Gynecology

Gynecology

Gynecology is a medico-surgical specialty which deals with the physiology and affections of the female genital system. The specialist doctor who practices gynecology is called a gynecologist. The specialty of medical aspects for men is called andrology.

INDICATIONS:
Bleeding and / or
Pain caused by benign pathologies (fibroids, adenomyosis, etc.).
It can also be used to treat certain prolapse or gynecological cancers.
Total hysterectomy is the most common.
TREATMENTS
Surgery is mainly used to treat tumors confined to the cervix.
The purpose of surgery is to remove all of the tumor and eliminate the risk of recurrence. This most often involves removing the uterus and the network of lymph nodes located near the uterus.
Several types of interventions exist. The choice depends on the precise extent of the cancer. But your age and your possible desire for a child can also influence this choice.
ENLARGED COLPO-HYSTÉRECTOMY
The most frequently performed procedure is an enlarged colpo-hysterectomy, also known as the Wertheim procedure. During this procedure, the surgeon removes the uterus, the parameters and the upper part of the vagina. Most often, the ovaries also need to be removed. Enlarged colpo-hysterectomy is offered to treat tumors limited to the cervix and smaller than 4 centimeters in size.
Enlarged colpo-hysterectomy may be preceded by brachytherapy performed 6 to 8 weeks before the operation. Preoperative brachytherapy makes it possible to reduce the size of the tumor to promote its total removal during surgery. Most often, it takes about a week in hospital.

It is often necessary to remove the lymph nodes from the pelvis. This procedure, called lymph node dissection or pelvic lymphadenectomy, can be done before uterine surgery, but most often it is done at the same time as the enlarged colpohysterectomy.
The sentinel node technique is under evaluation. It involves removing the lymph node (s) closest to the tumor to determine if they have been invaded by cancer cells. This technique would avoid removing all of the lymph nodes from the pelvis if it is not necessary.

This operation involves removing only the uterus (simple hysterectomy) and also, in some cases, parameters and lymph nodes. This is called an enlarged hysterectomy.
Hysterectomy may be offered to treat small tumors limited to the cervix.

This information is given as an indication and must be transmitted by a doctor on the day of your treatment.

The information contained on this site should not be used as a substitute for a medical consultation. Always speak with your doctor for information on diagnosis and treatment.

A trachelectomy involves removing only the cervix and sometimes also the upper part of the vagina, parameters and lymph nodes (enlarged trachelectomy).
When the cervix is ​​removed, the surgeon makes special stitches (called cerclage) to partially close the uterus where the cervix was. The new orifice formed allows the evacuation of blood from the uterus to the vagina during menstruation.
This procedure can treat certain tumors limited to the cervix that are no larger than 2 centimeters in size, while preserving the uterus. This so-called conservative surgery is an alternative that can be offered to young women who wish to maintain their fertility and are considering a future pregnancy. Very delicate, this intervention is carried out in a few specialized centers in France.
This information is given as an indication and must be transmitted by a doctor on the day of your treatment.

The information contained on this site should not be used as a substitute for a medical consultation. Always speak with your doctor for information on diagnosis and treatment.

When the tumor is larger than 4 centimeters or when it has spread beyond the cervix (without forming distant metastasis), the standard treatment is concomitant radiochemotherapy.
However, this treatment can sometimes be supplemented by surgery. The need for surgery and the type of surgery to be performed are discussed on a case-by-case basis during the multidisciplinary consultation meeting.

This information is given as an indication and must be transmitted by a doctor on the day of your treatment.

The information contained on this site should not be used as a substitute for a medical consultation. Always speak with your doctor for information on diagnosis and treatment.

This can be done by:

Abdominal approach (laparotomy),
Vaginal use (hysteroscopy)
By laparoscopy:

Abdominal myomectomy requires an incision in the abdomen and one or more incisions in the uterus to remove the fibroid (s).

This information is given as an indication and must be transmitted by a doctor on the day of your treatment.

The information contained on this site should not be used as a substitute for a medical consultation. Always speak with your doctor for information on diagnosis and treatment.

A set of nerves run through the chest. The different types of tumors that can affect them are not serious.
Neurogenic tumors are treated with an operation. Most often, it is sufficient to remove them. Sometimes the presence of a neurosurgeon is necessary for the surgical work.
This is the subject of discussion during a multidisciplinary staff.
This information is given as an indication and must be transmitted by a doctor on the day of your treatment.

The information contained on this site should not be used as a substitute for a medical consultation. Always speak with your doctor for information on diagnosis and treatment.

The salpingectomy is performed under general anesthesia and requires hospitalization between one and five days.
There are two methods of performing a salpingectomy, similar to those of oophorectomy (removal of the ovaries).
Laparotomy ablation
During a laparotomy, the surgeon makes several incisions in the abdomen. He then uses it to insert instruments that will be used to remove the fallopian tube (s).

Ablation by laparoscopic surgery
The gynecological surgeon begins by injecting carbon dioxide directly into the abdomen using a needle and a thin tube. He can then insert an optical cable to follow the operation on a video screen. Incisions are made in the abdomen, to introduce the instruments necessary for the removal of the uterine tube (s).
The difference between these two methods and that during a laparotomy, one “opens” the abdomen of the patient, while a laparoscopic surgery keeps the abdomen “closed”, one sees inside with the help of an optical cable.
Why resort to salpingectomy?
Tubal infection
Salpingitis
This is the overall term for inflammation of the uterine tubes. Its causes are often sexually transmitted diseases, which cause inflammation of one or two tubes. It does not require the removal of the tubes, except in the case of a major complication.
Hydrosalpinx
Hydrosalpinx is an infection of one of the fallopian tubes. It fills with fluid, sometimes pus, which prevents it from functioning and delivering the eggs. If this infection is treated in time, one can simply unblock the affected tube. On the other hand, if it is too damaged to continue to function, even after the infection has passed, it must be removed by salpingectomy.
Pyosalpinx
One of the most severe complications of salpingitis, infection of the fallopian tubes. Purulent abscesses appear, which causes intense pain and in many cases prevents sterility of the patients. As with hydrosalpinx, the damaged tube will have to be removed by salpingectomy.
Tubal ectopic pregnancy
Ectopic pregnancy is an abnormal pregnancy (also called ectopic): instead of growing in the womb, the embryo develops elsewhere. In the ovary, or sometimes in the fallopian tubes that connect the ovary to the uterus.
This environment is absolutely not adapted to the good growth of an embryo. Worse, he endangers the mother by blocking this trunk.
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Definition
Oophorectomy is the removal of one or two ovaries in women. They are removed if there is a cyst or suspected infection or cancer. A woman can still have children with only one ovary. The operation is performed under anesthesia.

The ovaries will produce eggs, which are necessary for procreation, as well as hormones such as estrogen and progesterones. Therefore, if the oophorectomy involves the removal of both ovaries, it will lead to sterilization of the woman and trigger her menopause.

The removal of the ovaries or fallopian tubes are procedures mainly performed by laparoscopy (exploration of the abdomen). To do this, three small skin incisions are made to introduce the instruments and a camera into the abdominal cavity.

Depending on the case, the operation can take place on an outpatient basis, the patient being able, in principle, to go home the same evening. In the case of an oophorectomy performed for cancer, the length of hospital stay can vary from 1 to 7 days

This information is given as an indication and must be transmitted by a doctor on the day of your treatment.

The information contained on this site should not be used as a substitute for a medical consultation. Always speak with your doctor for information on diagnosis and treatment.

For French expatriates who are affiliated with the CFE (Caisse de Français de l’Etranger) you must
report your pregnancy within the first 3 months to https://www.ameli.fr/assure/droits-
procedures / family / maternity-paternity-adoption / pregnancy, if you would like to
take care of in a French hospital, we can put you in
contact with an approved hospital.

Why have you followed in France?
Some emerging countries have hospital structures but which are not at the level of
Western institutions and because of the complications that may arise during this
period, it is essential to be serene by the presence of a high-performance technical platform such as a
neonatal ward or intensive care unit.
In addition during this period you can count on the presence of your family to share
this unique period in the life of a woman
Your pregnancy can be monitored by a midwife or a doctor (general practitioner, Gynecologist
doctor or obstetrician-gynecologist). If it presents particular risks, regular monitoring should
be insured by an obstetrician-gynecologist.
Support is provided throughout your pregnancy period and consists of the stages
following:
1. Before the end of the 3rd month, prenatal examinations with the completion of a 1st
ultrasound and biological examinations for screening
rubella, toxoplasmosis, hepatitis B, blood group, HIV, albuminuria,
Detection of irregular antibodies, Glycosuria, Assay of markers of
Fetal trisomy 21.
2. 4th month, additional examinations with an early prenatal interview and oral check-up.
dental.
3. 5 th MONTH, Prenatal examination with 2 nd ultrasound
4. 6 th MONTH, Prenatal examination
5. 7 th MONTH, Prenatal examination with beginning of the 7 sessions of preparation for birth and
parenthood
6. 8 th MONTH, Prenatal examination with 3 rd ultrasound and consultation with an anesthetist
7. 9th MONTH, Prenatal examination with end of the preparation sessions for birth and
parenthood.

Oophorectomy involves the removal of one ovary (unilateral oophorectomy) or both ovaries (bilateral oophorectomy) and is commonly associated with the simultaneous removal of the fallopian tubes (salpingo-oophorectomy) due to:
Cyst or
Benign ovarian tumor
Endometriosis
Torsion of the ovary
Tubo-ovarian abscess
Ovarian cancer
Increased risk (BRCA1 or BRCA2 gene mutations) of ovarian cancer or breast cancer

Surgical intervention :
Ovariectomy by laparoscopy (or laparoscopy), the most frequent, the most recent, and minimally invasive technique, consisting in making several small incisions (3 or even 4) on the abdomen to introduce the operating instruments, to perform the intervention by video /camera. This technique allows a shorter hospital stay and has the advantage of being not very aggressive, causing little postoperative pain, and allows a rapid resumption of daily activities

After the intervention:
Taking simple analgesics
Possibly rapid resumption of normal daily activities and light activities
Resumption of normal physical and sports activities after 1 month
No specific post-operative diet
Work stoppage of 2 to 4 weeks, depending on the physical nature of the profession or not
In the event of a laparoscopy: pain towards the shoulders or under the ribs may occur the day after the operation and disappear within 24 / 48h
Post-operative consultation 1 month after the operation by your surgeon

Duration of the intervention: 1 hour
Average length of hospitalization: 2 to 4 days

Little painful intervention
Under general anesthesia

Excellent
Cosmetic
Surgery

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