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Hysterectomy Hysterectomy Eric Cui Bio

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Hysterectomy Hysterectomy Eric Cui Bio Powered By Docstoc
					Hysterectomy
Eric Cui
Bio 199
Spring 2009
Hysterectomy
•   Usually performed by a gynecologist
•   Uterus is removed
•   Other reproductive organs may be removed
•   No longer able to have a baby
•   Periods will stop
Indications
• Fibroids
• Endometriosis
• Uterine prolapse
• Cancer of the uterus, cervix, or ovaries
• Vaginal bleeding
• uncontrollable postpartum obstetrical
  haemorrhage
• Transgender man
Risks and Side Effects
• Earlier onset of menopause
• Greater risk of cardiovascular disease
• Increased chance of osteoporosis and bone
  fractures
• Uncontrolled urination
• Reduced libido
• Vaginal dryness
Epidemiology
• Hysterectomy is the second most common
  surgery among women in the United States
• One in three women in U.S. had one by age 60
• Each year, more than 600,000 are done
• Over 90% are performed for benign conditions
• Over 70% also involved the surgical removal of
  ovaries
Types of Hysterectomy
                • Partial Hysterectomy
                  ▫ Removes 2/3 of uterus

                • Total Hysterectomy
                  ▫ Removes uterus and cervix

                • Radical Hysterecomty
                  ▫ Removes uterus, cervix, and
                    vagina
Types of Incisions

              Vertical Incision


            Pfannenstiel Incision
Abdominal Hysterectomy
• the uterus is removed through an incision in the
  woman’s abdomen.
• Most invasive method
• Incision site at abdomen
• Hospital stay of 5-6 days
• Recovery time 6 weeks
• Possible retention of cervix
• Required for endometriosis and large fibroids
Vaginal Hysterectomy
•   the uterus is removed through the vagina.
•   Less invasive than abdominal hysterectomy
•   Incision site at inner vagina
•   Hospital stay 1-3 days
•   Recovery time 4-6 weeks
•   Cervix cannot be preserved
Laparoscopic Hysterectomy
• the uterus is removed in sections through small incisions
  using a laparoscope
• Hospital stay 1-3 days
• Recover time is 4-6 weeks
• Longer duration of procedure
• Requires greater surgical expertise
• Urinary track injuries are more likely
• Fewer abdominal wall infections or febrile episodes
• Less blood loss
Robotic Hysterectomy

                 •   3-dimensional image
                 •   Greater articulation
                 •   Eliminate hand tremors
                 •   Increased accuracy and
                     precision
References
• “Hysterectomy.” Wikipedia. <http://en.wikipedia.org/wiki/Hysterectomy>.
• Johnson, Neil, et al. “Methods of hysterectomy: systematic review and meta-analysis
        of randomised controlled trials.” BMJ 2005;330:1478 (25 June). 18 June 2009
        < http://www.bmj.com/cgi/content/full/330/7506/1478>.
• Kho, Rosanne M. MD, et al. “Robotic hysterectomy: technique and initial outcomes.”
        Am J Obstet Gynecol 2007;197;113.e1-113.e4.
• “Laparoscopic Supracervical Hysterectomy.” 18 June 2009
        <http://www.laparoscopicsupracervicalhysterectomy.com/>.
• Torpy, Janet M., Cassio Lynm, and Richard M. Glass. “Hysterectomy .” JAMA.
        2004;291(12):1526. 18 June 2009
        <http://jama.ama-assn.org/cgi/reprint/291/12/1526.pdf>.
• “Types of hysterectomy.” Online image. 18 June 2009
        <http://www.lifespan.org/adam/graphics/images/en/17073.jpg>.
• “Vertical and Pfannenstiel incisions.” Online image. 18 June 2009
        <http://www.mayoclinic.com/health/medical/IM00129>.

				
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