Unglaublich viel Infos zu Folgen von UnterleibsOPs im englischen und französischen Netz

Réflexe bistouri
Bien qu'on y pense désormais à deux fois avant d'opter pour la «grande opération», le réflexe du bistouri semble encore trop courant, estime le docteur Robert Sabbah, chef du département d'obstétrique-gynécologie de l'hôpital du Sacré-Coeur. De nos jours, 60.000 Canadiennes, dont 15.000 Québécoises, subissent chaque année l'hystérectomie. «Selon moi, plus de la moitié des hystérectomies qui sont pratiquées en Amérique du Nord ne s'imposent pas. La principale justification pour enlever l'utérus a longtemps été l'existence de saignements anormaux. Mais les saignements, ça peut se régler autrement. Si l'organe est sain, il n'y a absolument pas lieu de l'enlever». Des propos que corrobore une étude menée en 1998 par le Collège ontarien des médecins (Understanding the variation in hysterectomy rates in Ontario) qui allait même jusqu'à conclure qu'une majorité de ces interventions ont lieu parce qu'elles s'avèrent bien plus «payantes» pour les chirurgiens que des traitements alternatifs moins brutaux!

We have been reduced from being powerful and psychic during our periods, a time so awesome that, to paraphrase Judy Grahn,(5) we can only compare it to an atomic bomb blast and event that isn't as powerful an image. There was a time when the whole fabric of the community was based on our dreams and actions, on our perceptions through our connections to our menstrual cycles and our wombs. We have been reduced to the point of no attributes, no power at all. We slap on a tampon and take our place at our jobs, checking out groceries, preparing food, installing electronic components in computers to remain productive even though our cycle is telling us something else and we take drugs to deal with out denial and men's erasure of what we truly are. No wonder we have "female problems." These wouldn't be labeled as problems if the differences between men and women weren't labeled as negatives for women. No wonder we have cramps, excessive or scant bleeding, hot flashes, PMS, headaches, anxiety and anger. No wonder.

The courts and the medical community know sex offenders and serial killers are "subdued" when they are given chemicals to decrease their testosterone. But this is never used. We sure don't cut their balls off. Even women have been programmed to consider this a barbaric thought. What could be of greater importance to the world than the male testicles and penis? But who is interested if a woman has feelings, has sensuality, has arousal, has her sexual organs, other than the woman herself. Countless unnecessary medical "procedures" are performed on women all the time. Beyond medical mutilation, beyond physical castration exist other subtler forms of castration being done on women also.

I think we must liken ourselves to these not so distant women in Africa and India who voluntarily allow themselves to have clitoridectomies and who when interviewed say that they do it because it's a tradition, their mothers did it and so on. Alice Walker quotes Efua Dorkenoo speaking about a time when, and I hope all, genitally mutilated women will understand what has been stolen from them.

Christchurch Women's Hospital Canterbury, New Zealand
© Canterbury District Health Board 2003 | Legal Notice

Gynaecology Services - Hysterectomy

Introduction

Hysterectomy has special significance for many women. For some it may conflict with traditional concepts of fertility and motherhood, while for others it represents a loss of part of their body or fear of the unknown. These fears and concerns need to be recognised and taken seriously.

Research shows that women who have sufficient information about hysterectomy, and are able to decide for themselves whether they have the operation, are more likely to make a speedy recovery.

Every woman should be in a position to make a fully informed decision by weighing the positive and negative aspects of the procedure and considering other options that may be available to her.

This webpage is designed to supplement advice given by your Doctor, Nurse, Physiotherapist or Educator. The advice given is from different members of our team at Christchurch Women’s Hospital. We have tried to cover all the areas you might have questions about, whether it is about the kind of surgery you’re having; what will happen during your stay in hospital; or about your recovery after you have gone home.

Please feel free to ask if there is anything you don’t understand or if there is something worrying you.

Decision Making

In order to make a fully informed decision, it is important that you understand all the information that is given to you by your Doctor. Ask the Doctor why a hysterectomy has been suggested to you and what are the other options. This way you can make the best decision for you, knowing you’ve had a chance to look at all the options.

Some women find it empowering and supportive to take another person along to the Doctor’s appointment. It enables the support person to hear and understand the information given and may help you clarify any concerns you may have.

If in doubt - ask!

© Canterbury District Health Board 2003 | Legal Notic

.................Pelvic Floor Exercises

Your pelvic floor muscles are attached from the pubic bone (at the front) to the tail bone (at the back), and to the sides of the pelvis. The main function of the pelvic floor muscles is to support the pelvic organs, bowel, uterus and bladder. If you have had a hysterectomy, the uterus will have been removed, but the pelvic floor muscles still need to support the bowel and bladder.

Following surgery the muscles can become weak and it is very important to exercise them to build up strength again. Pelvic floor muscle exercises should be started following surgery and continued for the rest of your life.

Bowels & Bladder

It may take a week or two for your bladder and bowels to function normally again. It is important to avoid constipation and particularly important that you do not strain when going to the toilet. It is better to take a mild laxative than to strain.

Your food intake has an important effect on bowel function. For the sake of your general health and bowel activity, make an attempt to change the way you eat so that you can say yes to each of the following:

Complications after Surgery

As with all major surgery, a hysterectomy can be followed by the development of complications.

The immediate risks are:

• Infection
• Blood Clots
• Haemorrhage
• Constipation
• Bladder Infection of Failure to Function

Some of the long term complications may include:

Adhesions - scar tissue formation within the abdomen.
Prolapse - can occur up to ten years after surgery, the bladder or bowel may collapse into the vagina or the vagina may sag down.
· Ovarian Failure - this may occur even when the ovaries have not been surgically removed. The ovaries may no longer function properly after the removal of the uterus. Some women may experience a degree of hormonal imbalance as a result of this, but this is generally temporary. If the ovaries have been retained, it is not uncommon for some women to reach menopause earlier.

Spirituality and Well-being

Full recovery of health and well-being comes from a good balance and harmony of body, mind, emotions and spirit. Spiritual, psychological, emotional, physical, and social connections assist the healing process.

Physical ‘un wellness’ (such as excessive bleeding and pain) disturbs the overall sense of well-being. This causes harmony and balance to be lost.

For some women having a hysterectomy, grief and identity issues emerge. These are often related to loss of unique womanly body parts and the inability to have a child. Discussion of these issues and feelings with a trusted person can contribute to a return to health and well-being.

Hysterectomy may bring a sense of relief, excitement, a new lease of life, new beginnings and a desire to celebrate. Celebration signals a woman’s return to well-being, harmony and balance.

In addition, use of ritual , visualisation and meditation can also assist in the restoration of one’s spiritual well-being in particular. The result can be a new sense of wellness.

There is a variety of books and tapes available from book shops to assist you on your journey to full health and well-being.

Sex

It takes about four weeks for the top of the vagina to heal after a hysterectomy. If you have intercourse too soon after your hysterectomy the top of the vagina could hurt and the wound could get infected. It is important that your partner understands this as well as you. If you wish to have sex with full penetration, ask your partner to go gently. Increasing the time spent love-making before penetration will help make things more enjoyable. Otherwise you might find this an excellent time to be as imaginative and creative as you can. Experiment with different positions that may lessen penetration. With the focus off penetrative sex you can experiment with new forms of sensuality and intimacy. Feel free to express yourself through plenty of touching, cuddling, massage, or anything else you enjoy. Initiating sexual contact is difficult for many women. However, bear in mind that your partner is probably unsure as to when it is safe to resume your normal relationship so if you make the first move he will probably be grateful and it may give more confidence in yourself. If you take a dominant position, i.e. if you are the one on top, you can control the level of penetration more easily. Sex could be tried just before the 6 weeks visit to the Doctor. If there have been any difficulties you can discuss these with the Doctor at this visit. If you have a vaginal repair as well as a vaginal hysterectomy you may find your vagina is a little narrow to begin with, so you will both need to take care. It may take a few weeks before your vagina feels quite comfortable again. Sometimes a lubricant makes intercourse easier - try using KY jelly which can be bought at a chemist or supermarket.

Acknowledgements & Source

The information in this page has been drawn from a variety of sources, primarily the following books:

Hysterectomy

Sandra Coney and Lynn Potter (Heinemann Reed 1990)

Hysterectomy Information Package

Southern Canterbury Women’s Wellness Centre

Staff at Christchurch Women's Hospital

So You're Having a Hysterectomy

Megan Gressor (Gore & Osment Publications)

Some illustrations by Marisa Swanink

Cervical Cancer: A book for Every Woman.

http://cdhb.digiweb.co.nz/cwh/gynaecology/Hysterectomy/hysterectomy.htm

http://cdhb.digiweb.co.nz/cwh/gynaecology/Hysterectomy/support_groups.htm

Darüber wird bei uns kaum eine Frau informiert, die eine Hysterektomie vor sich hat: Da kommt sie dann eh selber drauf …

Post hysterectomy complications Long Term
Long-term side effects of hysterectomy involve:

• Premature menopause
• Constipation,
• Heat flashes
• Vaginal dryness
• Insomnia
• Migraines
• Osteoporosis and heart disease.

True, hysterectomy is an upsetting event. Some women loose their self-esteem and get trapped in depression called post hysterectomy depression, which provokes behavioral changes, while for many, hysterectomy is happy event as it permanently removes the risk of getting pregnant and they freely enjoy sex without any fear.

http://www.info-about-hysterectomy.com/hysterectomy/Hysterectomy-And-Sexual-Functioning.html

GUIDELINE TITLE
Prophylactic oophorectomy.

BIBLIOGRAPHIC SOURCE(S)
American College of Obstetricians and Gynecologists (ACOG). Prophylactic oophorectomy. Washington (DC): American College of Obstetricians and Gynecologists (ACOG); 1999 Sep. 7 p. (ACOG practice bulletin; no. 7). [33 references]
GUIDELINE STATUS
This is the current release of the guideline.

According to the guideline developer, this guideline is still considered to be current as of December 2004, based on a review of literature published that is performed every 18-24 months following the original guideline publication.

MAJOR RECOMMENDATIONS
The grades of evidence (I-III) and levels of recommendations (A-C) are defined at the end of "Major Recommendations" field.

The following recommendations are based primarily on consensus and expert opinion (Level C):

The decision to perform prophylactic oophorectomy should not be based only on age; it should be a highly individualized decision that takes into account several patient factors and choices.
Removal of one ovary at the time of hysterectomy in premenopausal women may indicate the suspicion of clinical disease. The likelihood of future pathology in the retained ovary is therefore greater. The patient should be counseled before surgery that if ovarian pathology is found, bilateral oophorectomy may be indicated.
Hormone replacement therapy should be considered for women undergoing prophylactic oophorectomy, and patients should be counseled about the risks and benefits of hormone replacement therapy prior to undergoing surgery.
Compliance with hormone replacement therapy is important in women undergoing prophylactic oophorectomy to reduce the risk of future morbidity.
Prophylactic oophorectomy should be considered for select women at high risk of inherited ovarian cancer.
In addition to health risks and benefits, patient counseling should include consideration of how oophorectomy may relate to the individual patient's body image, perceptions concerning sexuality, and personal feelings.

http://www.guideline.gov/summary/summary.aspx?doc_id=3958&nbr=003095&string=oophorectomy+AND+prophylactic

T. F. Jakobs1, 2 Contact Information, T. K. Helmberger1 und M. F. Reiser1
(1) Institut für Klinische Radiologie, Klinikum der Universität München—Großhadern,
(2) Institut für Klinische Radiologie, Klinikum der Universität München—Großhadern, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 München

Contact Information T. F. Jakobs
Email: tobias.jakobs@ikra.med.uni-muenchen.de

MYOMEMBOLISATION kann sich im deutschsprachigen Raum nur schwer durchsezten - warum???
Online publiziert: 2. August 2003
Zusammenfassung
Hintergrund Ziel dieser Arbeit war es, Stand, Entwicklung und Implementierung der Embolisationstherapie von Uterusmyomen (UME) in das Behandlungskonzept von Patientinnen mit symptomatischen Uterusmyomen in Deutschland zu evaluieren.
Material und Methodik Ein Fragebogen zum Thema der Embolisation von Uterusmyomen wurde an 164 Abteilungen für Gynäkologie und Radiologie im gesamten Bundesgebiet versandt. Erfragt wurden Informationen zur klinischen Symptomatik, mit der sich die Patientinnen vorstellen, zu den empfohlenen Behandlungsstrategien, zur Interventionsvorbereitung, zur technischen Durchführung und zu den Komplikationen der UME.
Ergebnisse Von den angeschriebenen Abteilungen antworteten 33 radiologische und 19 gynäkologische Abteilungen. Nur 7 Abteilungen für Radiologie berichteten über eigene Erfahrungen bei der Durchführung der UME, während nur 2 gynäkologische Abteilungen die UME in das Repertoire möglicher Therapieoptionen für Patientinnen mit symptomatischen Uterusmyomen aufnehmen. Insgesamt bieten 18 radiologische Abteilungen die UME an, können jedoch nicht alle über eine Zuweisung zur Therapie berichten. Bezüglich der Diagnosesicherung mit Ultraschall und MRT, der Indikationsstellung, der bevorzugten Lokalisation der Myome, des technischen Vorgehens und des Schmerzmanagements herrschte abteilungsübergreifend hohe Übereinstimmung.
Schlussfolgerung Die UME zur Behandlung von Patientinnen mit symptomatischen Uterusmyomen hat sich trotz der weltweit dokumentierten Behandlungserfolge und niedriger Komplikationsrate in Deutschland bisher nicht etablieren können. Gynäkologen und interventionelle Radiologen müssen gemeinsam die Indikation zur UME stellen, um der UME einen Stellenwert als Alternative zur klassischen chirurgischen Therapie zu verschaffen.

Schlüsselwörter Uterusmyom - Embolisation - Meinungserhebung

http://www.springerlink.com/content/vcddx37b1dpky4n6/

FAKTENBLATT HYSTEREKTOMIE
Die Fakten über Hysterektomie in den USA von 1980 — 1993
Häufigkeit der Hysterektomie
- In den USA werden jedes Jahr etwa 600.000 Hysterektomien durchgeführt,
deren geschätzte jährliche Kosten über 5 Milliarden Dollar betragen. Über ein
Viertel der Frauen in den USA werden diese Operation hinter sich haben,
wenn sie 60 Jahre alt sind. Die Hysterektomie ist die zweithäufigste große
Operation bei Frauen im gebärfähigen Alter.
- Von 1980 bis 1993 wurde bei schätzungsweise 8,6 Millionen Frauen in den
USA eine Hysterektomie durchgeführt.
- Die Hysterektomieraten pro 1000 Frauen ab 15 Jahren nahmen von 1980
(7,1) bis 1987 (6,6) geringfügig ab. Von 1988 bis 1993 lag die
durchschnittliche Jahresrate stabil bei 5,5. Die von 1987 bis 1988 beobachtete
Abnahme ist Folge einer Änderung bei der zur Datenerhebung verwendeten
Methoden.
Frauen mit hohem Hysterektomierisiko
- Von 1980 bis 1993 waren die Hysterektomieraten je nach Alter unterschiedlich
hoch.
o Die Raten waren in jedem Jahr bei Frauen von 40-44 Jahren am
höchsten und bei Frauen von 15-24 Jahren am niedrigsten.
o 55% aller Hysterektomien wurden bei Frauen von 35-49 Jahren
durchgeführt.
- Die Hysterektomieraten unterschieden sich auch je nach geographischer
Region.
o Von 1988 bis 1993 wurde im Süden fast bei doppelt so vielen Frauen
eine Hysterektomie durchgeführt (6,8 pro 1000 Frauen) wie im
Nordosten (3,9). Die durchschnittlichen Jahresraten betrugen im
Mittleren Westen 5,5 und im Westen 4,9.
o Von 1980 bis 1993 betrug das Durchschnittsalter der Frauen, bei denen
eine Hysterektomie durchgeführt wurde, im Nordosten 47,7 Jahre, im
Mittleren Westen 44,5, im Westen 44,0 und im Süden 41,6 Jahre.
- Die Jahresraten waren bei den einzelnen Rassen nicht signifikant
verschieden.
Erkrankungen, wegen denen eine Hysterektomie durchgeführt wurde
- Von 1988 bis 1993 waren die drei Erkrankungen bei denen am häufigsten
eine Hysterektomie durchgeführt wurde, Uterusmyome, Endometriose und
Uterusprolaps (Gebärmuttersenkung).
- Bei Frauen unter 30 Jahren waren die Erkrankungen, bei denen am
häufigsten eine Hysterektomie durchgeführt wurde, Menstruationsstörungen
und Zervixdysplasie. Bei Frauen von 30 bis 34 Jahren war der häufigste
Grund eine Endometriose, bei Frauen von 35 bis 54 Myome und bei Frauen
ab 55 Jahren Uterusprolaps oder Krebs.
Hysterektomie-Melderegister
- Die CDC sammeln Informationen über Hysterektomien aus Daten ihres
bundesweiten Registers über Krankenhausentlassungen in den USA (National
Hospital Discharge Survey). Dieses Register liefert die einzigen
bevölkerungsgestützten Schätzwerte für die Hysterektomieraten in den USA.
- Daten aus einem landesweiten Hysterektomie-Register können verwendet
werden, um mehr über die relative Bedeutung zu erfahren, die Erkrankungen,
welche zu einer Hysterektomie führen, für das öffentliche Gesundheitswesen
haben, um Veränderungen in der klinischen Praxis zu erkennen und um
Schwerpunkte für die medizinische Forschung zu setzen.
August 8, 1997, Special Focus: Surveillance for Reproductive Health Surveillance
Summary, Hysterectomy Surveillance-United States, 1980-1993
Besuchen Sie www.gynecare.at, um mehr über Hysterektomie und die
Behandlungsmöglichkeiten zu erfahren.
Quelle: National Center For Chronic Disease Prevention and Health Promotion -
CDC’s Reproductive Health Information Source.