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12.12.2018 15:40:47
In recent years many innovations have appeared in surgical gynecology, offering patients a full range of treatments. They have minimized surgical trauma (injuries, wounds) and made it possible to preserve, for example, the uterus. Currently, many gynecologists stick to this principle. But despite this fact, in Germany uterus removal surgery is still performed much more often than in other countries.
For example, according to experts, every year between 30,000 and approximately 70,000 women (the data of 2016) suffering from prolonged and heavy bleeding undergo surgery for uterus removal, although currently there are better tolerated, modern treatment options that preserve the organs and, what is no less important, are less costly.
With the so-called endometrial ablation there is no need to make incisions in the abdominal wall, since this modern method is performed hysteroscopically (hysteroscopy, that is, through the cervix). The uterine mucosa (endometrium) is measured, then, for a short time, is evenly resected, so that during the menstrual cycle the new mucosa cannot grow and the bleeding decreases to normal amounts or disappears completely. The patient can go home as soon as she wakes up from anesthesia, and after two days of rest she can work again. Currently, the intervention is performed mainly under general anesthesia. In the Netherlands, if desired, it is also performed under local anesthesia. In Germany there has also been such a possibility for several years. This surgical procedure is in high demand.
If endometrial ablation is not possible, for example, because of endometriosis or myoma, before total hysterectomy partial endoscopic removal of the uterus (laparoscopic supracervical hysterectomy) should be considered. This leads to the desired treatment outcome in the absence of risks of total hysterectomy, for example, such concomitant complications as urinary incontinence or uterine prolapse. According to experts, one should always make a choice in favour of the most non-invasive methods.
