Pessary Meaning In Urdu

[Annemie]

Thissummary contains basic information about hysterectomies: the benefits, risks and alternatives to help you make an informed decision. The information provided here will help in discussions with your doctor as you decide whether or not to have the operation.

A hysterectomy is an operation to remove the uterus (womb). Most hysterectomies are not emergency operations, so you have time to think about your options. This booklet is designed to help you understand the options and their meaning for you.

The ovaries have two major functions. One is the production of eggs or ova, which permit childbearing. The second is the production of hormones or chemicals which regulate menstruation and other aspects of health and well-being, including sexual well-being.

Hysterectomy is one treatment for a number of diseases and conditions. If you have cancer of the uterus or ovaries or hemorrhage (uncontrollable bleeding) of the uterus, this operation may save your life.

There may be other ways of treating or dealing with these problems. Together with your doctor you should weigh all the alternatives and effects of the different choices to help you decide what is right for you.

These are common non-cancerous (benign) tumors of the uterus and they are the most frequent reason for recommending a hysterectomy. They grow from the muscular wall of the uterus and are made up of muscle and fibrous tissue. Many women over 35 have fibroids, but usually have no symptoms.

In some women, however, fibroids (myomas) may cause heavy bleeding, pelvic discomfort and pain and occasionally pressure on other organs. These symptoms may require treatment, but not always a hysterectomy. There are promising new experimental drugs that may temporarily shrink the tumors; however, these drugs may have serious side effects. They are generally very costly. There is a type of abdominal surgery (myomectomy) that removes the myoma without removing the uterus (see Alternatives for additional information). These treatments may be sufficient or they may offer temporary relief and enable a woman to postpone having a hysterectomy, especially if she still wishes to bear children.

Another common reason for recommending a hysterectomy is endometriosis. This is a noncancerous condition in which cells from the uterine lining grow like islands outside of the uterus. This growth occurs most commonly on the ovaries, fallopian tubes, bladder, bowel and other pelvic structures, including the uterine wall. These cells may cause pain and discomfort by bleeding at the time of menstruation. Endometriosis may also cause scarring, adhesions and infertility.

Symptoms can vary greatly and some women choose to do nothing, or find that drug therapy, pain relief medication or more localized surgery are effective. When these are not effective, hysterectomy may be the treatment of choice.

As a woman ages, the vaginal supports begin to lose their muscle tone and sag downward (prolapse). With prolapse, the bladder and/or rectum may be pulled downward with the uterus. This happens to most women to some degree. For the vast majority, the sagging is minor and symptoms are not severe.

If the prolapse worsens, some women experience a heavy or dragging feeling in the pelvic area, problems controlling bladder and/or bowel function, and occasionally, protrusion of one of the organs through the vaginal opening.

Some women get relief from these symptoms by doing special exercises ("Kegels") to strengthen the pelvic muscles, by taking hormone therapy or by using a plastic or metal ring (pessary) which may help to hold the uterus in place. None of these treats the underlying problem.

Precancerous changes in the cervix are often found on routine Pap smears. These lesions or abnormalities must be treated, but rarely with a hysterectomy. When detected early and treated effectively, most of these conditions do not progress to invasive, life-threatening cancer. they can be treated conservatively, usually on an outpatient basis.

A pre-cancerous change can occur when the lining of the uterus (endometrium) overgrows. "Hyperplasia of the endometrium" means an overgrowth of the lining of the uterus. It causes irregular and/or excessive bleeding. The overgrown lining can usually be treated with hormone therapy and/or a "D & C" (dilation and curettage) a simple outpatient procedure to clean out overgrown tissue. In more severe cases or cases that do not respond to treatment, hyperplasia of the endometrium may lead to cancer of the uterus. Upon diagnosis of cancer, a hysterectomy would be the treatment of choice.

Irritation of the lining of the abdomen may cause adhesions (scarring) which bind affected organs to each other. The adhesions can result from endometriosis, infection or injury. The symptoms may include severe pain, bowel and bladder problems and infertility.

Pain relief medication or less drastic surgery, such as laser therapy, can be effective in some cases. In very serious cases, hysterectomy may be recommended. However, a hysterectomy itself can cause adhesions.

It is normal for the amount and length of menstrual flow to vary from woman to woman. There may also be differences in menstrual flow from one cycle to the next. If bleeding that is unusually heavy or frequent for you occurs, this may be due to a variety of causes. The most common causes are fibroids and hormonal changes.

Because there can be many reasons for unusually heavy bleeding, getting an accurate diagnosis is vital before deciding on a course of treatment. Depending on the diagnosis, drug therapy or minor surgery may be indicated. Rarely, there can be hemorrhage of the uterus in which case a hysterectomy can be life saving.

This is a common symptom. As with heavy bleeding, there can be a number of causes for pelvic (lower belly) pain. These include endometriosis, fibroids, ovarian cysts, infection or scar tissue. Pain in the pelvic area may not be related to the uterus.

A hysterectomy may be life-saving in the case of cancer. It can relieve the symptoms of bleeding or discomfort related to fibroids, severe endometriosis or uterine prolapse. On the other hand, for these non-cancerous conditions, you may prefer to seek alternatives to surgery for these symptoms or other problems related to the uterus and pelvic organs.

Hysterectomy patients may have a fever during recovery, and some may develop a mild bladder infection or wound infection. If an infection occurs, it can usually be treated with antibiotics. Less often, women may require a blood transfusion before surgery because of anemia or during surgery for blood loss. Complications related to anesthesia might also occur, especially for women who smoke, are obese, or have serious heart or lung disease.

As with any major abdominal or pelvic operation, serious complications such as blood clots, severe infection, adhesions, postoperative (after surgery) hemorrhage, bowel obstruction or injury to the urinary tract can happen. Rarely, even death can occur.

In addition to the direct surgical risks, there may be longer-term physical and psychological effects, potentially including depression and loss of sexual pleasure. If the ovaries are removed along with the uterus prior to menopause (change of life), there is an increased risk of osteoporosis and heart disease as well. These will be discussed later along with possible treatments.

In making a decision, you should also consider that a hysterectomy is not reversible. After a hysterectomy, you will no longer be able to bear children and you will no longer menstruate. You need to think about the impact these changes would have on you.

If you have a diagnosis of uterine cancer, the ovaries should be removed because the hormones they secrete may encourage the growth of the cancer. They also may have to be removed in severe endometriosis because they produce the hormones that are responsible for endometriosis.

Some doctors believe that healthy ovaries should be removed as part of a hysterectomy in women who are are close to menopause or later, when the ovaries' function normally fades. It is done as a preventive measure to reduce the risks of developing ovarian cancer. This is because ovarian cancer is very difficult to detect at an early enough stage for it to be curable.

Other doctors disagree because this cancer is rare and because removing the ovaries does not always guarantee women will not develop ovarian cancer. (Rarely, the cells that cause ovarian cancer can be present in the body even after the ovaries are removed.) In addition, ovaries produce several hormones which are beneficial to women. They protect against serious common diseases such as heart disease and osteoporosis and contribute to sexual pleasure.

As a woman ages, the ovaries gradually reduce their production of hormones, but even after menopause they produce small amounts of hormones. Removing the ovaries causes menopause to occur more abruptly. The symptoms of menopause include hot flashes, night sweats, insomnia, fatigue, depression and vaginal dryness.

After ovaries are removed or when menopause occurs, hormone replacement therapy often helps reduce the risks of osteoporosis, and reduce menopausal symptoms like hot flashes and vaginal dryness. It may also contribute to sexual pleasure. However, there are some women who cannot be placed on hormone replacement therapy. For example, some women with liver disease or a history of hormone-dependent tumors, such as breast cancer, may not be able to take these hormones.

For some women, uterine contractions and pressure against the cervix add to sexual pleasure. Others may feel less pleasure or reduced desire due to loss of certain hormones if ovaries were removed. Loss of hormones can cause vaginal dryness and make sex uncomfortable. Hormone replacement therapy may relieve some of these symptoms. A vaginal gel or lubricant can reduce vaginal dryness. For some women, reduction in sexual pleasure is temporary while they and their partners adjust. Because sexual feelings are so individual, it may be difficult to predict exactly how a hysterectomy will affect your feelings.

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