Gynaecology Interventions

Question 1

What is a hysterectomy?

Answer 1

Surgical removal of the uterus

Question 2

What are the types of hysterectomy?

Answer 2

Sub-total - removal of body of uterus only. Leave cervix
Total - uterus and cervix
Total + salpingooophorectomy - uterus, cervix, fallopian tubes and ovaries
Radical - uterus, cervix, parametric, vaginal cuff, part/whole of fallopian tubes

Question 3

How can hysterectomies be done?

Answer 3

Abdominal - 2-5 day hospital stay

Vaginally or laparoscopic - 1-2 day hospital stay

Question 4

What are the main complications of a hysterectomy?

Answer 4

Damage to bladder or ureter
Long term bladder or bowel dysfunction
Pelvic infection/abscess
Menopause can occur earlier if ovaries conserved
Enterocoele or vaginal vault prolapse

+ standard op complications (VTE, anaesthesia etc.)

Question 5

What is endometrial ablation?

Answer 5

Destruction of endometrium used as treatment of heavy bleeding

Methods for this vary - heat, freezing, microwave

Question 6

What are the positives of endometrial ablation?

Answer 6

Much less invasive than hysterectomy

Question 7

What are the risks of endometrial ablation?

Answer 7

Fluid overload + electrolyte imbalance
Damage to cervix, bladder or bowel
Intrauterine scarring and tissue contraction –> obstruct menstrual flow

Question 8

What are the contraindications for endometrial ablation?

Answer 8

Women who wish to remain fertile
Endometrial hyperplasia or malignancy
Fibroids - distort cavity
Enlarged uterus