Dysfunctional uterine bleeding surgery: Difference between revisions

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__NOTOC__
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{{Dysfunctional uterine bleeding}}
{{Dysfunctional uterine bleeding}}
{{CMG}} {{AE}} {{VVS}}
{{CMG}}; {{AE}} [[User:AroojNaz|Arooj Naz, M.B.B.S]], {{VVS}}
== Surgery ==  
 
* Hysterectomy
==Overview==
* Endometrial ablation
Surgical procedures are reserved for patients that are unresponsive to medical treatment or those that do not desire [[fertility]]. Procedures can be specific according to underlying causes of dysfunctional bleeding as well as cancer stage. Common surgical interventions include [[hysterectomy]], [[endometrial ablation]] and [[laparoscopic removal]]. 
=== Indications for Surgery ===  
 
* Anatomic causes
==Surgery==
* If fertility is not desired
 
 
As surgery is more invasive, it is often reserved for cases uncontrolled by medications or those not desiring [[fertility]].<ref name="pmid15117012">{{cite journal| author=Albers JR, Hull SK, Wesley RM| title=Abnormal uterine bleeding. | journal=Am Fam Physician | year= 2004 | volume= 69 | issue= 8 | pages= 1915-26 | pmid=15117012 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15117012  }}</ref> Underlying anatomical cases of [[DUB]] are also an indication for surgery. Surgical treatments can be tailored according to the underlying cause of bleeding.
{| class="wikitable"
|+Surgical Options
!Condiiton
!Surgical Treatment<ref name="pmid304225082">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=30422508 | doi= | pmc= | url= }}</ref>
|-
|[[Endometrial Polyps|Polyps]]
|
*Surgical resection of polyps ([[polypectomy]])
*Polyps larger than 1.5 cm are unlikely to respond spontaneously and should consider [[polypectomy]]<ref name="pmid30855861">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=30855861 | doi= | pmc= | url= }}</ref>
*[[Dilation and curettage (patient information)|Dilation and curettage]]<ref name="pmid31105939">{{cite journal| author=Nijkang NP, Anderson L, Markham R, Manconi F| title=Endometrial polyps: Pathogenesis, sequelae and treatment. | journal=SAGE Open Med | year= 2019 | volume= 7 | issue=  | pages= 2050312119848247 | pmid=31105939 | doi=10.1177/2050312119848247 | pmc=6501471 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31105939  }}</ref>
|-
|[[Adenomyosis]]
|
*[[Hysterectomy]]
*[[Adenomyomectomy]]
*[[Endometrial ablation]]
*[[Uterine artery ligation]] or [[Uterine artery embolization|embolization]]<ref name="pmid24771944">{{cite journal| author=Taran FA, Stewart EA, Brucker S| title=Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy. | journal=Geburtshilfe Frauenheilkd | year= 2013 | volume= 73 | issue= 9 | pages= 924-931 | pmid=24771944 | doi=10.1055/s-0033-1350840 | pmc=3859152 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24771944  }}</ref>
|-
|[[Leiomyoma]] (fibroids)
|
*[[Hysterectomy]] (definitive treatment)<ref name="pmid308558612">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=30855861 | doi= | pmc= | url= }}</ref>
 
*[[Uterine artery embolization]]
*[[Endometrial ablation]]
|-
|[[Uterine cancer|Malignancy]] <ref name="pmid32965984">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=32965984 | doi= | pmc= | url= }}</ref>
|
*[[Surgical resection]] +/- [[adjuvant treatment]]
 
{| class="wikitable"
|+Surgical Treatment based on Cancer Stage
!Stage
!Treatment
|-
|1
|[[Transabdominal hysterectomy with bilateral salpingo-oophorectomy]]
|-
|2
|Radical or simple [[hysterectomy]] along with adjuvant [[radiotherapy]]
|-
|3
|[[Transabdominal hysterectomy with bilateral salpingo-oophorectomy]] and pelvic radiation
|-
|4
|Surgical resection and [[radiation]] therapy
|-
|5
|[[Palliative care]]; focus is on improving quality of life
|}
|-
|[[PCOS]]
|
*[[Laparoscopic surgery]]; [[ovarian drilling]]
|-
|[[Endometriosis]]
|
*[[Hysterectomy]]
*[[Endometrial ablation]]
|}


==References==
==References==

Latest revision as of 01:26, 7 August 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S, Vishnu Vardhan Serla M.B.B.S. [2]

Overview

Surgical procedures are reserved for patients that are unresponsive to medical treatment or those that do not desire fertility. Procedures can be specific according to underlying causes of dysfunctional bleeding as well as cancer stage. Common surgical interventions include hysterectomy, endometrial ablation and laparoscopic removal.

Surgery

As surgery is more invasive, it is often reserved for cases uncontrolled by medications or those not desiring fertility.[1] Underlying anatomical cases of DUB are also an indication for surgery. Surgical treatments can be tailored according to the underlying cause of bleeding.

Surgical Options
Condiiton Surgical Treatment[2]
Polyps
Adenomyosis
Leiomyoma (fibroids)
Malignancy [7]
Surgical Treatment based on Cancer Stage
Stage Treatment
1 Transabdominal hysterectomy with bilateral salpingo-oophorectomy
2 Radical or simple hysterectomy along with adjuvant radiotherapy
3 Transabdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic radiation
4 Surgical resection and radiation therapy
5 Palliative care; focus is on improving quality of life
PCOS
Endometriosis

References

  1. ↑ Albers JR, Hull SK, Wesley RM (2004). "Abnormal uterine bleeding". Am Fam Physician. 69 (8): 1915–26. PMID 15117012.
  2. ↑ "StatPearls".   ( ). 2022:  . PMID 30422508.
  3. ↑ "StatPearls".   ( ). 2022:  . PMID 30855861.
  4. ↑ Nijkang NP, Anderson L, Markham R, Manconi F (2019). "Endometrial polyps: Pathogenesis, sequelae and treatment". SAGE Open Med. 7 ( ): 2050312119848247. doi:10.1177/2050312119848247. PMC 6501471 Check |pmc= value (help). PMID 31105939.
  5. ↑ Taran FA, Stewart EA, Brucker S (2013). "Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy". Geburtshilfe Frauenheilkd. 73 (9): 924–931. doi:10.1055/s-0033-1350840. PMC 3859152. PMID 24771944.
  6. ↑ "StatPearls".   ( ). 2022:  . PMID 30855861.
  7. ↑ "StatPearls".   ( ). 2022:  . PMID 32965984 Check |pmid= value (help).

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