Added: 12/28/2005 |
Gynecologic Surgery Is Still The Current Method Of Treating InfertilityThe nature of an infertility treatment is to eliminate its causes, i.e., the factors that have resulted in infertility. Sometimes a gynecologic surgery is needed. For example, a tube type of infertility requires the recovery of uterine tubes patency. Nowadays it is done by laparoscopy. Its effectiveness is 30 - 40 per cent of the cases. If the disease has been for 2-3 years, or, if a laparoscopy has been done before, then extracorporal fertility is more effective.
The infertility concerned with endometriosis is diagnosed and treated with the help of laparoscopy. It is necessary to strengthen the result with medications. This treatment can continue for six months. The effectiveness rate is 30 - 40 per cent.
Some researchers, however, suppose that thousands of women could avoid a laparoscopic hysterectomy. The results of a detailed study of the gynecologic surgery show that a laparoscopic hysterectomy can be substituted by the less invasive methods.
In Great Britain 37,298 cases of hysterectomy were studied in 1994-1995. It was discovered that in 45 per cent of the studied cases, the hysterectomy was made when women suffered from voluminous menstruation. 50 - 75 per cent of these women could have avoided the hysterectomy, because the cause of their voluminous bleeding was endometrium.
Endometrial ablation is a laser ablation of the endometrial layer. Usually a Nd:YAG laser is used. It provides a local destruction of endometrium. The gynecologic surgery is often performed with local anesthesia and a hysteroscope is used.
A similar result can be achieved by electro coagulation. An endometrial ablation can be an alternative to hysterectomy or hormonal therapy in abnormal voluminous menstruation.
A laparoscopy allows the doctor to see the inner reproductive organs of a woman and to have detailed information on their condition. It refers to a gynecologic surgery when an optical instrument is introduced into the abdominal cavity. If the laparoscopy is diagnostic and it is made only to define the cause and character of infertility, one small incision (5-7 mm) is enough. Usually it is made in the area of the navel.
If the laparoscopy is not only a diagnostic one, and it is also aimed at surgical procedure in the tubes or ovary, one or two additional incisions are made. In such a case it is called operative laparoscopy.
The main contradiction is a big adhesive process in abdominal cavity that is caused by serious abdominal operations. In such a case there is a risk of dangerous damages.
There is another serious contradiction to a laparoscopy. It is a cardiac decompensation. Because the operation is performed when a woman is with head first and her abdominal cavity is filled by a gas. This condition can cause a cardiac decompensation.
During a laparoscopy the following can be performed:
- Adhesiotomy to recover uterine tube patency
- Small ovarian cyst ablation and myomatous nodes ablation
- Endometrial ablation
- Coagulation of polycystic ovary
- Uterine tube ablation in the case of extrauterine pregnancy
A laparoscopy has the advantage of a lower risk and a disadvantage of lower effectiveness in comparison with usual gynecologic surgery (i.e. abdominal operations).
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