Gómez Sugrañes Mª Teresa
¿Cuál es el mejor tratamiento para la endometriosis?
En la actualidad el tratamiento de la endometriosis es esencialmente quirúrgico. Debido a los últimos y recientes avances en técnicas quirúrgicas es muy probable que todavía sea el tratamiento de elección durante varios años.
¿Si me practican una histerectomía estaré menopaúsica?
No es así. La menopausia viene determinada por la disminución de la secreción hormonal de los ovarios. Si no existe ninguna patología ovárica, en la histerectomía se conservan los ovarios, y al no ser extirpados continúan produciendo hormonas.
Después de una histerectomía, desaparecen los períodos menstruales. La mujer ya no puede quedarse embarazada. Los ovarios siguen produciendo óvulos que, al no ser fecundados, se disuelven en el abdomen.
Una paciente que todavía tiene ovarios no experimentará los síntomas que acompañan frecuentemente a la menopausia como, por ejemplo, las sofocaciones o la sequedad vaginal.
- 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.
- What preparation is required for colposcopy?
No preparation is required, although the patient is recommended to take the examination when she is not menstruating. The patient reclines in the gynecological position and the vagina is opened with a speculum to facilitate examination of the uterine cervix.
- How is colposcopy performed?
Once the uterine cervix is exposed, it is viewed directly through the colposcope according to the enlarged image required. Any vaginal fluid can be absorbed with a gauze or swab and is later cleaned with diluted acetic acid, which in addition to effectively cleaning away the fluid and cellular material also highlights any cells of the uterine cervix that may present abnormalities.
Once these areas have been identified, the uterine cervix can be stained with a lugol solution known as Schiller's test, which is rich in iodine. Under the effects of female hormones, the normal uterine cervix cells contain glucogen, which stains with iodine. Thus its dark brown colour cannot be seen in a woman who still has periods, except for those areas where there are epithelial lesions. The examination lasts from 4 to 10 minutes and requires a careful exploration of each of the areas of the uterine cervix.
Morning | Afternoon | |
---|---|---|
Monday | 10.00 - 15.00 h | 16.00 - 19.00 h |
Tuesday | 10.00 - 13.00 h | 16.00 - 20.30 h |
Wednesday | 10.00 - 15.00 h | 16.00 - 19.00 h |
Thursday | 10.00 - 13.00 h | 16.00 - 20.30 h |
Friday | 09.00 - 14.00 h | 15.00 - 19.00 h |