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Endometriosis of the Pelvic Nerves
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Shaheen Khazali, Marc Possover
It should be kept in mind that the knowledge and skills required to perform such surgery are beyond the usual realm of gynecological surgery, even though the pathology is gynecological. An experienced gynecological surgeon may have the technical skills to work deep in the pelvis but an in-depth understanding of neurofunctional anatomy and, more importantly, clinical neuropelveological skills is required for diagnosis, patient selection, counseling and management of treatment failure or complications.
Women and the National Health Service: the carers and the careless
Published in Ellen Lewin, Virginia Olesen, Women, Health, and Healing, 2022
It is clear that the NHS offered women much greater access to medical care than they had in the past (Townsend and Davidson 1982). No distinction was made by sex or marital status, and services were available to all. As a result, there is evidence of a marked rise in minor gynecological surgery in the period immediately after the service was set up, as the chronic conditions that had ailed so many women at last received attention.1 Others obtained spectacles and false teeth for the first time, since they no longer had to be purchased entirely out of the family budget. As the health service expanded it also became an important new source of jobs for women. The NHS is now the largest single employer of women in the country and about 75 per cent of its employees are female.
Robotic Hysterectomy in Fibroid Uterus
Published in Rooma Sinha, Arnold P. Advincula, Kurian Joseph, FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Hysterectomy is one of the most commonly performed gynecological surgery. Established surgical techniques for hysterectomy include abdominal (open/minimally invasive), vaginal, for prolapse uterus and non-descent vaginal hysterectomy [1]. Selection of the route of hysterectomy for benign diseases of the uterus can be influenced by the size and shape of the uterus, accessibility, previous surgery, need for a concurrent procedure, surgeon’s training and experience, existing facilities in the hospital setup, whether it is an emergency or a routine procedure, and patient’s preference. Choosing a minimally invasive technique (laparoscopy/robotic approach) over laparotomy allows a reduction of trauma to the patient’s body by facilitating smaller surgical incision, less blood loss, less pain, faster recovery, shorter hospital stay, and reduced patient morbidity [2].
Menopause, hormone therapy and cognition: maximizing translation from preclinical research
Published in Climacteric, 2021
H. A. Bimonte-Nelson, V. E. Bernaud, S. V. Koebele
Mounting human and animal data reveal that menopause type is key to neurocognitive outcomes. There are numerous variations in gynecological surgery, including, but not limited to, oophorectomy, hysterectomy or oophorectomy plus hysterectomy (Figure 2). Preclinical research evaluating menopause, HT and resulting behavior has primarily been conducted using the ovariectomy (Ovx; surgical rodent procedure corresponding to oophorectomy) model. For Ovx, the ovaries and oviducts (an analog to the fallopian tubes) are removed, while uterine tissue remains [19]. Ovx models surgical ovary removal in women, resulting in rapid declines in circulating ovarian hormones. Oophorectomy, particularly prior to natural menopause, has been associated with negative health outcomes including poorer memory, increased risk of affective disorders, neurodegenerative disease, cardiovascular disease, osteoporosis, diabetes, cancer and all-cause mortality [3,20–25]. Although fewer than 15% of women undergo oophorectomy, the Ovx model, from a basic science perspective, is fundamental to understanding the consequences of complete ovarian hormone loss. Moreover, exogenous HT in an Ovx background allows assessments of a given hormone without interpretive concerns regarding interactions with other ovarian-derived hormones.
Risk Factors for Constipation in Adults: A Cross-Sectional Study
Published in Journal of the American College of Nutrition, 2020
Gamze Yurtdaş, Nilüfer Acar-Tek, Gamze Akbulut, Özge Cemali, Neslihan Arslan, Ayfer Beyaz Coşkun, Fatmanur Humeyra Zengin
In several studies, the prevalence of constipation was reported to be higher in females than for males (22, 23). Consistent with the literature, this study also demonstrated that females were more likely to have constipation (18.5%), than males (13.6%) (Table 1). Binominal logistic regression analysis showed that being female increases the risk of having constipation by 1.49 times (OR: 1.49, 95% CI: 1.25–1.78) (Table 5). In a systematic review, it was reported that females in North America had a 2.2 times higher constipation prevalence, when compared to males (24). The reasons why females have higher constipation risks can be attributed to hormonal factors, for example, in the luteal phase of the menstrual cycle, progesterone appears to increase the risk of constipation (25). Another reason may be that during gynecological surgery, pelvic floor muscles can be damaged (25). In addition, the nerves required for defecation are vulnerable to injury in females (23).
Preoperative Carbohydrate Loading in Gynecological Patients Undergoing Combined Spinal and Epidural Anesthesia
Published in Journal of Investigative Surgery, 2020
All patients were scheduled for elective open gynecological surgery, and all surgical procedures were performed in less than 2 h by the same team of surgeons in the morning. All patients were brought into the operating room at 8:00 am without premedication. All patients in our study were given a preload of 5 ml/kg colloid before CSEA. Patients were monitored after entering the operating room, via electrocardiography (ECG) and measurement of pulse oxygen saturation, heart rate (HR), and noninvasive blood pressure (NIBP). During surgery, Ringer’s solution 12 ml kg−1 was administered intravenously; additional fluids were administered only to replace intraoperative fluid losses (blood loss, urine volume, redistribution of fluid in vivo). We also adjusted the infusion speed according to the blood pressure.