Treatments for Hysterectomy
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Pelvic Masses - Female:
Treatment
(In a Page: Signs and Symptoms)
- Treat the underlying etiology
- Ovarian masses
–Premenarchal: Immediate gynecologic referral because of high malignancy potential
–Premenopausal: If simple ovarian cyst <10 cm, observe 4–6 weeks, attempt to suppress with OCP; if persists, consider diagnostic laparoscopy; surgical evaluation is indicated if ovarian solid mass, complex cyst, or ascites is present
–Postmenopausal: If <3 cm, asymptomatic, and normal exam, follow with serial ultrasounds; if persists, consider surgical evaluation; laparoscopy if cyst is >3 cm, symptomatic, or solid
- Leiomyoma
–Hypoestrogenic medications (e.g., Depo-Provera, leuprolide)
–Minimally invasive procedures: Hysteroscopic laser
myomectomy, uterine artery embolization
–Surgical: Myomectomy versus hysterectomy
>>>>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Pelvic Pain - Female:
Treatment
(In a Page: Signs and Symptoms)
-
Primary dysmenorrhea: NSAIDs; consider oral contraceptives to suppress ovulation in severe disease
-
Positive pregnancy test: Determine last menstrual period; obtain quantitative β-hCG; confirm intrauterine pregnancy
-
In patients at high risk for STDs, treat empirically for PID (to cover gonorrhea and Chlamydia)
–Ofloxacin 400 mg PO BID for 14 days plus metronidazole 500 mg PO BID for 14 days, or
–Ceftriaxone 250 mg IM single dose plus doxycycline 100 mg PO BID for 14 days
-
Endometriosis: Treat with hormonal medications or surgical
laparoscopy
–Oral contraceptives for 3–4 months, or
–Provera 39 mg QD for 2 months, or
–Danazol 200–800 mg QD for 6 months, or
–GnRH agonist (e.g., leuprolide)
'>>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Pelvic inflammatory disease:
Treatment
(Professional Guide to Diseases (Eighth Edition))
To prevent progression of PID, antibiotic therapy begins immediately after culture specimens are obtained. Such therapy can be re-evaluated as soon as laboratory results are available (usually after 24 to 48 hours). Infection may become chronic if treated inadequately.
Development of a pelvic abscess necessitates adequate drainage. A ruptured abscess is life-threatening. If this complication develops, the patient may need a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Alternatively, laparoscopic drainage with preservation of the ovaries and uterus may be done.
Concurrent treatment of sexual partners and condom use throughout the course of treatment are necessary.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Pelvic inflammatory disease:
Treatment
(Handbook of Diseases)
To prevent the progression of PID, antibiotic therapy begins immediately after culture specimens are obtained. Such therapy can be reevaluated when laboratory test results are available (usually after 24 to 48 hours); infection may become chronic if treated inadequately.
The guidelines of the Centers for Disease Control and Prevention (CDC) for outpatient treatment include a single dose of cefoxitin plus probenecid given concurrently or a single dose of ceftriaxone. Each of these regimens is given with doxycycline for 14 days.
The CDC guidelines for inpatient treatment recommend doxycycline alone or a combination of clindamycin and gentamicin.
Development of a pelvic abscess necessitates adequate drainage. A ruptured abscess is life threatening. If this complication develops, the patient may need a total abdominal hysterectomy with bilateral salpingo-oophorectomy.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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