 |
 |
||
|
Endoscopy & Sexual Health Thomas L. Lyons, MD, to Address Quality of Life Post Hysterectomy at AAGL’s 38th Global Congress of Minimally Invasive GynecologyAbdominal Hysterectomy Rates Far Too HighTwenty years ago, in 1989 Thomas L. Lyons, MD, of the Center for Women’s Care & Reproductive Surgery in Atlanta developed the Laparoscopic Supracervical Hysterectomy (LSH). It leaves the cervix in place a keystone support for the anatomy, and since then he has trained hundreds of surgeons on the procedure. Studies have shown that women experience improved sexual function and can resume intercourse two weeks after the surgery, an outpatient procedure. Recuperative time is one week or less. However, a shocking 60-65% of the 600,000 hysterectomies annually in the U.S. are still performed abdominally, with long incisions. Recuperation time involves several days in the hospital and 6-8 weeks out of work. In 2005, the American College of Obstetrics & Gynecology expressed that the number of abdominal hysterectomies should be lowered to less than 30 percent. “The regrettable fact is that, even though LSH has proven effective for thousands of women worldwide, many members of our own professions still do not offer it as a viable option,” said Dr. Lyons. “However, smart health consumers are much more proactive in researching their own options on the Internet, and many are not willing to settle for the way it’s always been done,” he said. Potential Complications with Total Hysterectomy“Less is more in surgery,” explained Dr. Lyons. The LSH or sub-total hysterectomy spares the cervix, which is a small, doughnut shaped mass of tissue at the base of the uterus, and helps prevent pelvic prolapse. Additionally, leaving the cervix in place can help prevent the problem of dehistence, which is the vaginal incision’s breaking open during intercourse. Depending on the size of the opening, a woman may herniate bowel into the vagina; the bowel might become entrapped, causing potential compromise to the blood supply and the bowel might die. “When the cervix is removed, there’s no buffer—and the vaginal incision has to heal before intercourse is comfortable again,” he said. Dehistence is not a factor for patients who have had LSH because the cervix is still in place. Dr. Lyons explained that over the past two years, this has been a major topic of discussion on the American Association of Gynecologic Laparoscopists’ blog. Better Sexual Function Post Surgery Dr. Lyons and some researchers believe that for many women, the cervix may contribute to sexual pleasure. “Leaving the cervix in place helps prevent unnecessarily shortening the vaginal canal,” said Dr. Lyons. Research from a Finnish study in 1983 found pain upon intercourse pre-hysterectomy was better relieved by the cervix-sparing procedure. Another study of the same women determined that the frequency of orgasms decreased in women who had their cervix removed but not in those who hadn’t had it removed. Additional data collected about sexual function post-surgery often don’t even begin comparisons until one year after the procedures (either abdominal, laparoscopic, cervix-sparing or not) are performed. In those studies, sexual function customarily returns to normal after a year, no matter how the procedure was performed. “When I lecture about it, I comment that it’s only a year,” said Dr. Lyons drily. Often surgeons hesitate to recommend procedures that they are unable to perform, even though they are easier on the patient. Seeking Dr. Lyons through Internet research, patients come to him from around the world for advanced laparoscopic procedures with quick recovery times. Sexual Problems Cloaked by Other IssuesAlthough 99 percent of gynecologic patients visit their gynecologist with a problem related to sex, according to Thomas L. Lyons, MD, few walk through the door expressing that as the problem. Issues are usually described as pelvic pain, abnormal uterine bleeding or infertility, he explained. Endoscopic pioneer Dr. Lyons is a featured presenter and panelist at the American Association of Gynecologic Laparoscopists’ 38th Global Congress of Minimally Invasive Gynecology, November 15-19, 2009, in Orlando. One of AAGL’s early members, he is a world -renowned expert who has performed telesurgery and lectured for them since 1995. He will serve as a panelist on Endoscopy and Sexual Health. The AAGL Global Congress is the pre-eminent meeting for physicians interested in providing optimal patient care through minimally invasive gynecology. Performed through tiny incisions, laparoscopic or endoscopic procedures involve less pain, less risk and less recuperative time. From the standpoint of physical, emotional and economic wellbeing, and overall quality of life, endoscopic procedures make more sense than ever.
Center for Women's Care &
Reproductive Surgery© 2006 |
Printer Friendly Acrobat Reader Required
What To Do When the Doctor Says It's Endometriosis
"Everything you need to know to stop the pain and heal your fertility."
 |
 |