Malignant
(carcinoma, sarcoma) and benign (polyp, myoma) tumors of
the uterus as well as various endocrine disorders, generally
present with abnormal vaginal bleeding. D&C is the main
diagnostic procedure for identification of the cause of abnormal
bleeding by removal of the lining of the uterus and uterine
cervix for patho-histological studies. For certain types
of abnormal bleeding the procedure is not only diagnostic
but curative as well, by stopping the bleeding.
One day surgery
"One day surgery" means,
that patients can leave the outpatient center on their own
feet, accompanied by a helper, within 24 hours of surgery
(usually after few hours of observation), and continue the
healing process in the familiar confines of their own home. "One
day surgery" requires strict professional, social, and
various other preconditions that are discussed at the stage
of the consultation when the need for surgery becomes clear.
(I.e.: good general health, absence of serious systemic disease,
patient must take responsibility for arrangement of transportation,
home care, and must have phone to contact the clinic or the
surgeon if necessary, etc).
Preparation for surgery
Evaluation by the gynecologist
always precedes surgery. This includes pelvic (vaginal) examination
as well as screening for cancer. Cancer screening consists
of colposcopic exam - the "microscopic examination" of
the cervical os - as well as cytological examination of epithelial
cells obtained during the procedure. After all the results
are known the decision is made on whether D&C is indicated
and can be performed as one day surgery, in consultation
with a gynecologist. After the necessary laboratory tests
and medical exams we set up a date for the surgery with the
patient over the phone.
The D&C procedure
The procedure may be performed
under general anesthesia, or using local
anesthesia (infiltration
of the surgical field with 1% Lidocaine). During the procedure,
we obtain tissue scrapings from two different sites: the
uterine cervix and the uterus. The samples are carefully
labeled for site of origin and sent to pathology. The procedure
also provides information on the size and possible gross
abnormalities of the uterus or the uterine wall (myoma).
Possible complications
No doctor
can guarantee complication-free surgery. Complications can
arise even following the most carefully performed procedures.
Possible early complications like postoperative bleeding
and inflammation, are, however, treatable. The most common
complications of D&C are uterine inflammation that can
spread to pelvic structures in more complicated cases, and
perforation of the uterine wall. Signs of inflammatory complications:
Prolonged bleeding (exceeding 2-3 days), foul smelling, bloody
vaginal discharge, lower abdominal pain, low grade fever,
or high temperature. Any of these symptoms should prompt
the patient to notify the surgeon immediately in order to
start timely and appropriate treatment. In case of perforation,
the surgeon will make arrangements for hospital admission.
Our clinic has a contract with the Ob&Gyn Department
of the Szent István Hospital that provides hospital care
if complications occur.
Postoperative care
Surgery is commonly followed
by 1-2 hours of observation, during which
time vital functions (blood pressure, urine output) stabilize,
the sedative effects
of the premedications wear off, and patients are able to
leave the center on their own feet, with the help of an assistant.
With spinal anesthesia or surgery performed in narcosis,
the period of observation increases to 5-6 hours. The day
following surgery, most of our patients can continue their
daily routine, taking time off work is not necessary. The
average recovery time after surgery is 2-4 days. This is
the time it takes for the patient to resume unlimited activities.
However, this time frame only applies to patients without
complications. In order to avoid inflammation, patients should
refrain from using tampons, sexual
activity or tub-baths
for at least two weeks. We ask our patients back for follow-up
four weeks after surgery.
Fees
Charge for examination and consultation: 10.000
HUF > Euro
Surgery using local
anesthesia: 50.000
HUF > Euro
Charge for general anesthesia: 30.000 HUF > Euro
50% of the total cost has to be paid as a deposit before
surgery.
These prices are only representative, the final charge will
also depend on the severity of the condition.
Appointments:
Monday-Friday, 8 am - 8 pm.
Telephone: + (36 1) 266-7766
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