Amputation of the cervix can be done by various methods. This is due to the degree of its defeat and hypertrophy.
The following methods of surgery are available:
- high amputation of the cervix;
- wedge-shaped removal of the vaginal part;
- cone-shaped removal;
- diathermoconization.
This surgical intervention is prescribed for pronounced deformation as a result of multiple ruptures, for chronic endocervicitis with connective tissue degeneration, hypertrophy or the presence of recurrent polyps. In addition, cervical amputation is indicated for leukoplakia, follicular hypertrophy, long-term non-healing or recurrent erosion, as well as erythroplakia.
The high removal method is used for adenoma, deep tears in combination with ectropion (eversion of the mucosa). In addition, this technique is used in case of pronounced neck elongation extending beyond the genital gap.
Cone-shaped amputation is advisable for recurrent erosion, chronic endocervicitis, accompanied by recurrent polyps.
Wedge-shaped amputation of the cervix is prescribed for moderate follicular hypertrophy, as well as for other pathologies that do not require the use of high amputation.
In the case of cancer diagnosis, a diathermoconization method using an electric knife or a knife cone-shaped removal method can be used. Moreover, the first method is more appropriate.
The supravaginal amputation of the uterus is the surgical removal of the body of an organ in the area of the internal pharynx in the area of the supravaginal portion of the neck. Thus, after the intervention, only the neck remains.
In some cases, the removal of the uterine body is slightly higher than the internal pharynx. This allows you to save a small area of the endometrium (mucosa). In the presence of functioning ovaries in a reduced (reduced) form, it (endometrium) goes through the same stages of changes as during the menstrual cycle. As a rule, there are no periods after supravaginal removal.
During such an intervention, the vagina does not have to be opened. In the area of the internal pharynx, the contents in the cervical canal are usually sterile. At the same time, the supravaginal removal of the uterus carried out by the abdominal-wall method is an intervention occurring in an aseptic surgical field. The exception is cases when the operation is carried out for inflammation in the appendages of the organ, perforation or spontaneous rupture during pregnancy.
Amputation of the uterus. Effects
Intraoperative complications include damage to the ureters, bladder.
More dangerous consequences - the formation of hematomas, bleeding. Postoperative hemorrhages are diagnosed and eliminated quite difficult. This is due to the fact that they occur in an enclosed space (parametrium), and after that into the abdominal cavity (or directly immediately into it). In this regard, at the phase of peritonization of the stump of all vessels and ligaments, a repeated examination is performed and, if necessary, additional dressing (especially in the presence of massive ligatures, dilated varicose vessels). If necessary, in the control of hemostasis, mandatory drainage of the peritoneum or an increase in the volume of surgical intervention before extirpation is carried out.
Postoperative consequences include the formation of hematomas, bleeding. In such cases, after surgery, relaparotomy is indicated. In case of late diagnosis, suppuration by hematomas, relaparotomy, drainage and debridement of the pelvis, and extirpation of the stump are prescribed.