1: Gynaecological Surgery Flashcards
What did surgical management miscarriage use to be called
evacuation retained products of conception
When is surgical management safer than medical management for miscarriage
< 13weeks
What is preferred method of surgical management of miscarriage
vacuum aspiration
what is a hysteroscopy
camera to inspect inside the uterus
what is laparoscopy used for in gynaecology
visualise peritoneal endometriosis
surgery - eg. laparoscopy hysterectomy
when may hysterectomy be performed
Menorrhagia
Cancer
what is a total hysterectomy
Removal uterus and cervix
what is a sub-total hysterectomy
Removal cervix
in a sub-total hysterectomy what will women need to continue having
Smear tests
what is wetheim’s hysterectomy also known as
Radical hysterectomy
what is removed in wetheim’s hysterectomy
- Uterus
- Cervix
- Vagina
- Pelvic lymph nodes
when is wertheim’s hysterectomy used
Cancer
what % of women will continue to have cyclical bleeding after removal of uterus
10
if ovaries are kept in hysterectomy what often ensues
pre-mature menopause
What is colporrhapy used for
repair prolapse
How is colporrhaphy performed
prolapse is due to lack of support of bladder (cystocele) or rectum (rectocele). This is corrected by excising epithelium
What is the problem with colporrhaphy
more tissue excised causes tighter vagina - therefore check if women is still sexually active
What is risk of posterior colporrhaphy
haematoma
what is needed for posterior colporrhaphy
vaginal pack - due to risk of haematoma
what is colposuspension performed for
stress incontinence
why is colposuspension rarely performed now
due to tension free vaginal tape used for strep incontinence as an alternative
what is cooper’s ligament
illiopectineal ligament
what are two absolute indications for lower-segment C-section
cephalopelvic disproportion
grade 3 or 4 placenta praaevia
what are the two types of C-Section
lower-segment
classical
what is classical c-section
longitudinal incision made in the upper-uterus
why is classical c-section no longer used
increased risk of uterine rupture in future pregnancies
what are serious risks of C-section to mother
VTE
Bladder, Ureter or bowel injury
Emergency hysterectomy
Death
what are serious risks of C-section for future pregnancies
Uterine rupture
Placenta praevia
Increases risk still-birth
