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Communication: a person-centred approach
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Did you think of the following examples? How the client identifies in relation to their sexuality.After a mastectomy or other surgery that alters body image.Where appearance has been altered due to medication (e.g. chemotherapy may cause a loss of hair and steroid therapy may cause weight gain).Effects of long-term medication use (e.g. some medications used for hypertension and mental illnesses can cause impotence/sexual dysfunction).People with long-term urinary catheters.People who are paralysed or have had a stroke.People who have had genital or reproductive surgery.
Computer-Assisted Laparoscopic Myomectomy
Published in John C. Petrozza, Uterine Fibroids, 2020
Randi H. Goldman, Antonio R. Gargiulo
As mentioned bove, of the greatest benefits that robot-assisted myomectomy provides is the quality of the hysterotomy closure. The gold standard for hysterotomy repair is a multilayer closure with no exposed suture; this microsurgical standard applies to all myomectomies, independently of whether they are performed through an invasive or with a minimally invasive approach. Single-layer closures cause hematoma formation and healing by second intention, while exposed sutures cause pelvic adhesions: both of these have no place in modern reproductive surgery. A proper wound approximation will decrease blood loss, the chances of adhesion formation and the risk of future uterine rupture [9,34,36,37]. It is important to make an open statement of what represents adequate microsurgical technique for the myomectomy operation, because it is a sad reality that minimally invasive myomectomy has become synonymous with “simplified” techniques in many cases. This is not an ethically acceptable logical step, because patients are completely unaware of such “shortcuts”, and therefore cannot make an informed decision regarding which surgical team to trust. The rule is simple, the basic tenets of myomectomy are constant and independent of technique used: (1) intracapsular myomectomy, (2) closure in layers, (3) no exposed sutures. These can be achieved via laparotomy or laparoscopy, but the operation does not change based on the access modality. When the rules of engagement are clear, the role of the robot in making the laparoscopic transition possible for many surgeons becomes much more clear.
Perimenopausal Women: Using Women’s Stories as a Theoretical Underpinning for Women’s Health
Published in Diana L. Taylor, Nancy F. Woods, Menstruation, Health, and Illness, 2019
Beverly J. McElmurry, Donna S. Huddleston
The women were selected for interviews after careful screening. Each was asked if she had a history of reproductive surgery such as tubal ligation, cancer, or severe debilitating disease or illness. Each woman was also asked if she had consulted a physician for any illness or disease in the past 6 months, or if she were currently taking ERT or any form of estrogen or progestin. Women who responded positively to any of these items were excluded from the study.
Decision points for individualized hormonal stimulation with recombinant gonadotropins for treatment of women with infertility
Published in Gynecological Endocrinology, 2019
Bruno Lunenfeld, Wilma Bilger, Salvatore Longobardi, Jan Kirsten, Thomas D’Hooghe, Sesh K. Sunkara
Treatment of female infertility needs to be considered in the context of the male infertility investigation results, and may include expectant management, reproductive surgery, lifestyle adjustment, and/or medically assisted reproduction, with the aim of:Monofollicular development – applicable in the context of natural fertilization in vivo, including ovulation induction (OI; pharmacological treatment with the intention of inducing normal ovulatory cycles), and intrauterine insemination (IUI; laboratory processed sperm placed in the uterus to attempt a pregnancy) with or without ovarian stimulation (pharmacological treatment with the intention of stimulating one dominant follicle, or at most 2 dominant follicles that are expected to ovulate).Multifollicular development – applicable in the context of treatment with ART (interventions that include the in vitro handling of both human oocytes and sperm or of embryos for the purpose of reproduction).Women diagnosed with ovarian insufficiency will require oocyte donation.