Medicine and surgery notes

Apr 24th, 2015
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Hysterectomy: A ReappraisalDavid Blair Toub, M.D.Department of Obstetrics and GynecologyPennsylvania Hospital, Philadelphia, PAdavid blair toub, m.d.Although it is unusual for myomectomy to betechnically implausible, the procedure may bedifficult, time-consuming, and associated with asubstantial complication rate...Hysterectomyusually is a simpler procedure than multiplemyomectomy, as well as the procedure to whichmost gynecologists are more accustomed.Te Linde, Operative Gynecology, Seventh Editiondavid blair toub, m.d.Hysterectomy:600,000/year, mostly TAH 33% of women havehysterectomies by age 60 Rates vary by geography, patientrace, and physician gender/age Mortality (benign) = 10/10,000david blair toub, m.d.Potential Complications:Blood loss Genitourinary Sexual Ovarian failure Depression? CVD?david blair toub, m.d.Benefits of Retained Uterus:Orgasmic Potential Retained Risk to Ureters Minimized Decreased Blood Loss Fertility Potentialdavid blair toub, m.d.TOP 10 LIST:Reasons to do a hysterectomydavid blair toub, m.d.10. Size > 12 Weeks9. Rapid Growth8. To Prevent Future Problems.7. Pelvic Relaxation6. Endometrial Hyperplasia inOlder PatientTOP 10 LIST:Reasons to do a hysterectomydavid blair toub, m.d.5.4.3.2.Incidental to BSODUBPelvic PainTOAAnd the #1 Reason:SymptomaticFibroids, Fertilit

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