Loaʻa i nā Wahine ʻAmelika nā Hysterectomies pono ʻole?

Anter

• ʻO ka mea mua, he aha ka hysterectomy?
• No ke aha i loaʻa ai nā wahine he nui i ka hysterectomies?
• Nā ʻokoʻa lāhui i ka Hysterectomy
• Pehea e loaʻa ai ka mālama āu e pono ai
• Nānā no

ʻO ka hemo ʻana i ka kōpū o ka wahine, ʻo ka ʻokana ke kuleana no ka ulu ʻana, a me ka hāpai ʻana i kahi pēpē a me ka menstruation nui loa. No laila e kahaha paha ʻoe i ka ʻike ʻana i ka hysterectomy - ka hoʻoneʻe ʻana i ka uterus i hiki ʻole ke hoʻihoʻi ʻia - ʻo ia kekahi o nā hana i hana pinepine ʻia i nā wahine ma ka U.S. Yep, ua lohe ʻoe i ka pololei: Kekahi 600,000 Hana ʻia nā hysterectomies i kēlā me kēia makahiki i ka US.

"Ma mua o ka lāʻau hou, ua ʻike ʻia nā hysterectomies ma ke ʻano he lapaʻau no nā pilikia āpau e hele mai ai ka wahine i ke kauka a i mea hoola paha," i wehewehe ai ʻo Heather Irobunda, M.D., kahi ob-gyn i hōʻoia ʻia e ka papa ma New York City. "I ka moʻolelo hou aku nei, ʻo nā pilikia a ka wahine e lawe ai i kāna kauka i pili i kāna pelvis hiki ke mālama ʻia me ka hysterectomy."

I kēia lā, nui nā maʻi - cancer, debilitating fibroids (non-cancerous ulu i ka io o kou kōpū i hiki nui loa ʻeha), kahe ʻole o ke kahe - hiki iā ia ke alakaʻi i kahi kauka e ʻōlelo i kahi hysterectomy. Akā hoʻopaʻapaʻa ka nui o ka poʻe loea i ka ʻoi loa o ke ʻoki kino a kuhikuhi ʻia, no nā kūlana like me nā fibroids - no nā wahine kala.

No laila he aha kāu e pono ai e ʻike e pili ana i kēia kaʻina hana maʻamau, kēia mau ʻokoʻa lāhui, a - ka mea nui - he aha ka mea oe hana inā hāʻawi ʻia ʻoe i hoʻokahi ma ke ʻano he lapaʻau?

ʻO ka mea mua, he aha ka hysterectomy?

I ka pōkole, he hana ia e wehe ai i ka ʻōpū, akā aia nā ʻano ʻano hysterectomy. Kuhi ke Kulanui ʻAmelika o nā Obstetricians a me nā Gynecologists (ACOG) i ka nui o ka hysterectomy ke hiki i kāu uterus holoʻokoʻa (me kāu cervix, ka hopena haʻahaʻa o kou kōpū e hoʻopili i ka pūpū a me nā ʻōpū). ʻO kahi supracervical (aka kahi subtotal a hapa paha) hysterectomy ke lawe ʻia ka ʻaoʻao luna o kāu kōpū (akā ʻaʻole ka cervix). A ʻo kahi hysterectomy radical ke loaʻa iā ʻoe kahi hysterectomy āpau me ka lawe ʻia ʻana o nā hale e like me kāu ovaries, a i ʻole nā ​​paipu Fallopian (e ʻōlelo, i ka maʻi ʻaʻai.

Hoʻohana pinepine ʻia ʻo Hysterectomy e mālama i ka make o nā kūlana olakino mai fibroids a me ka prolaps uterine (ke iho i lalo a i ʻole i loko o ka ʻōpū) i ka hoʻokahe ʻia ʻana o ka uterine, nā maʻi ʻeha gynecologic, ʻeha pelvic maʻi mau, a me ka endometriosis, e like me ka ACOG.

Ma muli o ke ʻano o ka hysterectomy āu e pono ai (a me ke kumu o kou makemake ʻana), hiki ke hana ʻia ke ʻoki i kekahi mau ʻano like ʻole: ma o kou ʻōpū, ma kou ʻōpū, a i ʻole ma ka laparoscopy - kahi i hoʻokomo ʻia ai kahi telescope liʻiliʻi no ka ʻike a hiki i kahi kauka ke hana i ke kaha me nā kaha liʻiliʻi liʻiliʻi loa.

No ke aha i loaʻa ai nā wahine he nui i ka hysterectomies?

ʻO kekahi hysterectomies (e like me nā mea i hana ʻia ma o kou ʻōpū) ʻoi aku ka nui o ka invasive ma mua o nā mea ʻē aʻe (hana ʻia ma o laparoscopy). A he mea pono nō hoʻi ia e hoʻomaopopo i nā manawa he nui, ʻoiai ke kuhikuhi ʻia ka hysterectomy, aia kekahi mau koho lapaʻau ʻē aʻe (e ʻōlelo, no nā pilikia e like me fibroids a endometriosis). Ka pilikia? ʻAʻole hōʻike ʻia kēlā mau koho ma ke ʻano he koho maoli ma nā wahi āpau.

"I kekahi manawa, kaukaʻi ʻia i ka ʻāpana o ka ʻāina āu e noho nei, aia kekahi poʻe kauka lapaʻau ʻoluʻolu ʻole me nā hana hoʻoweliweli liʻiliʻi e alakaʻi aku ai i kēlā mau wahine e loaʻa ana i nā hysterectomies," i wehewehe ai ʻo Kauka Irobuna.

Eia kekahi laʻana: Ke hoʻohana ʻia no ka fibroids, hysterectomy hana ʻaʻole e hoʻi hou nā hōʻailona (ma hope o nā mea a pau, ua hala kou ʻōpū kahi i loaʻa ai kēlā mau fibroids), akā hiki iā ʻoe ke wehe i nā fibroids a waiho i ka ʻōpū ma kahi. "Manaʻo wau aia nā hysterectomies i ʻōlelo ʻia e nā kauka ma muli wale nō o ka loaʻa ʻana o nā fibroids ma kahi hoʻokolohua," wahi a Jeff Arrington, M.D., he kauka lapaʻau gynecologic advanced minimally invasive a me ka loea endometriosis ma The Center for Endometriosis ma Atlanta, GA. A ʻoiai ʻo ka fibroids hiki ke hōʻeha a hoʻonāwaliwali loa (a hiki i ka hysterectomy ke kōkua i ka hoʻopau ʻana i kēlā ʻeha), hiki ʻole i nā fibroids ke ʻeha ʻole. "He nui nā mea maʻi e hoʻomaʻamaʻa maikaʻi inā aia nā fibroid ma laila a he ʻano maikaʻi lākou," wahi a Dr. Arrington o ke koho e hana ʻole.

ʻO nā kaʻina hana liʻiliʻi ʻē aʻe e pili ana i ka myomectomy (ke ʻoki e wehe i nā fibroids mai ka ʻōpū), nā lapaʻau e like me ka fibroid uterine embolization (ʻoki i ke koko i nā fibroids), a me ka radiofrequency ablation (ʻo ia ka mea e puhi ai i nā fibroids). Eia kekahi, nui nā koho lapaʻau non-invasive e like me ka contraceptive waha a me nā lāʻau lapaʻau ʻē aʻe.

Akā, eia ka mea: "Ua lōʻihi ka lōʻihi o ka Hysterectomies, a aʻo kēlā me kēia gynecologist pehea e hana ai iā lākou i kā lākou noho hoʻomaʻamaʻa noho ʻana - [akā] ʻaʻole ia he ʻoiaʻiʻo no nā koho lapaʻau āpau," e pili pū ana me kēia mau kaʻina hana hoʻoemi liʻiliʻi. wahi a Kauka Irobuna.

Ma kēia ʻano, ʻoiai ʻo ka hysterectomy i manaʻo ʻia he "ʻoiaʻiʻo" (heluhelu: mau loa) no ka endometriosis, "ʻaʻohe mea hōʻike - ʻaʻole hoʻokahi haʻawina - e hōʻike ana i ka hele wale ʻana a wehe i kahi kōpū e hoʻopau i nā endometriosis ʻē aʻe a pau. aku, "wehewehe a Kauka Arrington. Ma hope o nā mea āpau, ma ka wehewehe ʻana, ʻo ka endometriosis ke ʻano like ke ʻano o ka uhi o ka uterus waho o ka kōpū. ʻO Hysterectomy, i ʻōlelo ʻo ia, hiki hoʻomaikaʻi i nā pae ʻeha o ka endometriosis o kekahi poʻe, akā ʻaʻole ia iā ia a mālama iā ia i ka maʻi. (Pili: ʻO Lena Dunham i loaʻa kahi Hysterectomy piha e hōʻoki i kāna ʻeha endometriosis)

No laila no ke aha e hāʻawi pinepine ʻia ai ka hysterectomy i nā wahine me ka endometriosis? He paʻakikī ke ʻōlelo, akā hiki i ka hoʻomaʻamaʻa, hōʻoluʻolu, a me ka hōʻike ʻana, wahi a Dr. Arrington. Hoʻomaʻamaʻa maikaʻi ʻia ʻo Endometriosis ma o ka hemo ʻana o ka endometriosis ponoʻī, i ʻike ʻia ma ke ʻano he ʻoki kūloko. A ʻaʻole hoʻomaʻamaʻa ʻia kēlā me kēia kōkō i kēia ʻano ʻoki kino e like me ke ʻano e aʻo mau ʻia ai nā hysterectomies.

Nā ʻokoʻa lāhui i ka Hysterectomy

ʻO kēia overprescribing o hysterectomies e lilo i mea ʻikea ke nānā aku i ka mōʻaukala o ka hana ma waena o nā mea maʻi ʻeleʻele. Ke hōʻike nei kekahi mau noiʻi i nā wahine ʻeleʻele ʻehā mau manawa e loaʻa i ka hysterectomy ma mua o nā wahine keʻokeʻo. Ua hōʻike pū nā Centers for Disease Control and Prevention (CDC) i ka ʻikepili e hōʻike ana i ka ʻokoʻa lāhui i waena o ka poʻe i loaʻa ke kaʻina hana. A loaʻa nā noiʻi ʻē aʻe he mau hysterectomies nā wahine ʻeleʻele i ke kiʻekiʻe kiʻekiʻe ma mua o kekahi heihei ʻē aʻe.

Maʻemaʻe ka noiʻi a me nā loea: ʻoi aku paha ka maikaʻi o nā wahine ʻeleʻele ma mua o nā wahine keʻokeʻo e hana i ka hysterectomy, wahi a Melissa Simon, MD, ka luna o ka Institute for Public Health and Medicine Center for Health Equity Transformation ma Northwestern's Feinberg School of Medicine. ʻO ka mea maʻamau, ʻoi aku ka nui o ka loaʻa ʻana o ka hysterectomy abdominal invasive, hoʻohui ʻo ia.

Nui paha nā kumu no kēia. No hoʻokahi, ʻike nā wahine ʻeleʻele i nā fibroids - kekahi o nā kumu maʻamau no ka hysterectomy ma waena o nā lāhui āpau - ma nā helu kiʻekiʻe ma mua o nā wahine keʻokeʻo. "ʻOi aku ka nui o nā kumu hana i ʻelua a ʻekolu mau manawa i nā wahine ʻAmelika ʻAmelika ma mua o nā wahine keʻokeʻo ma ʻAmelika," i ʻōlelo ʻia ʻo Charlotte Owens, MD, ka luna lapaʻau o ka lāʻau lapaʻau ma AbbVie. "Hoʻokumu pū kekahi nā wahine ʻApelika ʻAmelika e hoʻomohala i nā hōʻailona ʻoi loa a ma mua, pinepine i ko lākou 20s." ʻAʻole maopopo ka poʻe akamai i ke kumu o kēia, wahi a Kauka Owens.

Akā ʻoi aku ka nui o ka ʻokoʻa lāhui ma mua o ka maʻi fibroids. No hoʻokahi, kēlā pilikia o ke kiʻi ʻana i nā hōʻailona hōʻemi iki? Hiki iā ia ke pā ikaika i nā wahine o ke kala. "ʻAʻole hiki ke loaʻa ke kālā no kekahi o nā ʻenehana e pono ai no ka hoʻokō ʻana i nā lāʻau lapaʻau kiʻekiʻe, ʻoi aku ka liʻiliʻi o ka invasive ma nā halemai e lawelawe ana i kekahi o nā kaiāulu kahi e noho ai kekahi mau wahine ʻeleʻele," wehewehe ʻo Dr. Irobunda. (Pili: ʻO kēia Wahine Wahine Hōʻeuʻeu Huakaʻi Hoʻohālikelike i nā Disparities i ke olakino olakino no nā wahine ʻeleʻele)

Eia kekahi, i ka wā e pili ana i nā koho no ka mālama ʻana i nā wahine o ka waihoʻoluʻu a me ka mālama fibroid, ʻaʻole i kūkākūkā pinepine ʻia nā koho like ʻole, wahi a Kecia Gaither, M.D., M.P.H., he kauka lapaʻau ob-gyn a maternal-fetal ma NYC Health Hospitals/Lincoln. "Hāʻawi ʻia ka Hysterectomy ma ke ʻano he koho therapeutic hoʻokahi." Akā ʻo ka ʻoiaʻiʻo o kēia mea, ʻoiai he koho pinepine ka hysterectomy ma ka papa kuhikuhi o ka wahine no nā koho lapaʻau, ʻaʻole ia ka wale koho. A ʻaʻole pono ʻoe e noʻonoʻo e like me ʻoe e lawe ai a haʻalele iā ia i kou wā olakino.

I kēia nui, aia ka ʻōiwi ʻōnaehana a me ka līkaha e hoʻokau nei i kahi kuleana ma aneʻi, wahi a ka poʻe loea. Ma hope o nā mea āpau, he nui nā pelvic a me nā kaʻina hānau i loaʻa nā aʻa lāhui e like me ka mea i hana mua ʻia a hoʻokolohua ʻia ma luna o nā kauā wahine ʻeleʻele. I nā makahiki 2000 mua, aia kekahi mau hihia o ka sterilization non-consensual i ka ʻōnaehana paʻahao Kaleponi, wehewehe ʻo Dr. Irobuna.

"Kaulana nō ia e pili ana ke kuhihewa e pili ana i nā wahine ʻeleʻele a me ka mālama olakino - ua ʻike maka wau iā ia," wahi a Kauka Gaither.

Hiki ke hoʻomālamalama ʻia nā bias o nā kauka. Inā manaʻo kahi kauka, no ka laʻana, ʻaʻole hiki i nā wahine ʻeleʻele ke kūlike me nā koho lapaʻau e like me ka pill kaohi hānau o kēlā me kēia lā a i ʻole kahi kī (e like me Depo Provera i hiki ke kōkua me ka ʻeha pelvic a me ke kahe nui o ka menstrual) e ʻoi aku paha lākou. e hāʻawi paha i kahi lāʻau hoʻōla hou e like me ka hysterectomy, i ʻōlelo ʻo ia. "ʻO wau, eia nō naʻe, ua nui nā maʻi wahine ʻeleʻele i hele mai e ʻike iaʻu me nā hopohopo ma hope o ka hāʻawi ʻia ʻana o nā hysterectomies e kekahi poʻe kauka ʻē aʻe a ʻaʻole maopopo inā he hysterectomy ke ʻano kūpono o ka mālama ʻana iā lākou."

Pehea e loaʻa ai ka mālama āu e pono ai

He lāʻau lapaʻau koʻikoʻi nā Hysterectomies no kekahi mau pilikia olakino - ʻaʻohe nīnau. Akā e hāʻawi ʻia nā kaʻina hana ma ke ʻano he he ʻāpana o kahi hoʻolālā mālama kūpono, a ma ke ʻano he koho. "He mea nui ia me ka hoʻoholo ʻana he mea nui e like me ka hemo ʻana o kahi ʻōpala, maopopo ka mea hoʻomanawanui i nā mea e hana nei me kona kino a me nā ʻano o nā koho i loaʻa no ka lapaʻau ʻana," wahi a Kauka Irobunda.

Ma hope o nā mea a pau, hiki mai ka hysterectomy me nā hopena ʻaoʻao - nā mea āpau mai ka hiki ʻole ke hānau keiki i ka constipation a i ʻole ka hoʻohaʻahaʻa ʻana i ka naʻau a me ka menopause mua a me ka koke inā ʻaʻole ʻoe i hele maʻamau i kēia. (BTW, hysterectomies kekahi o * nui * kumu o ka menopause mua.)

ʻO kekahi mau mea e noʻonoʻo ai inā piʻi mai ka hysterectomy i ke kamaʻilio? "Kūkākūkā mau wau i nā mea maʻi, ʻo ka poʻe maʻi hoʻi o ke kala a me nā maʻi ʻeleʻele, mai makaʻu e nīnau i nā nīnau," wahi a Dr. Simon. "E nīnau no ke aha e koi aku ai kahi kauka lapaʻau a i ʻole kauka i kahi hoʻokokoke ʻana i ka lāʻau no kekahi ʻano pilikino, e nīnau inā aia he mau koho lapaʻau ʻē aʻe, a - inā hoʻoholo ʻia he hysterectomy. ʻo ia ke ala e hele ai - e nīnau e pili ana i nā ala e hiki ke hoʻohana ʻia, e like me ke ala liʻiliʻi-invasive."

I ka pōkole: Pono ʻoe e noʻonoʻo ua pane ʻia kāu mau nīnau a lohe ʻia ʻoe. Inā ʻaʻole ʻoe, e ʻimi i ka manaʻo ʻelua (a ʻekolu paha), wahi āna. (E pili pū ana: 4 mau mea e pono ai i kēlā me kēia wahine ke hana no kona ola kino, e like me ka Ob-Gyn)

ʻO ka hope loa, ʻo ka hysterectomy kahi koho pilikino e pili ana i nā mea āpau mai ka pilikia āu e kū nei, i ke ʻano o ke ola āu e noho nei, a he aha kāu pahuhopu. A ʻo ka laina lalo, ʻo ia ka hōʻoia ʻana ua ʻike ʻia ʻoe e like me ka hiki ke kī.

"Ke ho'āʻo nei au e hele i nā koho likeʻole a pau, nā mea maikaʻi a me nā pōʻino, a laila e kōkua i ka mea maʻi e hoʻoholo i ka koho kūpono no lākou," wahi a Dr. Arrington.

Nānā no