5: The low risk of concomitant adnexal surgery
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Data on ovarian dysfunction after hysterectomy are found in literary sources, but the nature of changes in the hormonal profile, its chronological sequence, the issue of prognosis and possible preventive measures, even in the case of preservation of ovarian tissue, remain contradictory and fragmentary, which prompted the conduct of this research. The aim of the research is to assess the risk of menopausal disorders after hysterectomy with opportunistic salpingectomy during the menopausal transition. Research materials and methods.A comprehensive assessment of the long-term consequences of hysterectomy in 160 women of reproductive age was carried out. Risk factors were identified during a general clinical examination, based on anamnestic data. Indicators were evaluated in the examined women. Inclusion criteria: age of menopause transition, hysterectomy due to benign uterine pathology, patient's consent to participate in the study. Research results. The data obtained by us after 12 months from the moment of surgical intervention demonstrate neurovegetative and psychoemotional manifestations in 87 patients - 46.25%. Conclusions. 12 months after GE with opportunistic salpingectomy, 46.25% of patients have a gradual formation of components of the menopausal syndrome. age older than 45, hysterectomy, hormonal therapy of benign uterine pathology demonstrate a connection with the development of metabolic disorders in the distant postoperative period, and their combined effect increases the risk of their development.
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Ovarian Reserve
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Current Procedural Terminology
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Nephrology
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Journal Article Salpingectomy by operative laparoscopy and subsequent reproductive performance Get access G. Oelsner, G. Oelsner 1 Department of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel 1To whom correspondence should be addressed Search for other works by this author on: Oxford Academic PubMed Google Scholar M. Goldenberg, M. Goldenberg Department of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel Search for other works by this author on: Oxford Academic PubMed Google Scholar D. Admon, D. Admon Department of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel Search for other works by this author on: Oxford Academic PubMed Google Scholar M. Pansky, M. Pansky 2Department of Obstetrics and Gynaecology, Assaf Harofeh Medical Centre, Zerifin, Sackler School of Medicine, Tel Aviv UniversityIsraelDepartment of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel Search for other works by this author on: Oxford Academic PubMed Google Scholar I. Tur-Kaspa, I. Tur-Kaspa Department of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel Search for other works by this author on: Oxford Academic PubMed Google Scholar O. Rabinovitch, O. Rabinovitch Department of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel Search for other works by this author on: Oxford Academic PubMed Google Scholar H.J.A. Carp, H.J.A. Carp Department of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel Search for other works by this author on: Oxford Academic PubMed Google Scholar S. Mashiach S. Mashiach Department of Obstetrics and Gynaecology, The Chaim Sheba Medical CentreTel Hashomer, Israel Search for other works by this author on: Oxford Academic PubMed Google Scholar Human Reproduction, Volume 9, Issue 1, 1 January 1994, Pages 83–86, https://doi.org/10.1093/oxfordjournals.humrep.a138325 Published: 01 January 1994 Article history Received: 22 December 1992 Accepted: 10 September 1993 Published: 01 January 1994
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Hysterectomy and mid-urethral sling (MUS) are common operations, but little is known about how hysterectomy after MUS affects the risk for stress urinary incontinence (SUI) relapse.We included 49 women with a MUS before hysterectomy and 41 women with a MUS concomitant with hysterectomy. The controls, matched by age (± 2 years), MUS type (retropubic vs transobturator) and operation year (± 2 years), included 201 women who underwent the MUS operation without a subsequent hysterectomy. We used health care registers for follow-up of 12.4 years in median (IQR 10.9-14.7) after the MUS operation to compare the number of SUI re-operations and hospital re-visits for urinary incontinence.The re-operation rates for SUI did not differ between the women with MUS before hysterectomy (n = 2, 4.1%), women with MUS concomitant with hysterectomy (n = 2, 4.9%) and their controls (n = 4, 4.9%, p = 0.8 and n = 6, 5.0%, p = 1.0, respectively). There were significantly fewer urinary incontinence re-visits among women who had a MUS concomitant with the hysterectomy compared to their matched controls (n = 2 and 31, 5 and 31%, p < 0.01) and to the women with a MUS prior to hysterectomy (n = 2 and 10, 5 and 20%, respectively, p = 0.03).Hysterectomy after or concomitant with MUS does not seem to increase the risk for SUI re-operation or hospital re-visits for urinary incontinence. These results can be used to counsel women considering hysterectomy after MUS operation or concomitant with MUS operation.
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For a period of six years, concomitant disorders were registered at annual routine examinations of 226 residents of a central institution for mentally retarded. Only in six patients were no concomitant disorders found. 19.5% displayed concomitant disorders from one type of disease, 30.5% displayed two or more concomitant disorders from two types of disease, and as many as 47.3% displayed concomitant disorders from three or more types of disease. The residents examined showed particularly high occurrences of various deformities, mental disorders, and diseases of the nervous system, sense organs and musculo-skeletal system. The most frequent singular disorders were epilepsy, cerebral palsy and deformities of the back and foot.
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To describe the clinical characteristics in classical trigeminal neuralgia (TN) with concomitant persistent pain and to investigate whether TN with concomitant persistent pain represents a distinct phenotype.There has been much debate about the possible pathophysiological and clinical importance of concomitant persistent pain in TN. This has led to subgrouping of TN into forms with and without concomitant persistent pain in the recent 3rd International Classification of Headache Disorders beta classification.In this cross-sectional study, data on the clinical characteristics were systematically and prospectively collected from consecutive TN patients.A total of 158 consecutive TN patients were included. Concomitant persistent pain was present in 78 patients (49%). The average intensity of concomitant persistent pain was 4.6 (verbal numerical rating scale). The concomitant persistent pain was present at onset or early in the disease course. Patients with concomitant persistent pain were on average 6.2 (P = .008) years younger at onset, but the 2 groups had the same duration of disease (P = .174). There was a preponderance of women in TN with (P < .001) but not in TN without concomitant persistent pain (P = .820). Right-sided pain was more prevalent than left-sided in TN without (P = .007) but not in TN with concomitant persistent pain (P = .907). TN with concomitant persistent pain more frequently had sensory abnormalities (P < .001) and less frequently responded to sodium channel blockers (P = .001). There were no significant differences in other clinical characteristics.Concomitant persistent pain is very prevalent in TN and is not a consequence of paroxysmal pain. Findings support that the 3rd International Classification of Headache Disorders beta division of TN with and without concomitant persistent pain is clinically and scientifically important.
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The first five cases of salpingectomy treated in our service by laparoscopy are presented. We describe clinical symptoms and signs, surgery techniques and anatomo-pathological findings in each cases. Current literature is also discussed.
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INTRODUCTION: Increasing prevalence of bilateral salpingectomy (BS) at time of hysterectomy has led to concern of increasing healthcare cost. A Canadian study found that salpingectomy at time of hysterectomy was associated with a lower lifetime cost than hysterectomy alone. Given the different healthcare system in Canada these findings may not apply in the United States. Our objective was to determine the cost associated with BS at time of hysterectomy based on USA healthcare data. METHODS: The 2013 National Inpatient Sample (NIS) was used to identify women over age 18 years who underwent hysterectomy with BS for benign indications. The primary outcome was higher cost defined as cost above the median. Stepwise multivariate regression analysis was used to evaluate the effect of co-variables on cost of hysterectomy. Statistical analysis was performed using JMP 10 (SAS, Carey NC). RESULTS: 18,717 hysterectomies with BS were identified, of these 17.1% were laparoscopic, 11.2% were robotic, 58% were abdominal and 14.2% were vaginal. For all types of hysterectomy, BS was associated with a median increase in cost of $1193 ($685-$1701). For vaginal hysterectomy, the median increase in cost was $2080 ($1733-$2427). Robotic, abdominal and laparoscopic hysterectomy were all associated with an increase of less than $75 if BS was performed. Only vaginal hysterectomy was associated with a statistically significant increase in risk of hysterectomy cost being above the median (aOR = 1.57, p=0.01). CONCLUSION: Bilateral salpingectomy at time of vaginal hysterectomy is more likely to be associated with an increase in cost of hysterectomy.
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