What is the best treatment for endometriosis?
The treatment currently employed for endometriosis is essentially surgical. In the light of recent advances in surgical techniques, it is likely to remain the treatment of choice for some years to come.
Will I be menopausal if I have a hysterectomy?
No, the menopause is determined by a reduction in the hormonal secretion of the ovaries. If there is no ovarian pathology, the ovaries remain intact during hysterectomy, and since they have not been removed they continue to produce hormones. Menstruation disappears, but the patient who still has ovaries will not experience the symptoms that often accompany the menopause.
- What is surgical menopause?
This is when, during the course of a surgical intervention, the ovaries are removed before the beginning of the menopause. This will indeed involve hormonal changes. It is as if the body undergoes a sudden menopausal change rather than a gradual process over several years, which is what occurs normally.
- Will I suffer from urinary incontinence if I have a hysterectomy?
With the appropriate surgical techniques there is no modification of the structures comprising the ligaments, muscles and fascia, which are those responsible for keeping the pelvic organs in place (bladder, uterus, rectum, intestines). Furthermore, if any structural defects are found in this area, specific surgical techniques are employed together with the hysterectomy or with the uterus removal in order to correct problems involving the pelvic support system.
- Will I have to have an operation if I suffer from urine loss?
Surgical treatment is normally required for stress urinary incontinence associated with physical exercise, coughing, sneezing, laughing or effort. The remaining types of incontinence are usually treated with medication.
- Will I need a general anaesthetic if I have a hysterectomy?
This depends on the type of hysterectomy and the procedure employed. Whether total or supracervical, hysterectomy by laparoscopy requires a general anaesthetic, but is not always necessary for vaginal hysterectomy.
- Is it necessary to open the abdomen to remove the uterus?
Rarely. At present, 90% of all hysterectomies are performed by laparoscopy or transvaginally, and there are surgical teams fully prepared for obtaining good results with these techniques.
- Can the vaginal opening be tightened after childbirth?
Yes, tightness can be restored. Surgical techniques for vaginal rejuvenation using laser reduce the diameter of the vagina and improve the quality of intercourse.
- Is the uterine cervix always removed in a hysterectomy?
The uterine cervix is not always removed. The upper part of the uterus is removed in a supracervical hysterectomy, while the cervix is left intact. The uterine cervix forms part of the support for the ligaments of the pelvis, and therefore it is better to leave it intact whenever possible.
- Do uterine myomas always require an operation?
Current laparoscopic techniques using minimally invasive surgery allow exeresis of myomas while maintaing the uterus intact, as well as providing quick post-operative recovery and a speedy return to normal everyday activity.
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