloating and pain may be noticed, but most of them are asymptomatic and are found incidentally during a medical examination. There are benign and malignant (ovarian cancer), but benign ones account for the majority. Bleeding and swelling in the ovary due to endometriosis (chocolate cyst), bleeding in the ovary during ovulation (ovarian hemorrhage), cyst remaining in the ovary without ovulation, etc. may also be diagnosed as an ovarian cyst.

treatment

follow-up

For a while after the cyst is found, if it is not large and there are no findings of malignancy, regular outpatient examinations are performed to monitor the progress. Ovarian bleeding and unruptured follicles disappear spontaneously. If it does not shrink even after half a year, it is less likely to disappear. If it is small, we will check the situation by regular outpatient visits, but if it reaches a certain size, there is a possibility of rupture or torsion (twisting of the ovary), so we recommend surgery.

when you need surgery

Treatment (surgery) is required if it is larger than 6 cm, grows gradually, or is suspected to be malignant. Emergency surgery is performed when ovarian pedicle torsion or rupture is suspected with severe pain.

surgical method

Laparoscopic surgery is often performed when malignancy is not suspected. There is a method of removing the swollen ovary (oophorectomy) and a method of removing only the swollen part (cystectomy). If you are premenopausal, it is possible to preserve ovarian function by enucleation. is. If malignancy is suspected, open surgery is performed. The final diagnosis of benign or malignant is determined by pathological examination.

Chocolate cysts can also be treated with drugs such as pills.

Uterine fibroids are benign tumors of the uterus. Treatment options include open surgery, laparoscopic surgery, and hysteroscopic surgery.

What is uterine fibroids

Uterine fibroids are benign tumors that grow with female hormones but shrink after menopause. It is often possible to have more than one, and the number and size vary. According to the location, it is divided into inside the uterus (submucosal fibroids), inside the muscle of the uterus (intramural fibroids), and outside the uterus (subserous fibroids). Symptoms include menorrhagia (heavy menstrual flow, anemia in severe cases) and swelling of the abdomen (feeling of pressure). It can also cause infertility and miscarriage. The patient is first diagnosed with a pelvic examination, an ultrasound, and in some cases an MRI.

treatment

As a treatment, if there are no subjective symptoms due to uterine fibroids, we will follow up, but if you have symptoms and it seems to interfere with your life, you will need treatment. Treatment includes surgery and drug therapy. In surgery, there is a method of removing the uterus (total hysterectomy) and a surgical method of removing only the fibroids (myomectomy). For those who wish to have children in the future, we perform surgery to remove only the fibroids, but since the uterus remains, there is a possibility that the fibroids will recur again.

Methods of total hysterectomy and myomectomy include open surgery and laparoscopic surgery. In the case of submucosal fibroids, there is also a method to remove the fibroids under a hysteroscope.

In the treatment of drugs, there is a treatment (pseudomenopause therapy) that puts the woman in a state of menopause. However, during this treatment, the secretion of female hormones is stopped, so side effects such as osteoporosis and menopause may occur, and treatment can only be done for half a year. During treatment, menstruation stops and uterine fibroids often shrink, but when treatment is stopped, they return to their original size. Therefore, it is used temporarily before surgery to shrink fibroids or as a temporary treatment until menopause.

• Laparoscopic Endometrial Cancer Radical Surgery
• Radical hysterectomy for cervical cancer
• Laparoscopic surgery for other malignancies

Laparoscopic Endometrial Cancer Radical Surgery

Early-stage endometrial cancer has been covered by insurance since April 2014, and our hospital has treated more than 30 patients annually, and has treated more than 150 patients so far.

Laparoscopic surgery, which is performed by making several small holes in the abdomen, can significantly reduce the invasiveness of surgery compared to the open abdominal method. Early return to society is possible. In addition, the amount of intraoperative bleeding is small, and complications such as intestinal obstruction tend to be small. By using a laparoscope, it is possible to observe the deep part of the pelvis more reliably than with direct vision, and the amount of bleeding can be reduced.

The stage of uterine cancer is diagnosed by pathological examination after surgery, but the stage is estimated by pathological examination before and during surgery, and the necessary surgery is performed for each stage. Whether or not it is early-stage endometrial cancer, which is an indication for laparoscopic endometrial cancer radical surgery, is determined by tissue examination of the endometrium and imaging tests such as MRI and CT before surgery. However, if there are large uterine fibroids or strong adhesions in the pelvis, laparotomy may be recommended. In addition, if the pathological examination during surgery reveals that the lesion is not an early lesion, laparoscopic or open surgery is performed, and lymphadenectomy in the upper abdomen (para-aortic lymphadenectomy) is added. will do.

Advanced Medicine: Laparoscopic Para-Aortic Lymph Node Dissection for Endometrial Cancer

Endometrial cancer that is more advanced than early stage endometrial cancer requires removal of the lymph nodes around the para-aorta (the large blood vessel near the plexus). However, at present, para-aortic lymphadenectomy is not covered by insurance for laparoscopic surgery, so it is necessary to make a large abdominal incision from the pubic bone to the solar plexus by laparotomy.

Laparoscopic para-aortic lymphadenectomy, which was approved as advanced medical care by the Ministry of Health, Labor and ministry of Health, Labor and Welfare notation in August 2017, performs laparoscopic surgery for endometrial cancer including para-aortic lymphadenectomy Thing. We have been using this technique since February 2018.

In "advanced medical care", all surgical costs are borne by the patient, but other costs (medical examinations, examinations, medication, hospitalization fees, etc.) are covered by insurance, just like normal surgery. The cost of surgery at our hospital is 790,420 yen. However, if an additional unscheduled operation is required, if the operation is changed to a conventional laparotomy during the operation, or if there are complications after the operation, the insurance treatment will be covered as usual.

Since it became insurance coverage from April 2020, the advanced medical treatment of this technique has ended.

Radical hysterectomy for cervical cancer

At our hospital, early stage cervical cancer (IA2, IB1, IIA1) has been treated as advanced medical care since June 2015, and has been covered by health insurance since April 2018.

This operation performs a radical hysterectomy using a laparoscope. A radical hysterectomy is surgery to remove part of the uterus and vagina, as well as associated lymph nodes.

Laparoscopic surgery, which is performed by making several small holes in the abdomen, can significantly reduce the invasiveness of surgery compared to the open abdominal method. Early return to society is possible. In addition, by using a laparoscope, it is possible to observe the deep part of the pelvis more reliably than with direct vision, and the amount of bleeding can be reduced.

Laparoscopic surgery for other malignancies

Laparoscopic tumor biopsy

If a malignant tumor in the pelvis is suspected by CT or MRI, but the diagnosis is unclear, a laparoscopic examination of the pelvis and tissue biopsy may be performed for the purpose of accurate diagnosis.

Compared to open surgery, tissue can be harvested with minimal invasiveness and can be used for subsequent treatment.

Endometrial cells bleed outside the uterus during menstruation, causing menstrual pain, pelvic adhesions, and infertility. Hormone therapy and surgery.

What is endometriosis

Endometriosis is a condition in which the endometrial tissue, which normally resides in the uterine cavity, develops in the ovaries and the abdomen outside the uterine cavity and proliferates, causing stronger menstrual pain and adhesions in the abdomen. It is a disease that comes and goes. It is said that there are 1-2 million patients in Japan.

symptoms

Many people are diagnosed with severe menstrual pain. Some people experience pain during sex and pain during bowel movements during menstruation. When the ovarian endometriosis is defeated, it becomes an acute abdomen and may be taken to the hospital. In addition, there are people who are found to be infertile even though they have no such symptoms, or who are found to have blood in their ovaries during a gynecological examination.

test

Diagnosis is made by confirming adhesions around the uterus during a pelvic examination, and by finding accumulations of sieved blood in the ovaries (called ovarian chocolate cysts) by ultrasonography. In blood tests, there are many people who have a mild rise in the tumor marker called CA125. Since ovarian chocolate cysts have a very low probability of becoming cancerous, a contrast-enhanced MRI may be taken for a more detailed examination.

treatment

Endometriosis is a disease to deal with, not a disease that can be cured. Since endometriosis is not a life-threatening disease, there are many people who can live comfortably with painkillers and herbal medicines without treatment for endometriosis itself. On the other hand, if the symptoms are severe or infertility, it may be better to treat the endometriosis itself. For those who want to have a baby right away, surgical adhesion ablation is recommended. Surgery is recommended when in doubt. If not, it can be treated with hormone therapy. Main options include (1) low-dose estrogen/progestin combination drug (2) dienogest (4) GnRH agonist (pseudomenopause therapy). Please understand the characteristics of each treatment method and find the treatment method that suits you with your doctor.

What is hysteroscopy

A hysteroscopy is a test in which an endoscope is inserted into the uterus to directly observe the inside of the uterus. It is performed when a lesion in the uterine cavity is suspected.
Hysteroscopic surgery is an operation that removes lesions in the uterine cavity while checking with a hysteroscope. The excised lesion is submitted for pathological examination. It is usually done under intravenous or spinal anesthesia.
Although it depends on the type and location of the lesion, most of the surgery takes about 30 minutes. You can usually leave the hospital on the same day or the next day.

What is cervical lesion conization

The purpose of this operation is examination and treatment to evaluate how advanced the lesion on the cervix is.

• If the outpatient test result is atypical or carcinoma in situ, check whether there is already an invasive cancer
• If microinvasive cancer is suspected, is the cancer at an advanced stage?

The purpose is to confirm

A cone-shaped excision of the cervix, including the lesion, confirms the diagnosis and at the same time reveals how much treatment is necessary. The final diagnosis is based on the pathological diagnosis of the resected specimen. Additional treatment is usually not necessary if the diagnosis is carcinoma in situ.

Even if the lesion reaches the entire incision of the resected specimen, the incision on the uterus side is sufficiently heat-coagulated with an electric scalpel, so a sufficient therapeutic effect can be expected in many cases. You may need to have a check-up or have additional surgery.

Many people are cured by conization, but since it is an operation that leaves the uterus with abnormal cells, there is a possibility that atypical epithelium or cervical cancer will recur after surgery, and the frequency is 3 to 3. It is said to be 5%. Regular cancer screenings are necessary even after surgery.

Method

It is performed under spinal anesthesia.

After anesthesia, take a position for pelvic examination (lithotripsy position) and operate from the vagina.

After applying the drug and confirming the lesion site, the cervix is excised in a conical shape while stopping bleeding with an electric scalpel. In addition, a sample of the mucous membrane inside the cervix is collected and submitted for examination.

After excising the neck in a conical shape, heat denaturation is added to the excised area in the sense of preventing bleeding and leaving lesions behind. Surgery time is about 30 minutes.

hospitalization schedule

As a general rule, the period of hospitalization is one night and two days.

You will come to the hospital on the morning of the surgery to prepare for the surgery.

On the day of the surgery, your family will come to the hospital and you will be asked to wait in the hospital during the surgery.

After the surgery, you will be transferred to the ward and will be admitted to the hospital for rest.

At our hospital, we perform painless epidural delivery for maternal complications such as heart disease and cerebrovascular disease. With the cooperation of Obstetrics and Gynecology, Anesthesiology, and specialist doctor (Cardiology, Neurosurgery, etc.), we carry out planned deliveries with due attention to safety.

epidural analgesia

General item

Female Outpatient consultation method

Obstetrics and Gynecology and gynecology outpatient consultation method

If possible, please refer Obstetrics and Gynecology local doctor.) If you receive a referral, you can make an outpatient appointment for the first visit by contacting the referring doctor.

Outpatient first visit without reservation is also possible.

Reservation for first visit by e-mail

We are sorry, but we do not accept appointments for outpatient visits by e-mail or telephone from patients.

紹介元の先生に所定の手続きを取って頂けましたらFAXでの初診予約が可能です。
紹介元の先生に当院代表電話078-302-4321にお電話して頂いてください。

Outpatient visits are possible even if you do not have an appointment. Please bring your referral letter and come directly to the outpatient reception desk at our hospital between 8:30 and 11:30 on the day you wish to see a doctor.

Referral letter from another hospital

Outpatients at our hospital can be seen without a letter of introduction.
If you have a letter of introduction,

• Easy-to-understand medical information at other hospitals
• You can make an outpatient appointment for the first visit
• Avoid duplication of tests
• Unintroduced patient first visit fee (7,000 yen) is no longer required
  *Even if you visit other departments of our hospital, you may be charged for the first visit.

Since there are advantages such as, please receive a referral as much as possible and see a doctor.

If you find it difficult to get a referral, you can do without a letter of introduction.

do you need a letter of introduction

Outpatients at our hospital can be seen without a letter of introduction.
If you have a letter of introduction,

• Easy-to-understand medical information at other hospitals
• You can make an outpatient appointment for the first visit
• Avoid duplication of tests
• Unintroduced patient first visit fee (7,000 yen) is no longer required
  *Even if you visit other departments of our hospital, you may be charged for the first visit.

Since there are advantages such as, please receive a referral as much as possible and see a doctor.

If you find it difficult to get a referral, you can do without a letter of introduction.

Obstetrics

Home delivery consultation

If there are no abnormalities during pregnancy and there is no scheduled caesarean section, please have a prenatal checkup at our hospital from around 34 weeks of pregnancy.

When you go home, please bring a letter of introduction from the doctor who is currently having a prenatal checkup.

In addition, we recommend that you visit our hospital once during your pregnancy before returning to your hometown, receive hospitalization guidance, and make a delivery reservation.

Cesarean section home delivery consultation

If possible, please make an appointment for a birth that requires a caesarean section at our hospital by 32 weeks.

Please bring a letter of introduction from the doctor who is currently having a prenatal checkup at the time of your consultation.

Childbirth reservation from another hospital

Childbirth reservations are accepted at any time.

Please visit the Obstetrics Outpatient Department from Monday to Friday.

Outpatient reception hours are from 8:30 to 11:30.

Also, please have a referral letter issued by the medical institution where you have undergone prenatal checkups.

with a letter of introduction

• You can make an outpatient appointment for the first visit
• Unintroduced patient first visit fee (7,000 yen) will not be required
  *Even if you visit other departments of our hospital, you may be charged for the first visit.

For reservation procedures, please contact the medical institution that introduced you or our representative.

Book a home delivery that requires a caesarean section

If you wish to make an appointment for childbirth requiring a caesarean section at our hospital, please make an appointment no later than the 32nd week of pregnancy in order to determine the date of surgery. Please bring a letter of introduction from the doctor who is currently having a prenatal checkup at the time of your consultation.

Childbirth costs

Date and time of birth (daytime, nighttime, weekdays, holidays, etc.), delivery details (whether special treatment or medicine was required, etc.), condition of the baby (whether Pediatrics treatment was required, etc.), number of days of hospitalization (usually) 5-7 days after giving birth), but the cost to be paid at the time of discharge is about 380,000 to 500,000 yen.

Delivery costs during caesarean section

The delivery cost for caesarean section is around 400,000 to 500,000 yen, depending on the length of hospital stay.

Can I use a private room in the hospital for childbirth?

The obstetrics department of our hospital has a labor room and a treatment room for severely ill patients.

The number is limited, and priority will be given to critically ill patients.

It is available if there is hope when there is space. (A private room request will be asked at the time of the hospitalization reservation procedure.)

I'm sorry, but postpartum normal delivery will be a general room (4-person room).

Gynecology

cancer screening

Due to the division of roles among medical institutions in Kobe City, our hospital mainly provides medical care to referral patients and emergency patients.

For general primary cancer screenings (preventive screenings for those who have not yet developed cancer), in principle, we introduce local hospitals and private practice doctors.

Menopause

Menopausal disorders require continuous treatment centered on counseling and drug therapy.

In addition, due to the division of roles among medical institutions in Kobe City, our hospital mainly treats referral patients and emergency patients. For this reason, in principle, we introduce local hospitals and practitioners.

We are looking for a few Senior Resident and Obstetrics and Gynecology this year as well.

充実した産婦人科専門研修がうけられます。詳しいお問い合わせ・見学のご希望は、産婦人科医局メールobgyn@kcho.jp にご連絡ください。応募締め切り・試験日は病院ホームページでご確認ください。

Philosophy of the latter term training at our hospital

Practically learn basic and uptodate medical care for perinatal area, gynecological area, reproductive medicine, and emergency Obstetrics and Gynecology and gynecology. We will develop human resources who can lead obstetrics and Obstetrics and Gynecology in Japan in the future as obstetrics and Obstetrical and Gynecological Specialist.

Target

(1) Oncology/Gynecology

For benign diseases, laparotomy such as simple hysterectomy can be performed, and laparoscopic surgery such as ovarian tumor can be performed. For malignant diseases, learn comprehensive management including malignant tumor surgery, chemotherapy, radiotherapy, and how to interact with patients with malignant diseases, and be able to perform radical hysterectomy and para-aortic dissection. .

(2) Perinatal period

Be able to handle normal and typical abnormal deliveries. In particular, imminent dangers to the mother and fetus can be grasped without delay and can be dealt with. Be able to judge and perform emergency delivery, especially vacuum delivery, and emergency caesarean section. In addition, it will be possible to cope with obstetrical heavy bleeding and obstetrical DIC.

(3) Reproductive Medicine

Acquire general infertility treatment such as timing therapy, ovulation induction method, and artificial insemination. Endometriosis is actively diagnosed and treated by laparoscopy. Training in advanced reproductive medicine such as in vitro fertilization is also possible.

(4) Emergency Obstetrics and Gynecology and Gynecology

Be able to independently respond to obstetrics and Obstetrics and Gynecology emergencies at an initial stage. In particular, you will be able to make quick decisions and perform operations such as emergency surgery.

facility certification

Comprehensive Perinatal Maternal and Child Medical Center, Regional Cancer Center Hospital, Japan Society of Gynecologic Oncology Specialist Training Facility, Japanese Perinatal and Neonatal Society Temporary Training Facility, Japanese Society of Obstetrics and Gynecology and Senior Resident At the completion stage, it is possible to apply for a Certified Medical Specialist by the Japan Society of Obstetrics and Gynecology and Gynecology and a Maternal Health Act Designated Physician) Obstetrics and Gynecology and gynecology training program core hospital

The medical treatment results (2019)

weekly schedule

Characteristics of each department

Department of Oncology and Gynecology

This is a central cancer treatment facility in Kobe City, and as a training facility for specialists of the Japanese Society of Japan Society of Gynecologic Oncology Japan Society of Gynecologic Oncology and General Clinical Oncologist (by JBCT) in Japan. can. In addition, it is one of the leading facilities for laparoscopic surgery in the Kansai region, and many cases of laparoscopic and hysteroscopic surgery can be trained under the Certified Medical Supervisor of the Obstetrics and Gynecology and Gynecology Society of Endoscopy and technical reviewers. Short-term training in related departments such as surgery and Urology is also possible.

perinatal department

This is a comprehensive perinatal center in Hyogo Prefecture, where you can learn about various complicated pregnancies and abnormal deliveries. NICU training is possible as a related department.

Department of Reproductive Medicine

Many cases of laparoscopic endometriosis treatment, hysteroscopic surgery, etc. can be trained. Out-of-hospital specialized training such as microscopic fertilization, oviductoscopy, reproductive genetic counseling, etc. can be taken at reproductive medicine facilities in Kobe City.

gynecological emergency

Since we accept 1st to 3rd emergency cases from all over Kobe City 24 hours a day, we can master the treatment of most obstetrics and Obstetrics and Gynecology emergency diseases in 3 years.

Society activities

Actively participate in academic conferences, research groups, seminars, etc., and make presentations at academic conferences. During the second semester training period, students will make presentations at national conferences and write first papers.

Collaboration with university hospitals

As an affiliated facility of Kyoto University Hospital, we are participating in the "specialist training program based on Kyoto University Hospital Magnet Hospital Cooperation", and training at the Obstetrics and Gynecology and gynecology department of Kyoto University Hospital and affiliated hospitals is also possible. It is also a clinical teaching hospital of Kansai Medical University.

Career path after completing the second term training

We will recommend and introduce you as an obstetrics and Obstetrics and Gynecology staff at our department or a related hospital. It is also possible to go on to university and study as a graduate student or research student, or to study abroad. At the end of the latter term training, if there is a hospital of your choice, we will recommend it. There is a serious shortage of young Obstetrics and Gynecology and gynecologists nationwide, and in particular there are many hospitals and university hospitals that welcome applicants who want staff from our department.

2015-2nd term training, male doctor

What do you expect from the obstetrics and Obstetrics and Gynecology course? Each person has different needs, but I would like to introduce the strengths of the training at our clinic that I personally emphasized and experienced.

Overwhelming number of cases: There are about 1,300 surgeries per year at our hospital, and more than 150 surgeries can be performed from the first year. Especially for laparoscopic surgery, it can be said that it is one of the facilities where you can accumulate the most experience among the hospitals in Japan where you can train in the latter term. Also, not only is there a large number of cases, but it is also good to receive feedback from seniors and M.D. in the medical director class after surgery.

Professionals in each field: Our clinic has professionals in each field, and they are all friendly people, so you can feel free to talk to them and get expert opinions on any case. . Although we do not actually treat infertility, we have staff who originally specialized in this field.

On and off: A busy life doesn't mean you can enjoy your life. Our hospital has a doctor-on-duty system, and basically, the doctor on duty for the day handles childbirth and emergency cases. There are many teachers who use holidays that are not on duty for rest and hobbies, and everyone is enjoying life. In addition, there are many exchanges with Senior Resident of other departments, and we often go out drinking on Fridays, Saturdays, and Sundays. There are many delicious restaurants in Kobe.

I wrote a lot, but please come and visit us anyway!

June 2017

2014-2016 2nd term training, female doctor

Continuing from the initial training, I was able to complete the latter training in March of this year. I feel that the training was very fulfilling.

In the obstetrics and Obstetrics and Gynecology training at our hospital, you can learn a wide range of obstetrics and gynecology, and you can experience many surgeries. In addition, it is an environment where you can train your ability to respond to emergency diseases.

In addition, training at other facilities is possible if desired, and autonomy is respected. The overall atmosphere of the medical office is friendly, and the co-medical staff are all cooperative, so I think that I can do my training at ease.

I am looking forward to making new friends. Please come to the training.

June 2017

2013-2015 2nd term training, female doctor

After completing the initial training at another hospital, I have been working at our hospital since the latter training.

When deciding on a hospital for my later training, I focused on two things: being able to learn a wide range of subjects from perinatal to gynecology, and being able to experience many cases, including surgery. It is important to build a foundation as an Obstetrics and Gynecology and Obstetrical and Gynecological Specialist to learn all fields in a well-balanced manner in the three years leading up to becoming an obstetrician and gynecologist. However, I don't think there are many hospitals that can provide training in a wide range of obstetrics and Obstetrics and Gynecology fields, from perinatal to oncology and women's medicine, in a well-balanced manner.

Our hospital is a general perinatal center with many cases, and you can learn from normal prenatal checkups to pregnancy management for high-risk cases. In the field of gynecology, it is possible to consistently learn from the diagnosis of malignant diseases to surgical treatment and outpatient management. Of course, you can also learn enough about the management of general gynecological diseases. In addition, as a tertiary medical institution, there are many emergency cases, so you can experience various emergency diseases regardless of obstetrics or gynecology. Every day is busy and sometimes difficult, but for those who want to study Obstetrics and Gynecology and gynecology, the training at our hospital should be filled with a sense of fulfillment. The goodness of the staff is also the selling point of our clinic. Come study with us at our school! We are waiting for everyone who is full of motivation.
June 2017

2009-2011 2nd term training, female doctor

I'm in my second year of postdoctoral training. As a main hospital in Kobe City, I am receiving training every day at a hospital that provides a wide variety of medical treatments. The most distinctive feature is that many pregnant women with complications and patients with gynecological diseases gather from the surrounding area, and sometimes with the cooperation of specialists in each department who are on duty 24 hours a day, we treat primary to tertiary diseases. I am undergoing medical treatment. There are many emergency surgeries, and you can learn not only caesarean sections but also the medical care of gynecological patients who need emergency treatment. And every weekday is a surgery day, and you can experience various surgeries such as laparoscopic surgery, open surgery, vaginal surgery, and hysteroscopic surgery as a surgeon or an assistant. Of course, these treatments were completely impossible in the spring of my third year when I finished my Junior Resident residency, but I gradually mastered them by having my supervising doctor guide me from morning to night, from outpatient, surgery, and on-duty duty. I think it's working. There is an environment where you can immediately consult not only the instructor but also the senior doctors in training, so you can feel at ease even if you are doing everything for the first time. Meetings and conferences are always held so that I can experience each case as my own patient and at the same time absorb various knowledge and techniques from the cases of my fellow trainees. That's the good thing about the department. I am devoted every day to provide medical care that supports the life of women. Let's train together.

September 2010

cancer treatment

Current cancer treatment requires multidisciplinary treatment by all departments of the hospital centered on the department in charge. Our hospital is a regional base hospital for cancer treatment in Kobe City and one of the most advanced general medical facilities in the Kyoto University region. As an affiliated facility, we accept cancer patients not only from Kobe City but also from Hyogo Prefecture and Kinki prefectures. The instructor is a Certified Medical Specialist /instructor of the Japan Society of Gynecologic Oncology.

Related Links

• Lymphedema care outpatient
• Outpatient Chemotherapy Center
• Palliative care outpatient

(Scheduled to be created below)

• endometrial cancer treatment
• ovarian cancer treatment
• Laparoscopic surgery for malignant tumors
• Nerve-sparing surgery in radical hysterectomy
• Surgery to reduce lymphedema during lymphadenectomy
• Radiation therapy/chemotherapy concurrent treatment
• Home care (central parenteral nutrition, palliative care, etc.)
• Intraperitoneal anticancer drug treatment
• endometrial hyperplasia hormone therapy

palliative treatment

In cancer treatment, palliative treatment is an important treatment along with anticancer treatment (surgery, radiation, anticancer drugs). This is a medical treatment aimed at relieving symptoms caused by cancer, such as pain, fever, nausea, insomnia, and anxiety, and is performed in parallel with anticancer treatment. Recently, there has been an increase in the use of drugs for pain relief, antiemetic, and anti-anxiety drugs, and various prescriptions and medications can be prescribed according to the symptoms.

Our hospital has a palliative care outpatient department and a palliative care team, which is effective in palliative care.

Laparoscopic surgery

Recent advances in surgical techniques and equipment have made it possible to perform many surgeries laparoscopically. Compared to conventional laparotomy, there is less postoperative pain and adhesion, and early discharge from the hospital is possible. It also keeps the scratches inconspicuous. In our department, the number of annual implementations as an Obstetrics and Gynecology and gynecology department is one of the largest in the Kinki region. The instructor is a Technology Certified Physician of the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy.

Possible laparoscopic surgeries include:

• Endometrial cancer surgery
• Cervical cancer surgery (preparing for advanced medical treatment)
• total hysterectomy
• Uterine fibroid enucleation
• Ovarian cystectomy
• Ovariectomy/salpingectomy
• endometriosis surgery
• infertility test
• ectopic pregnancy surgery
• contraceptive surgery
• Uterine prolapse surgery
• others

hysteroscopic surgery

Recent advances in surgical techniques and equipment have made it possible to perform a variety of surgeries using a hysteroscope. Compared to conventional laparotomy, postoperative pain is much less, and early discharge is possible. No scratches left. Possible hysteroscopic surgeries include:

• Myomectomy
• endometrial ablation
• Endometrial polypectomy
• Bicornuate uterus surgery (septectomy)
• others

Uterine fibroid

Uterine fibroids are benign tumors occurring in the uterus and are the most common tumors occurring in the uterus. Including small fibroids that do not require treatment, it is said that about 20% of women over the age of 35 have fibroids. The stages of treatment are:

1.If there is no particular need for treatment and the progress can be observed with regular checkups

• No abnormalities were found in cervical cancer screening.
• Dysmenorrhoea (menstrual pain), menorrhagia, lumbago, anemia, and other symptoms thought to be caused by fibroids are within acceptable limits (can be managed with painkillers and hematopoietic drugs).
• The size of the fibroid is smaller than the size of a fist, and the size and symptoms of the fibroid have not worsened compared to before.

In this case, a periodic inspection is required every six months. Fibroids grow gradually during menstruation. However, after menopause, fibroids gradually shrink.

2. When it is necessary to treat with medicine

• The above symptoms interfere with daily life.
• Exacerbation of fibroid size and symptoms compared to before.

Hormones are commonly used to stop menstruation. During treatment with drugs, the disease condition will be alleviated and the fibroids will shrink, but the fibroids will not disappear. There are individual differences in the effect, and recurrence occurs when treatment is discontinued. The main purpose is to temporarily keep fibroids under control (until menopause or surgery).

3. When surgery is required

• Drug treatment is not effective enough.
• Strong drug side effects. (menopausal symptoms, loss of bone density, etc.)
• Abnormalities in cancer screening.
• Uterine fibroids are thought to be the cause of infertility.

Surgery is required for definitive treatment of uterine fibroids.

4. Surgery method

Myomectomy (laparoscopic, laparotomy, hysteroscopic)

Only the myoma is hollowed out. The uterus remains, but there is a possibility that the myoma will recur in the future. It is performed when you want to keep the uterus, such as when you want to become pregnant after surgery. It can be performed laparoscopically or requires an open operation. Fibroids in the uterine cavity (submucosa) can be operated under a hysteroscope.

vaginal hysterectomy

The uterus is removed from the vagina without cutting the abdomen. It is difficult if the fibroid is large, the vagina is narrow, or there are adhesions.

Laparoscopic hysterectomy

When vaginal enucleation is difficult, the uterus is removed from the vagina using an endoscope (laparoscopic). This is the latest method that allows surgery without laparotomy, even if conventional laparotomy was necessary due to excessive fibroid size or severe adhesion.

abdominal hysterectomy

Cut open the abdomen and remove the uterus. It is performed when the myoma is very large, when the adhesion is severe, or when there is a suspicion of malignancy.

ovarian cyst

An ovarian cyst is a large swelling of the ovary filled with fluid or mucus. Abdominal distension, pain, etc. may be noticed, but it is often discovered incidentally without subjective symptoms. It can be benign or malignant (ovarian cancer). In addition, if the ovary bleeds and swells due to a disease called endometriosis, in which the endometrial tissue grows outside the uterine cavity (old bleeding that looks like melted chocolate, it is called an ovarian chocolate cyst). ovarian hematoma), ovarian hematoma (ovarian hematoma), ovulatory cyst (unruptured follicle) ) are also sometimes diagnosed as ovarian cysts.

What happens when you see nature

If it is not large (diameter of 4-6cm or less) or there is no malignant finding, and if it has just been diagnosed, it should be followed up with periodic examinations for a while. Ovarian hematomas and unruptured follicles are likely to disappear spontaneously. Ovarian cysts that persist for 3 to 6 months are unlikely to disappear spontaneously, and continuous regular check-ups are required if they are not treated. It is not uncommon for the disease to remain asymptomatic or unchanged, but large cysts may sometimes rupture or twist the stalk, causing abdominal pain (in this case, emergency surgery is required). In addition, malignant changes (development of cancer) may be observed during long-term observation.

if you need treatment

Treatment (surgery) is required if there is a suspicion of malignancy, if the tumor is larger than 4-6 cm in diameter, or if it grows gradually. is. Severely painful pedicle torsion and rupture require emergency surgery. For ovarian cysts that do not disappear over a long period of time, even if they are asymptomatic or unchanged, it is necessary to have surgery at an appropriate time, considering the risk of canceration in the future.

what kind of surgery is needed

If there is no suspicion of malignancy, laparoscopic surgery is performed (laparoscopic cystectomy or oophorectomy). If you are premenopausal, surgery to leave the healthy part of the ovary is also possible. Surgery takes 1 to 2 hours. A few days in the hospital. If there is suspicion of malignancy, open surgery may be required. A postoperative pathological examination is required for the final diagnosis of ovarian cysts (including the distinction between malignant and benign).

Necessary tests for ovarian tumors

Pelvic examination and ultrasound diagnosis (vaginal or abdominal) are required for general medical examinations, and MRI imaging, CT imaging, and tumor markers (blood tests) are required for detailed examinations.

endometriosis

Endometriosis is a disease in which the endometrial tissue inside the uterus grows and proliferates in a place other than its proper place for some reason.

The lining of the uterus grows in response to hormones from the ovaries and sloughs off during menstruation, causing bleeding. Similarly, endometriosis causes internal bleeding during menstruation, which reacts with surrounding tissue and causes pain. Since this is repeated every menstruation, adhesions with the surroundings occur, and in the ovary, internal bleeding becomes a chocolate-like cyst (chocolate cyst). The main sites of endometriosis include the wall of the uterus (adenomyosis), the space between the uterus and the rectum (Douglas pouch), the sacrouterine ligament (base of the uterus), and the ovaries.

symptoms

A typical symptom of endometriosis is menstrual pain that gets worse each month. In addition, you may experience low back pain, pain in the lower abdomen, pain during sexual intercourse, pain in defecation, etc., even when you are not menstruating. It can also cause infertility. On the other hand, in some cases, there are few subjective symptoms.

Treatment

Endometriosis can be treated with drug therapy, surgical therapy, or a combination of these, depending on the patient's age and symptoms.

1. Medication

In mild cases, menstrual pain should be managed with anti-inflammatory analgesics and regular check-ups should be conducted. If the symptoms are strong, the pill is used to make menstruation weak without ovulation, or pseudomenopausal therapy is used to stop menstruation with hormone drugs. The growth and bleeding of endometriosis stop, the lesions atrophy, and symptoms such as pain gradually improve. The duration of treatment is 3-6 months. As a side effect of pseudomenopausal therapy, menopause-like symptoms may occur, although they are temporary. Repeated long-term treatment may cause a decrease in bone density.

2. Surgical therapy

We perform excision, incineration, adhesion exfoliation, etc. of the lesion. To preserve fertility and reduce the risk of recurrence, careful and thorough laparoscopic surgery is necessary. In our department, we make full use of lasers and ultrasonic scalpels, etc., to improve the effect. Endometriosis requires a hospital stay of about one week and general anesthesia.

Adenomyosis of the uterus

Obstetrics and Gynecology and Gynecology Uterine fibroids Adenomyosis is endometriosis that forms in the wall of the uterus (myometrium).

Like uterine fibroids, the uterus is enlarged and bleeding occurs in the uterus every time menstruation occurs, causing severe menstrual pain and adhesions to the ovaries and intestines. It is often complicated by ovarian and other endometriosis. is.

symptoms

A typical symptom of uterine fibroids is menstrual pain that gets worse each month. In addition, you may experience low back pain, pain in the lower abdomen, pain during sexual intercourse, pain in defecation, etc., even when you are not menstruating. It can also cause infertility.

Treatment

Adenomyosis and endometriosis can be treated with drug therapy, surgical therapy, or a combination of these, depending on the patient's age and symptoms.

1. Medication

In mild cases, menstrual pain should be managed with anti-inflammatory analgesics and regular check-ups should be conducted. If you do not want to get pregnant right away, taking the pill relieves menstrual cramps and alleviates adenomyosis and endometriosis. If the symptoms are severe, pseudomenopausal therapy is used to stop menstruation with hormones. The growth and bleeding of endometriosis stop, the lesions atrophy, and symptoms such as pain gradually improve. The method is a nasal spray twice a day or an injection once a month. The duration of treatment is 3-6 months. Menopause-like symptoms may occur as a side effect, although this is temporary. Repeated long-term treatment may cause a decrease in bone density. Topical treatment with danazol (bonzol) may be effective.

2. Surgical therapy

The definitive treatment is hysterectomy. Uterine-sparing adenomyosis can be removed under certain conditions. For complicating endometriosis, we perform excision, incineration, adhesion detachment, etc. of the lesion. Careful and thorough surgery is necessary to preserve fertility and reduce the risk of recurrence. In our department, we use laparoscopic lasers and ultrasonic scalpels to improve results.

Responsible nurse system

When you are admitted to our hospital for the first time, you will be assigned a nurse. When treatment is long-term, it is possible to respond to continuous nursing care and detailed consultation.

Female Outpatient

性発育・月経・更年期・老年期・性病・性交渉などの女性特有の体の不調について、女性医師による相談室を設けています。完全予約制ですので、病院外来事務　(病院代表電話　078-302-4321）までお問い合わせ下さい。

Complications pregnancy/delivery

As a main general hospital in Kobe City and as an emergency hospital, with the cooperation of each department, we treat pregnant women with illnesses, premature births that are difficult to manage at general hospitals, premature birth, hypertension of pregnancy, and intrauterine fetal development. We actively accept pregnant women with complications during pregnancy such as insufficiency.

In complicated (high-risk) pregnancies and deliveries, postnatal care is also important. As a perinatal center in Kobe City and southern Hyogo Prefecture, our hospital accepts many maternal and neonatal transports. The Prematurity and Neonatal Center, managed by the Pediatrics and Neonatology, is located adjacent to the maternity ward and, in full cooperation with the Department of Obstetrics, manages newborns, including all babies born at our hospital.

Prematurity and Neonatal Center (NICU)

Our department has a prematurity and neonatal center (NICU). Babies born prematurely or who have any doctor conditions can be seen by a Pediatrics immediately.

fetal ultrasound outpatient

Ultrasound diagnosis is indispensable in current prenatal checkups. As a result, it has become possible to correct the expected date of delivery and diagnose the development of the baby in detail. In addition, with recent advances in obstetric ultrasound diagnostic technology, various fetal diseases are now being diagnosed before delivery. In particular, diagnosis of fetal diseases requires special skills and a certain amount of examination time.

Already, all pregnant women in our department undergo ultrasound examinations, but it is becoming difficult to respond to adequate examinations for fetal diseases, etc. within the hours of general prenatal checkups. Therefore, in our department, we have set up a Special Outpatient for specialized ultrasound fetal diagnosis during the second trimester (20th to 30th week of pregnancy), which is the most suitable time for ultrasound diagnosis.

By checking the baby's illness during pregnancy, it is possible to cooperate with the neonatal center and Pediatrics before delivery and use it for pregnancy, delivery, and postnatal care of the baby. Ultrasound alone cannot detect all illnesses in babies, but we highly recommend that you do so.

Fee: 2,000 yen

(At the patient's request, video recording is not currently being performed. Please accept our apologies.)

Even those who have not come to our clinic for prenatal checkups can have a checkup.

Please consult your family doctor and make a fax reservation through the Regional Medical Promotion Division.

NIPT

Recently, in the field of Obstetrics and Gynecology, awareness of NIPT (Non-Invasive Prenatal Genetic Testing), a test that uses maternal blood to check for specific fetal chromosomal abnormalities before birth, is spreading, and our hospital has also established a system to implement it. We have an accredited infrastructure and offer genetic counseling and testing.
NIPT examines the possibility of the baby having a chromosomal disorder (trisomy 21, trisomy 18, trisomy 13) by examining maternal blood. Undergoing NIPT is an option when the incidence of these chromosomal disorders is high:
* Elderly pregnant women
* If maternal serum marker test suggests that the baby may have a chromosomal abnormality
*Pregnant women who have had a baby with a chromosomal abnormality
* Either parent has a balanced Robertsonian translocation, suggesting that the baby may have trisomy 13 or trisomy 21
*If fetal ultrasound suggests that the baby may have a chromosomal abnormality

However, regardless of the frequency of occurrence of the target disease, for pregnant women whose concerns about chromosomal abnormalities in their babies cannot be resolved even after receiving genetic counseling, we will provide sufficient information and support before making decisions on their own. will be honored.
At our hospital, we perform NIPT for pregnant women with single or twin pregnancies between 10 and 14 weeks of pregnancy. If an amniocentesis is to be done, it is done between 16 and 18 weeks of gestation.
Genetic counseling and testing are available at the perinatal genetic counseling outpatient clinic. Reservations and information for the perinatal genetic counseling outpatient clinic are available at our Obstetrics Outpatient Department.
・If you are visiting our obstetrics outpatient clinic and wish to have NIPT, please consult with your doctor.
・If you are a family member of another hospital and wish to have NIPT at our hospital, please consult your family obstetrician and Obstetrics and Gynecology and make an appointment for an obstetric outpatient visit at our hospital.

First, please refer to Frequently Asked Questions (FAQ). For additional inquiries, please contact us at the email address below.

神戸市立医療センター中央市民病院　産婦人科医局 obgyn@kcho.jp（パソコンからのメール着信拒否にしている場合、返信内容が届かないのでお気をつけ下さい）

If you are in a hurry, please contact Kobe City Kobe City Medical Center by phone or fax.

Kobe City Medical Center General Hospital

病院代表　電話　078-302-4321 FAX　078-302-7537

Depending on the content of your inquiry, we may not be able to respond by email, phone, or fax.