Cov poj niam Asmeskas puas muaj qhov tsis tsim nyog hysterectomies?

Zoo Siab

• Ua ntej, qhov kev phais plab yog dab tsi?
• Vim li cas thiaj muaj coob tus poj niam tau txais hysterectomies?
• Racial Differences In Hysterectomy
• Yuav Tau Txais Kev Saib Xyuas Li Cas Koj Tsim Nyog
• Ntsuam xyuas rau

Tshem tus poj niam lub tsev menyuam, lub cev ua lub luag haujlwm rau kev loj hlob, thiab nqa menyuam thiab lub cev ntas yog qhov loj. Yog li koj yuav xav tsis thoob kom paub tias kev hlais menyuam hauv plab - phais tsis tuaj yeem tshem tawm ntawm lub tsev menyuam - yog ib qho kev phais feem ntau ua rau poj niam hauv Asmeskas Yep, koj tau hnov ​​txoj cai ntawd: 600,000 hysterectomies tau ua txhua xyoo hauv Teb Chaws Asmeskas Thiab los ntawm qee qhov suav, ib feem peb ntawm tag nrho cov poj niam Asmeskas yuav muaj ib tug thaum muaj hnub nyoog 60 xyoo.

Heather Irobunda, MD piav qhia Heather Irobunda, MD, pawg thawj coj saib xyuas ob-gyn hauv New York City tau hais tias "Ua ntej siv tshuaj niaj hnub no, kev phais plab tau pom tias yog kev kho mob rau ntau yam teeb meem uas tus poj niam yuav tuaj ntsib kws kho mob lossis tus neeg kho mob rau". "Hauv keeb kwm yav dhau los tsis ntev los no, txhua yam teeb meem uas tus poj niam yuav coj mus rau nws tus kws kho mob uas koom nrog nws lub plab tuaj yeem raug kho nrog kev phais plab hlaub."

Niaj hnub no, ntau yam mob-mob qog noj ntshav, ua rau lub cev tsis muaj zog (kev loj hlob tsis yog mob qog noj ntshav hauv cov leeg ntawm koj lub tsev menyuam uas tuaj yeem ua tau zoo heev mob), ntshav txawv txav - tuaj yeem ua tus kws kho mob pom zoo kom phais plab hlaub. Tab sis ntau tus kws tshaj lij sib cav hais tias kev phais tau ua tiav dhau thiab tau sau tseg, tshwj xeeb rau qee yam mob xws li fibroids-tshwj xeeb rau cov poj niam uas muaj xim.

Yog li dab tsi koj yuav tsum paub txog cov txheej txheem no ib txwm muaj, kev tsis sib xws ntawm haiv neeg, thiab - qhov tseem ceeb tshaj plaws - yuav tsum ua dab tsi koj ua yog tias koj puas tau muab ib qho kev kho mob?

Ua ntej, qhov kev phais plab yog dab tsi?

Hauv ntej, nws yog tus txheej txheem uas tshem tawm lub tsev menyuam, tab sis muaj ntau yam sib txawv ntawm hysterectomy. American College of Obstetricians and Gynecologists (ACOG) sau tseg tias tag nrho cov kev phais menyuam yog thaum koj lub tsev menyuam tag nrho (suav nrog koj lub ncauj tsev menyuam, qis qis ntawm koj lub tsev menyuam uas txuas rau lub tsev menyuam thiab chaw mos). Supracervical (aka a subtotal or partial) hysterectomy yog thaum tsuas yog ib sab ntawm koj lub tsev menyuam (tab sis tsis yog lub ncauj tsev menyuam) raug tshem tawm. Thiab qhov kev phais mob hnyav yog thaum koj muaj tag nrho txoj kev hlais me nyuam ntxiv rau kev tshem tawm cov qauv xws li koj lub zes qe menyuam, lossis cov hlab ntaws (hais, thaum muaj mob qog noj ntshav).

Hysterectomy feem ntau yog siv los kho cov kev mob nkeeg los ntawm fibroids thiab uterine prolapse (thaum lub tsev menyuam sags mus rau los yog mus rau hauv qhov chaw mos) mus rau uterine los ntshav, gynecologic cancer, mob pelvic mob, thiab txawm endometriosis, raws li ACOG.

Nyob ntawm seb hom hysterectomy koj xav tau dab tsi (thiab qhov laj thawj koj xav tau nws yog dab tsi), kev phais tuaj yeem ua ob peb txoj hauv kev sib txawv: los ntawm koj lub paum, los ntawm koj lub plab, lossis ntawm laparoscopy - qhov twg tsom iav me me tso rau kom pom kev thiab tus kws phais muaj peev xwm ua qhov kev phais nrog ntau qhov me me.

Vim li cas thiaj muaj coob tus poj niam tau txais hysterectomies?

Qee qhov hysterectomies (xws li cov uas ua los ntawm koj lub plab) yog qhov cuam tshuam ntau dua li lwm tus (ib qho ua los ntawm laparoscopy). Thiab nws tseem tsim nyog sau cia tias ntau zaus, txawm tias thaum hysterectomy qhia, muaj lwm txoj hauv kev kho mob (hais, rau cov teeb meem xws li fibroids lossis endometriosis). Qhov teeb meem? Cov kev xaiv no tsis yog ib txwm nthuav tawm raws li kev xaiv muaj tseeb nyob txhua qhov chaw.

"Qee lub sij hawm, nyob ntawm ib feem ntawm lub teb chaws koj nyob hauv, muaj cov kws phais neeg uas tsis xis nyob nrog kev kho mob tsawg dua uas ua rau tag nrho cov poj niam tau txais hysterectomies," piav qhia Dr. Irobuna.

Nov yog ib qho piv txwv: Thaum siv rau fibroids, hysterectomy ua yuav xyuas kom meej tias cov tsos mob yuav tsis rov qab los (tom qab tag nrho, koj lub tsev menyuam uas muaj cov fibroids tam sim no ploj mus), tab sis koj tuaj yeem phais tshem tawm cov fibroids thiab tawm hauv tsev menyuam. "Kuv xav tias muaj hysterectomies uas tau pom zoo los ntawm cov kws kho mob vim lawv pom fibroids ntawm kev kuaj mob," hais tias Jeff Arrington, MD, tus kws phais mob qog noj ntshav tsawg tsawg thiab tus kws kho mob endometriosis ntawm Lub Chaw rau Endometriosis hauv Atlanta, GA. Thiab thaum cov fibroids tuaj yeem ua rau mob hnyav heev thiab ua tsis taus pa (thiab hysterectomy tuaj yeem pab tshem tawm qhov mob), fibroids kuj tuaj yeem tsis mob. Dr. Arrington hais tias "Yuav muaj ntau tus neeg mob uas yuav nkag siab zoo tias fibroids nyob ntawd thiab tias lawv yog benign," hais tias Dr. Arrington ntawm qhov kev xaiv tsis ua haujlwm.

Lwm cov txheej txheem nruj me ntsis suav nrog myomectomy (kev phais kom tshem tawm cov fibroids ntawm lub tsev menyuam), kev kho mob xws li uterine fibroid embolization (txiav cov ntshav tawm mus rau fibroids), thiab radiofrequency ablation (uas yog qhov pib hlawv cov fibroids). Ntxiv rau, muaj ntau txoj hauv kev kho mob uas tsis cuam tshuam xws li tshuaj tiv thaiv qhov ncauj thiab lwm yam tshuaj.

Tab sis, ntawm no yog qhov: "Hysterectomies tau nyob ib ncig ntawm lub sijhawm ntev, thiab txhua tus kws kho mob gynecologist kawm yuav ua li cas rau lawv hauv lawv qhov kev cob qhia nyob - [tab sis] tsis muaj tseeb rau txhua txoj kev kho mob," suav nrog cov txheej txheem tsis tshua muaj kev cuam tshuam, hais tias Dr. Irobuna.

Hauv txoj hlab ntshav no, thaum kev phais plab hlaub raug txiav txim siab "qhov tseeb" (nyeem: tas mus li) kev kho mob endometriosis, "tsis muaj pov thawj - tsis yog kev tshawb fawb ib leeg - uas qhia tau tias tsuas yog nkag mus thiab tshem lub tsev menyuam tawm mus ua qhov zoo tag nrho ntawm lwm qhov endometriosis mus nyob deb, "piav qhia Dr. Arrington. Tom qab tag nrho, los ntawm kev txhais, endometriosis yog thaum cov ntaub so ntswg uas zoo ib yam li ntawm ob sab ntawm lub tsev menyuam loj tuaj sab nraum ntawm lub tsev menyuam. Hysterectomy, nws hais tias, ua tau txhim kho qee tus neeg mob endometriosis, tab sis nws tsis nyob hauv thiab ntawm nws tus kheej kho tus kab mob. (Txog: Lena Dunham Muaj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj Hwj, Lena Dunham Tag Nrho Hysterectomy kom tsis txhob mob Endometriosis)

Yog li vim li cas thiaj li siv tshuaj hysterectomy feem ntau muab rau cov poj niam uas muaj endometriosis? Nws nyuaj rau hais, tab sis nws tuaj yeem nqes mus rau kev cob qhia, kev nplij siab, thiab raug, hais tias Dr. Arrington. Endometriosis yog kho tau zoo tshaj plaws ntawm kev phais tshem tawm ntawm endometriosis nws tus kheej, hu ua excision phais, nws hais. Thiab tsis yog txhua tus kws phais neeg raug cob qhia hauv hom kev phais zoo ib yam li hysterectomies feem ntau qhia.

Racial Differences In Hysterectomy

Qhov kev sau ntau dhau ntawm cov tshuaj no dhau los ua qhov pom tau ntau dua thaum saib keeb kwm ntawm kev coj ua ntawm cov neeg mob Dub. Qee qhov kev tshawb fawb qhia tias cov poj niam Dub muaj plaub npaug ntau dua yuav tau txais hysterectomy dua li cov poj niam dawb. Lub Chaw Tiv Thaiv thiab Tiv Thaiv Kab Mob (CDC) kuj tau tshaj tawm cov ntaub ntawv uas qhia txog kev ntxub ntxaug lwm haiv neeg ntawm cov neeg uas muaj cov txheej txheem. Thiab lwm qhov kev tshawb fawb pom tias Cov poj niam Dub muaj kev hlais menyuam hauv siab ntau dua li ib yam lwm haiv neeg.

Cov kev tshawb fawb thiab cov kws tshaj lij tau pom tseeb: Cov poj niam dub yeej muaj feem ntau dua li cov poj niam dawb kom tau txais hysterectomy, hais tias Melissa Simon, MD, tus thawj coj ntawm Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Tshuaj Khomob rau Kev Noj Qab Haus Huv Kev Ncaj Ncees ntawm Northwestern's Feinberg School of Medicine. Qhov tseem ceeb, lawv kuj muaj feem ntau yuav ua rau mob plab hysterectomy ntau dua, nws hais ntxiv.

Yuav muaj ntau qhov laj thawj rau qhov no. Rau ib qho, Cov poj niam Dub ntsib cov qog nqaij hlav - ib qho ntawm qhov laj thawj uas ua rau tsis muaj menyuam hauv txhua haiv neeg - ntawm tus nqi ntau dua li poj niam dawb. Charlotte Owens, MD, tus thawj coj saib xyuas kev noj qab haus huv ntawm AbbVie hais tias "Cov xwm txheej tshwm sim yog ob txog peb zaug ntau dua hauv Asmeskas African poj niam dua li cov poj niam dawb hauv Asmeskas." "Cov poj niam African Asmeskas kuj zoo li tsim cov tsos mob hnyav dua thiab ua ntej, feem ntau hauv lawv 20s." Cov kws tshaj lij tsis paub meej tias vim li cas qhov no thiaj li tshwm sim, hais tias Dr. Owens.

Tab sis muaj feem ntau rau kev sib txawv ntawm haiv neeg ntau dua li qhov tshwm sim ntawm fibroids. Rau ib qho, qhov teeb meem ntawm kev nkag mus rau kev kho mob tsawg dua? Nws tuaj yeem tsoo cov poj niam uas muaj xim tawv dua. "Cov nyiaj txiag rau qee qhov kev siv thev naus laus zis uas xav tau los ua kom tau zoo dua, kev kho mob tsawg dua yuav tsis muaj nyob hauv cov tsev kho mob uas ua haujlwm rau qee cov zej zog uas qee cov poj niam Dub nyob," piav qhia Dr. Irobunda. (Muaj feem cuam tshuam: Tus Poj Niam Cev Xeeb Tub Txoj Kev Txaus Siab Tshaj Plaws qhia qhov sib txawv hauv kev saib xyuas kev noj qab haus huv rau Cov Poj Niam Dub)

Tsis tas li ntawd, thaum nws los txog rau kev xaiv rau kev saib xyuas cov poj niam ntawm cov xim thiab kev kho mob fibroid, ntau yam kev xaiv tsis tau tham ntau zaus, hais tias Kecia Gaither, MD, M.P.H., tus kws kho mob ob-gyn thiab niam-fetal tshuaj ntawm NYC Health Hospitals/Lincoln. "Hysterectomy tau muab los ua qhov kev kho mob nkaus xwb." Tab sis qhov tseeb ntawm qhov teeb meem yog, thaum hysterectomy feem ntau yog ib qho kev xaiv ntawm tus poj niam cov zaub mov ntawm kev kho mob, nws feem ntau tsis yog qhov xwb xaiv Thiab koj yuav tsum tsis txhob xav tias zoo li koj yuav tsum coj nws lossis tso nws thaum nws los txog rau koj kev noj qab haus huv.

Txog qhov no, muaj kev ntxub ntxaug thiab kev tsis ncaj ncees uas ua lub luag haujlwm ntawm no, hais cov kws tshaj lij. Tom qab tag nrho, ntau tus txheej txheem hauv plab thiab ua me nyuam muaj keeb kwm kev ntxub ntxaug raws li lawv tau pib thiab sim ua ntawm cov poj niam dub qhev. Thaum pib xyoo 2000s, kuj muaj cov xwm txheej ntawm kev tsis pom zoo ua kom tsis muaj menyuam nyob hauv California lub tsev kaw neeg, piav qhia Dr. Irobuna.

"Nws paub zoo tias kev tsis ncaj ncees muaj tshwm sim raws li nws cuam tshuam rau cov poj niam Dub thiab kev kho mob - Kuv tau pom nws tus kheej," Dr. Gaither hais.

Kev tsis ncaj ncees ntawm cov kws phais neeg kuj tuaj yeem ci los ntawm. Yog tias tus kws phais mob, piv txwv li, xav tias cov poj niam Dub yuav tsis tshua muaj feem ua raws li kev kho mob xws li tshuaj tiv thaiv hnub yug lossis txhaj tshuaj (zoo li Depo Provera uas tuaj yeem pab nrog mob plab thiab hnyav ntog ntog), lawv yuav ntau dua Nws hais tias yuav muab kev kho mob ntau dua li hysterectomy, nws hais. "Kuv, hmoov tsis zoo, tau muaj ntau tus poj niam Dub cov neeg mob tuaj ntsib kuv nrog kev txhawj xeeb tom qab tau muab hysterectomies los ntawm lwm tus kws phais neeg thiab tsis paub tseeb tias hysterectomy yog txoj kev kho rau lawv."

Yuav Tau Txais Kev Saib Xyuas Li Cas Koj Tsim Nyog

Hysterectomies yog kev kho mob muaj txiaj ntsig rau qee yam teeb meem kev kho mob - tsis muaj lus nug. Tab sis cov txheej txheem yuav tsum tau muab raws li ib feem ntawm txoj kev npaj kho mob muaj peev xwm, thiab ib txwm yog qhov kev xaiv. "Nws yog ib qho tseem ceeb uas nrog kev txiav txim siab tseem ceeb xws li tshem tawm cov khoom nruab nrog cev, tus neeg mob nkag siab tias yuav ua li cas rau nws lub cev thiab hom kev xaiv twg muaj rau kev kho mob," Dr. Irobunda hais.

Tom qab tag nrho, hysterectomy los nrog cov kev mob tshwm sim - txhua yam los ntawm kev tsis tuaj yeem ua rau cov menyuam yaus mus rau cem quav lossis kev xav tsis zoo thiab thaum ntxov thiab tam sim no tag nrho yog tias koj tsis tau dhau los ntawm qhov no lawm. (BTW, poj niam cev xeeb tub tsuas yog ib qho ntawm * ntau * ua rau cov poj niam cev xeeb tub thaum ntxov.)

Qee yam yuav tsum nco ntsoov yog tias kev hlais menyuam tawm hauv kev sib tham? "Kuv ib txwm qhia cov neeg mob, tshwj xeeb yog cov neeg mob ntawm cov xim thiab cov neeg mob Dub, tsis txhob ntshai nug cov lus nug," hais tias Dr. Simon. "Nug yog vim li cas tus kws phais lossis tus kws kho mob pom zoo ib txoj hauv kev rau kev kho mob tshwj xeeb, nug seb puas muaj lwm txoj kev kho mob, thiab - yog tias nws tau txiav txim siab tias hysterectomy yog txoj kev mus-nug txog txoj hauv kev uas tuaj yeem siv tau, xws li txoj kev mus rau qhov tsawg tshaj plaws.

Hauv luv luv: Koj yuav tsum xav tias koj tau teb koj cov lus nug thiab hais tias koj tau hnov. Yog tias koj tsis ua, nrhiav lub tswv yim thib ob (lossis thib peb), nws hais. (Muaj feem cuam tshuam: 4 Yam Txhua Tus Poj Niam Yuav Tsum Ua Rau Nws Kev Sib Deev, Raws Li Ob-Gyn)

Thaum kawg, kev phais menyuam yaus yog kev xaiv tus kheej uas nyob ntawm txhua yam los ntawm qhov teeb meem koj tab tom ntsib, theem ntawm lub neej koj nyob, thiab lub hom phiaj twg koj muaj. Thiab cov kab hauv qab yog qhov ua kom koj paub tseeb li qhov ua tau yog qhov tseem ceeb.

"Kuv sim mus dhau txhua yam kev xaiv sib txawv, qhov zoo thiab qhov tsis zoo, thiab tom qab ntawd pab tus neeg mob txiav txim siab seb qhov kev xaiv twg yog qhov zoo tshaj rau lawv," Dr. Arrington hais.

Ntsuam xyuas rau