Title Komplikacije uroginekoloških operacija
Title (english) Complications of urogenital surgery
Author Mateja Ivančić
Mentor Slavko Orešković (mentor)
Committee member Marina Šprem Goldštajn (predsjednik povjerenstva)
Committee member Dinka Pavičić-Baldani (član povjerenstva)
Committee member Slavko Orešković (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Gynecology and Obstetrics) Zagreb
Defense date and country 2015-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Urology
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Abstract Uroginekologija je mlada kirurška subspecijalizacija, nastala iz urologije i ginekologije kao odgovor na ogroman napredak medicine i anatomsku složenost dna male zdjelice. Najčešći problemi koje rješava uroginekologija su inkontinencija mokraće i poremećaji dna male zdjelice. Inkontinencija mokraće je nevoljno otjecanje mokraće, a liječi se konzervativno i kirurški. Prevalencija inkontinencije je u porastu te iznosi oko 20 % među ženama starijim od 70 godina. Zlatni standard u liječenju stresne inkontinecije su sling metode koje koriste polipropilensku trakicu kao potpora vratu mokraćnog mjehura i uretri. Disfunkcija dna male zdjelice uz inkontinenciju mokraće uključuje i prolaps zdjeličnih organa. Česti uzroci disfunkcije dna male zdjelice su pretilost, menopauza, trudnoća i porod. Razlikujemo prolaps uterusa, prolaps svoda vagine, cistokelu, rektokelu i enterokelu. Prolaps prednje vaginalne stjenke se rješava prednjom kolporafijom, a stražnje stjenke stražnjom kolporafijom. Prolaps svoda vagine i uterusa se liječi sakrokolpopeksijom. Nakon svakog kirurškog liječenja potrebno je misliti na pojavu mogućih komplikacija. Komplikacije svakako produžuju boravak u bolnici što poskupljuje liječenje pacijentica. Vrućica je najčešći dijagnostički problem u postoperativnom razdoblju. Krvarenje je jedna od postoperativnih komplikacija koje se najviše bojimo, jer može dovesti do šoka. Komplikacije vezane uz dišni sustav su atelektaza, upala pluća i plućna embolija. Intravenski kateteri su česti uzrok površinskog tromboflebitisa. Kompleksan problem i komplikacija uroginekoloških operacija je nastanak urogenitalnih fistula. Često se javljaju kao posljedica ozljede uretre, uretera i mokraćnog mjehura. Ne treba zanemariti i pojavu komplikacija mokraćnih puteva kao što su infekcija, retencija mokraće i prolaps pelvičnih organa. Rijetke komplikacije su paralitički ileus i opstrukcija crijeva. Incidencija javljanja postoperativne mučnine i povraćanja je oko 25%. Vrlo česta komplikacija je infekcija rane koja se prezentira crvenilom, boli, purulentinim iscjetkom, neugodnim mirisom i vrućicom.
Abstract (english) Urogynecology is a young surgical subspecialty, originated from the urology and gynecology in response to the tremendous progress of medicine and anatomical complexity of the female pelvic floor. Most common conditions treated in urogynecology are urinary incontinence and pelvic floor disorders. Urinary incontinence is the involuntary leakage of urine and can be treated conservatively and surgically. The prevalence of incontinence is increasing and it is about 20% among women older than 70 years. The gold standard in the treatment of stress incontinence are sling procedures that use a polypropylene strip to support the neck of the bladder and urethra. Besides urinary incontinence, pelvic floor dysfunction include prolapse pelvic organs. Common causes of pelvic floor dysfunction are obesity, menopause, pregnancy and childbirth. We distinguish uterine prolapse, vaginal vault prolapse, cystocele, rectocele and enterocele. Prolapse of anterior vaginal wall is an indication for anterior colporrhaphy, and prolapse of posterior vaginal wall can be treated with procedure of posterior colporrhaphy. Abdominal sacral colpopexy can be performed for apical vaginal and uterine prolapsed. Every surgery carries a risk of complications. Complications increase the duration of the postoperative stay in the hospital. Fever is the most common diagnostic problem in the postoperative period. Bleeding is severe postoperative complication, because it may lead to shock. Complications related to the respiratory system are atelectasis, pneumonia and pulmonary embolism. Intravenous catheters are a common cause of superficial thrombophlebitis. Complex problem of urogenital surgery is the occurrence of urogenital fistulae. The development of urogenital fistulae is often attributed to inadvertent bladder, ureter and urethra injury during pelvic surgery. We should not forget the occurrence of urinary tract complications such as infections, urinary retention and prolapse of pelvic organs. Rare complications are paralytic ileus and intestinal obstruction. The incidence of postoperative nausea and vomiting is about 25 %. Common complication of any surgery is surgical site infection. An infected wound may be characterized by pain, redness, swelling, pus discharge, bad odor or fever.
Keywords
uroginekologija
inkontinencija
prolaps organa male zdjelice
urogenitalne fistule
postoperativne komplikacije
Keywords (english)
urogynecology
urinary incontinence
pelvic organ prolapse
urogenital fistulae
postoperative complications
Language croatian
URN:NBN urn:nbn:hr:105:218557
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2016-08-09 10:25:40