"Women's gait changes, an interest in life appears!»
The RCH treats women's "uncomfortable" problems not talked about for free.
At first glance, someone may find a topic addressed by the Real Time from the medical today section strange. And yet, the fact that this disease is not discussed does not mean that it does not exist. Rather, it is even two concomitant diseases: stress urinary incontinence and pelvic organ prolapse in women. This problem is so delicate that those who suffer from it just shy to tell about their torment, even to close ones. As a rule, they simply do not know which of the specialists will help them. The problem is also social in nature: women are left alone with their difficulties for many years and cannot live a whole life. The RCH doctors who treat such patients for free, even from other regions, beat the alarm. They say that this issue can be resolved!
"I should have had the operation 60 years ago"
The problem of pelvic organ herniation, or pelvic prolapse, is relevant for many women, regardless of age and activity type. Herniated protrusion of organs can occur in older women and women of reproductive age, for example, after a difficult birth, if the fetus was large. Intra-abdominal pressure also increases in adulthood, in postmenopause. The composition of the connective tissue muscles changes against the background of a decrease in the level of hormones, including during excessive physical exertion, says Farida Minnullina, the head of the Gynecology Department of the RCH, to our publication.
According to her, there are different combinations of loss of internal organs. Often, the omission of the anterior wall of the vagina is combined with stress urinary incontinence: when coughing, sneezing, sudden movement, there is a situation when a woman can not control urination.
"This is a social problem. Women are not adapted in this regard. They do not talk about it anywhere. They do not write about it. Women do not know which specialist to turn to. They do not even admit to the closest people. We go to the districts, and we see that the health care system there is suffering. The doctors hear about the operations that we do to such patients in the RCH for the first time. But it is in the countryside that women have a heavy physical load. Besides, there is a recent trend: born children are large, which also gives such consequences," the doctor describes the situation.
Often, rural or district paramedics are too busy with work. Only swabs are taken from women during examinations, and they are shy to talk about incontinence. When faced with a pelvic prolapse, someone from the medium-grade medical staff, trying to calm the woman, may say: "Yours is not that big; you will live with it." And women go to "live with it" — after all, they do not die from the prolapse of the uterus or the anterior wall of the vagina. Urinary incontinence in one hundred percent of cases occurs with other diseases, such as chronic pyelonephritis, cystitis, explains Farida Minnullina, so, as a rule, in such situations, consultations of several specialists are required. However, urologists, for example, cannot fully help the patient with stress urinary incontinence.
"Women believe that the problem of organ prolapse or stress incontinence was with my mother, my grandmother — all this is age-related. And they continue to live with it... They do not carry pads in the bag, but real diapers: one sneeze — and the whole volume of urine can pour out. The fact that you can treat such problems learned, rather, by accident. And when there has already been a complete fall out of organs, it is necessary that the woman still had the opportunity to get examined, and there would be no other obstacles to this. We live in the 21st century, and one needs to contact, at least to get a consultation, to understand what tactics are needed in this case," the head of the RCH department calls.
Such operations are performed not for life-saving reasons but to improve the quality of life. And of course, it is easier to operate on a woman at a younger age when the disease is just beginning, and there is less risk of complications.
"I had a patient, and she was 89 years old. After the operation, she told me: "I should have done this operation 60 years ago." Can you imagine? She is timid, did not go with her husband to the baths, admitted that she envied those who could walk on the beach or in the pool, and she could not allow it: it was a complete loss, and it causes a dysfunction of adjacent organs, the doctor told us.
The complex treatment, free of charge, and no waiting list
Not all clinics help patients with such problems, although these issues are pretty well studied, and, most importantly, they are treatable.
"Private clinics are more willing to treat women when they do not have other diseases, and it is easier. When a woman has many other problems, we, the RCH doctors, can not provide just one service. We fully examine the patient, show her to all specialists, exclude all risks that may arise. People are not well informed after all, and they are not sure that this operation is done. For example, if a woman has recently had a myocardial infarction, our anesthesiologists take up operations even in such cases. It happens that during routine training, diabetes and heart diseases are detected. Before deciding on an operation at this stage, we collectively weigh the pros and cons. In some cases, we prescribe therapy, observe the patient in dynamics, rewrite it for another date, in any case, we do not abandon it, we accompany it to the operation," the doctor explains.
Despite the history of concomitant diseases, the percentage of contraindications for such operations in the RCH is very low. In the most extreme cases, surgical intervention for women is replaced with alternative methods, which also relieve their suffering.
Many people do not want to seek treatment, assuming long walks around offices and a tedious waiting list for surgery afterward.
"Nothing of the sort! To get help in the RCH, you first need to contact a doctor at your place of residence. In each district and city, there are responsible persons for providing gynecological care; they reach us, have a general chat with specialists, and prepare for the arrival of the patient. There is no waiting list for several months in advance; the regulations and routing are established. The queue is formed for the upcoming week, and the entry is only a few days ahead; the head of the department debunks popular myths.
Few people know that these RCH operations are entirely free; they are done under the MHI policy. In the department of gynecology, high-quality mesh implants, slings are used; there are no restrictions on the use of which they are always available in the institution. To solve urinary incontinence and pelvic organ prolapse problems, residents of other regions go to Kazan, from Mari El, Udmurtia, Chuvashia — no one is denied in the republican hospital. These problems are dealt with not only in Tatarstan. But the implementation of the relevant operations depends on the management of medical institutions. Perhaps, not everywhere this kind of assistance is provided by the MHI. Some state medical clinics refuse, fearing concomitant diseases and possible complications.
"Why live in fear?!"
According to Farida Minnullina, technically, operations for vaginal extirpation with pelvic floor plastic surgery are quite complex. Such problems are sometimes solved by a multidisciplinary team of gynecologists, proctologists, and urologists. But in the department of gynecology of the RCH, such operations are performed for about 40 years. And all ten doctors of the department skilled in this technique perfectly. On average, up to one and a half thousand such surgical interventions are performed per year, and this is about 45% of all operations that are performed in the department.
"Sling operations using mesh implants have been performed since 2008. They are attached and grow in tissues of the human body, and after some time, it is impossible to diagnose. The so-called weight is formed, which helps to maintain the urethra, and during physical exertion in women, the urine does not flow out spontaneously," the specialist explains.
The operation with spinal anesthesia lasts an hour, and with the installation of the implant, it takes a little longer than an hour. Although patients are usually ready for discharge on the second day after surgery, hospitalization still lasts 3-4 days.
"Unfortunately, the problems of our patients are accompanied by extragenital pathology, in other organs and systems. It is precisely to improve the quality of life that we cannot allow post-operative complications. Therefore, we detain them for a few days to monitor their condition," explains Farida Minnullina.
The operations give excellent results; not a single patient has returned for repeated help. Every woman has a doctor's phone number, which she can contact at any time if she is concerned about any questions. Doctors give advice and recommend supportive exercises.
"You can't imagine how women are transformed on the second or third day after surgery! They begin to use cosmetics, their gait changes, and a sparkle in their eyes, interests in life and self-confidence grow, and they choose a new beautiful underwear. Why do you need to spend years living in fear and waiting for something, without having an intimate and generally whole life, for example, the opportunity to go somewhere, play sports?! Do not be afraid to seek medical help. We have a serious team of not just surgeons but also anesthesiologists and resuscitators. They will improve the quality of life of women," the doctor assures.
Источник : https://realnoevremya.ru/articles/206720-u-zhenschin-menyaetsya-pohodka-poyavlyaetsya-interes-k-zhizni