Gynaecological Surgery

Question 1

What are the general precautions taken before and after gynaecological surgery?

Answer 1

1. Stop COCP 4 weeks before, don’t start until 2 weeks after major surgery.
2. Mobilise early, TED stockings, hydration
3. LMWH for major operations
4. Prophylactic antibiotics
5. Routine catheterisation prior to most operations

Question 2

What is this describing?

Total (including cervix) or subtotal (leaving cervix) removal of uterus. Can be open, vaginal, or laparoscopic.

Answer 2

Hysterectomy

Question 3

What procedure is recommended alongside a hysterectomy and why?

Answer 3

Salpingectomy - ovarian cancer may come from the tubes

Question 4

What are the risks involved in a hysterectomy?

Answer 4

Bleeding, infection, injury to bladder/bowel/ureters, scarring, VTE, earlier menopause if ovaries retained.

Question 5

What is this describing?
Fine tube inserted into vagina, passed through cervix into womb. Allows visualisation of womb, can take samples and remove fibroids and polyps.

Answer 5

Hysteroscopy

Question 6

What is this describing and why is hysteroscopy preferred?

Cervix dilated with steel rods and endometrium is scraped and biopsied.

Answer 6

1. Dilatation and curettage

2. Because the uterus is not visualised

Question 7

What is this describing?

Cervix dilated and retained non-viable foetus or placental tissue is removed using a suction device.

Answer 7

Evacuation of retained products of conception (ERPC)