Some
abnormalities of the uterine cervix (rupture, erosions, epithelial
abnormalities, etc.) maintain chronic inflammation that manifests
as recurrent abnormal vaginal discharge and sometimes may
become the basis for later development of malignancies.
Treatment options
The only correct approach
in such cases is complete removal of the abnormal tissue
well within the surrounding normal tissue, followed by a
patho-histological examination. This procedure is performed
in our clinic with a radio-wave cutting device (Loop conization
procedure), allowing short procedure time (15 - 20 minutes)
and postoperative observation period (1-2 hour). The average
time of recovery after the procedure is 4-5 weeks. During
this time, the wound on the cervical os heals, the epithelium
regenerates. Decision on further treatment is made based
on the pathology results of tissue samples obtained during
surgery. In the majority of the cases, the procedure is curative
as well, which is confirmed upon regular subsequent cancer
screening exams. It is important to note, that after this
procedure risk of inability to carry future pregnancies to
term is also minimized.
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, 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 the exam a decision
is made in consultation with the oncologist whether one day
surgery is appropriate for treatment of the patients uterine
cervical abnoramality.Next, the doctor provides a detailed
explanation of the patient's condition, treatment options,
and the proposed procedure. It is at this point that the
patient is acquainted with the concept of one day surgery.
It is also here, that the patient is informed about laboratory
and other accessory studies (Imaging, ECG, abdominal ultrasound,
medical exam etc.) that might be required for surgery, options
for anesthesia, possible complications, home care-related
issues, stages of recuperation, i.e. all the information
that is relevant for the patient to make a decision on which
treatment method, or surgery to choose.
The LLETZ procedure
On the day of surgery the
patient signs the consent form, and pays the surgery fee.
The procedure may be performed using local, spinal
or general anesthesia. If general or spinal anesthesia is used, immediately
before surgery, the patient is premedicated with an injection
containing analgesics and sedatives. The majority of our
surgeries are performed with local anesthesia, which means
infiltration of the surgical field with 1% Lidocain. We perform
the procedure using a special radio-wave cutting device.
We take advantage of the energy of radio-waves to vaporize
cells along the wolfram loop of appropriate shape and size
to remove the abnormal tissues. Due to the nature of this
modality, the surrounding tissue suffers minimal heat damage
allowing for fast wound healing. Lack of heat damage makes
the conical sharp-edged uterine tissue sample ideal for histopathology.
The method allows for epithelialization from the wound edges,
resulting in scar-free healing. After hemostasis, depending
on preliminary findings we may take additional samples from
the cervix during the the same procedure.
Possible complications
No doctor
can guarantee a complication-free surgery. Complications
can arise even following the most carefully performed procedures.
Possible early complications like postoperative bleeding
and inflammation are treatable. If you experience even the
slightest indication of complications (i.e. bleeding, lower
abdominal pain, foul smelling vaginal discharge), you can
contact your surgeon day or night, who will take the necessary
steps to resolve the problem.
Postoperative care
Surgery is commonly followed
by 1-2 hours of observation, during which
time the vital functions (blood pressure, urine output) stabilize,
and
patients are able to leave the center on their own feet,
with the help of an assistant. The day following surgery,
most of our patients can continue their daily routine, taking
days off work is not necessary. During the 4 weeks that takes
for the cervical os to heal scant vaginal discharge may occur.
In some cases, between the 5th-10th postoperative days vaginal
oozing of blood may occur that is lighter than a usual menstrual
bleeding. However, this is part of the healing process, and
should not be cause for concern.Pain, or other complaints
should not be present in uncomplicated cases. For 3-4 weeks
following surgery, tub-baths, tampons and sexual activity
are not recommended. If no complications arise, we ask our
patients to schedule a follow-up exam six weeks after surgery.
Fees
Gynecological exam (pelvic exam, colposcopy,
cytology):
10.000 HUF > Euro
Loop conization with local
anesthesia: 50.000 HUF > Euro
Charge for spinal or 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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