Hysterectomy - a common operation. Most often it is made with malignant tumors of the uterus. Today, most experts believe that even if the cancer is better to do not extirpation and hysterectomy - while retaining the cervix and the function of the pelvic organs.

Hysterectomy - a type of hysterectomy

Hysterectomy surgery or removal of the uterus. Depending on the amount of tissue removed, it is divided into the following types:

• subtotal hysterectomy, or amputation of the uterus - the removal of the body of the uterus without the neck;
• total hysterectomy or hysterectomy - complete removal of the uterus and cervix; with or without removal of the appendages on one or both sides;
• gisterosalpingoovariektomiya - removal of the uterus with appendages (fallopian tubes and ovaries);
• Radical hysterectomy - removal of the uterus, cervix, upper vagina, fallopian tubes and ovaries, as well as their surrounding tissue and nearby lymph nodes Lymph nodes - what keeps our immune system .

On the surgical approach following types of surgery removal of the uterus:

• laparatomicheskim (abdominal) access (laparotomy or abdominal hysterectomy) - through an incision in the abdomen;
• laparoscopy (laparoscopic hysterectomy) - through punctures in the abdomen with a special optical equipment with the output image on the screen;
• vaginal access (vaginal hysterectomy) - through the vagina.

Hysterectomy with appendages

Hysterectomy - is one of the most common operations. There are several types of this operation and the task of the physician is the selection of such an operation, which is the most suitable given patient. It's not so easy.

Hysterectomy with appendages or total hysterectomy with salpingo - an operation, after which due to the removal of the ovaries body is completely deprived of hormonal support. Removal of the cervix is ​​dangerous because blood circulation and innervation of the pelvic floor in the area, in addition, the pelvic organs lose support (it served as the cervix) and may be omitted. The emotional state of the women after such an operation also remains much to be desired.

Therefore, indications for such an operation is limited, it is:

• Malignant tumors of the uterus, cervix and ovarian cancer;
• sex change.

When planning a total hysterectomy surgery is required to pay attention to the age of the woman. Women who do not have menopause, as far as possible try not to remove the ovaries. But sometimes it can not, for example, ovarian cancer.

Progress surgery: general anesthesia laparotomy performed a hysterectomy, the surgeon makes a vertical incision from the womb to the navel, cut through the vagina, the cervix is ​​separated from the bladder, and then removed from the neck of the uterus and appendages (fallopian tubes and ovaries); then the wound is sutured in layers.

After surgery, hysterectomies Hysterectomy (removal of the uterus) - a terrible need   appendages women receiving hormone replacement therapy Hormone therapy - is it possible to fool nature? . It is also recommended to carry out the plastic for the prevention of pelvic floor prolapse of pelvic organs and urinary disorders.

Vaginal hysterectomy

Vaginal hysterectomy - a surgical procedure in which the vagina is performed to remove the uterus, cervix and sometimes the ovaries and tubes indications. This is the most sparing surgery that leaves no scars on the skin. Today, it is more often the method of choice if the following indications:

• multiple uterine fibroids;
• the average size of uterine fibroids in the presence of complications - bleeding and debilitating pain;
• adenomyosis - the presence of complications - bleeding and debilitating pain;
• being born in the vagina submucous (located directly under the mucosa) node benign tumor of uterine fibroids;
• born in the vagina necrotic (dead) tumor nodes connected to the wall of the uterus broad base;
• a large amount of fat in the anterior abdominal wall in women with uterine cancer, complicating the operation abdominal way.

Conducting a vaginal hysterectomy is contraindicated:

• for any acute illness and exacerbation of chronic diseases;
• for large size of the uterus;
• if a woman earlier caesarean section was performed and after it in a small basin formed adhesions Adhesions - how to get rid of them? .

The course operations: first removed born and born tumor sites; then an incision is made in the upper part of the vagina, the uterus is removed through which.

Any type of hysterectomy is best done after menopause. But for health reasons, this operation can be performed at any age.

Galina Romanenko

Antibiotics for inflammation of the appendages are considered to be the main method of treatment of acute inflammatory processes. In the treatment of chronic inflammation of the same are not always applicable, as the role of infections in chronic inflammation is greatly reduced.

How to choose the right antibiotic for inflammation of the appendages

Antibiotics are always assigned in acute inflammation of the appendages, and in some cases (with significant inflammation) during relapses of chronic inflammation of the women and men. The fact that the role of inflammation in chronic infection is markedly reduced, an exacerbation of the fore noninfectious inflammatory and allergic processes.

Sometimes a woman taken by biopsy during diagnostic laparoscopy material for research is sterile. But this is not always, and sometimes at an exacerbation of chronic processes still require antibiotics.

The choice falls on broad spectrum antibiotics Broad-spectrum antibiotics - not only treat but also cripple , Which shows the sensitivity of the majority of bacterial infections of genito-urinary organs.

At the same time try to choose antibiotics are active as intracellular pathogens infections - chlamydia, mycoplasma and Ureaplasma, which are very often cause inflammation of the appendages. To antibacterial drugs, meeting all these conditions are tetracyclines, macrolides and fluoroquinolones. They are the drugs of choice in the appointment of antibacterial therapy of patients with inflammation of the appendages. They are used in the treatment of inflammation of the appendages Treating inflammation of the appendages - long integrated approach   and other groups of antibiotics - penicillins, cephalosporins, aminoglycosides.

After the doctor receives the result of the analysis, identifying the type of agent and its sensitivity to the antibiotic, it corrects treatment if necessary. The need for correction occurs when antibiotic treatment against the patient's condition does not improve.

Treatment of inflammation of the antibiotic tetracycline

Tetracycline antibiotics are effective in this disease, however, clinicians have noted that the sensitivity of urinary pathogens to tetracyclines infections begins to decline. Also, tetracyclines have significant side effects. Of this group of drugs for the treatment of inflammation of the most commonly used doxycycline, which has fewer side effects and does not stay in the body of the patient.

Good exposure to the drug doxycycline has prepared technology soljutab (yunodoks soljutab, producer - a Dutch pharmaceutical company Astellas). Active ingredient of this drug is placed into small balls (microspheres) with a filler, resistant to acids. The microspheres do not dissolve in the acidic environment of the stomach, get food into the duodenum and only there to dissolve in an alkaline medium.

Treatment of inflammation of the antibiotic group marolidov

Macrolide antibiotics are also effective in the treatment of inflammation of the appendages. Besides these antibiotics have a longer half-life, allowing them to create high concentration in the inflammation. These include anitibiotikam sumamed Sumamed antibiotics wisely , Vilprafen Vilprafen - modern highly effective and non-toxic antibiotic , Klatsid and others. Macrolides are resistant to the acidic environment of the stomach, can actively suppress the livelihoods of most of the pathogens that cause diseases of the genitourinary organs, including intracellular pathogens. Inflammation of the macrolide antibiotics group treated effectively.

Treatment of inflammation of the fluoroquinolone antibacterial drugs

Fluoroquinolones are currently considered the most effective drugs for the treatment of infectious and inflammatory diseases of urinary organs. Resistance (immunity) to the pathogens it develops very slowly. Therefore, in the absence of contraindications patient contraindications try to prescribe drugs of this group: ofloxacin (zanotsin, tarivid, ofloksin), norfloxacin, ciprofloxacin (tsiprinol, tsiprobay, tsiprobid, tsifran), pefloxacin (abaktal), levofloxacin (police urobatsid, norbaktin) grepafloksatsin, lomefloxacin, gatifloxacin (tebris).

Is it enough for the treatment of inflammation of the appendages of the antibiotic?

More often than not. The fact is that the appendages inflammation is rarely caused by a single pathogen infection, they are likely to be several, including aerobic part (developing under air) and part of anaerobes (they develop without air).

High activity against anaerobes exhibit metronidazole and tinidazole, therefore antibiotics are often combined with these agents.

Galina Romanenko