Let’s start this section on women’s health problems with a description of common gynaecological operations and investigations, as these are frequently mentioned in the chapters that follow.
Gynaecological surgery
Gynaecological surgery generally has more emotional impact than surgery on other parts of the body, because our reproductive organs are so much a part of our sexuality and female identity. Most of us feel a greater loss after hysterectomy than if, say, our appendix or gall bladder is removed.
Much gynaecological surgery is either life-saving or can remove the cause of distressing symptoms and chronic ill health. However, some gynaecological surgeons have been accused of being too eager to remove women’s reproductive organs for unsound reasons or without giving non-surgical treatments a fair trial.
Some doctors (and some women) consider that after a woman has had as many children as she wants, her uterus is a useless organ that should be removed to prevent future possible disease. Some have the same belief about the ovaries after menopause. Prevention of possible future
disease is not a valid reason for the removal of healthy organs. It has never be suggested that healthy middle-aged ma should have their prostates removed although the prostate causes more ill health in more older men than the uterus or ovaries do in older women, and cancer of the
prostate causes more than twice as many deaths as cancer of the uterus and ovaries combined.
If you’re advised to have gynaecologal (or any other) surgery, there are some important points to consider.
• Has the cause of your symptoms been identified by appropriate investigations and have the results been satisfactorily explained to you?
• You should understand the reason for the surgery and believe that it is valid.
• Your surgeon should explain exactly what will be done and what the ореration aims to achieve. What is the access rate of such an operation?
• Are there non-surgical treatments that could be tried?
• Are there any risks to life or health from not having surgery?
Other things to find out before surgery include all possible complications and other consequences, length of time required in hospital, costs, whether any special aftercare might be needed, and the likely length of convalescence.
Second opinions
Except in emergencies, you should get a second opinion if:
• you have any doubts about whether you really want or need the operation
• your surgeon is reluctant to give you full, clear information about reasons for surgery
• the surgeon seems overenthusiastic or tries to hurry you into a decision about surgery.
Your surgeon should be willing to refer you for a second opinion if you want one. If not, or if you don’t want to bring up the matter with the surgeon, ask your family doctor to refer you to another specialist. If you have any problems getting a referral, see another GP.
Day surgery
Many minor gynaecological procedures are now performed on a ‘day only’ basis. Most public hospitals encourage day patients; there are now private day hospitals for surgery and some medical investigations. The advantages of day surgery are that you don’t have to spend time away from home and the cost of overnight hospital care is avoided. You’ll need someone to help you when you get home, especially if you’ve had a general anaesthetic.
When day surgery is performed, backup services are arranged in case something unexpected happens when you get home. If there are complications during or soon after the procedure, you may need to stay in hospital overnight: in such cases, if your surgery has been done at a day hospital, you’ll be transferred to a general hospital for overnight care.
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