Trachelectomy Abdomen pertama di Singapore, suatu teknik operasi pada penderita penderita kanker leher rahim sementara mempertahankan fungsi rahim

Seorang Bankir Lisa Guit, 31 tahun, mungkin merupakan pasien pertama di Singapore yang sukses menjalani trachelectomy dengan mengambil leher rahim melalui dinding perut sementara tetap mempertahankan fungsi fertilitas rahim yang lengkap.
Leher rahim adalah bagian dari organ kandungan. Pada kasus kanker leher rahim yang diderita Lisa, biasanya seluruh bagian organ kandungan harus diangkat. Trachelectomy memungkinkan pengangkatan leher rahim saja, sementara kemampuan seorang wanita untuk konsepsi (mengandung bayi) tetap bisa dipertahankan.Teknik pembedahan yang tidak umum ini dimaksudkan untuk memelihara kesuburan seorang wanita ketika mengangkat leher rahim yang terkena kanker, dan telah berhasil dilakukan di Thomson Medical Centre, Singapura.

Trachelectomy dilakukan dengan operasi melalui dinding perut ketimbang melalui vagina. Singkatnya, pembedahan tersebut dilaksanakan sebagai berikut :
Langkah pertama , operasi dari bagian perut untuk melihat organ - organ di rongga panggul, saluran ureter (menghubungkan ginjal dengan kandung kencing), pembuluh darah rahim, leher rahim, dan kandung kencing.
Langkah kedua, pembuluh-pembuluh darah yang menjadi saluran darah utama ke rahim ditandai.
Langkah ketiga, bagian sebelah bawah leher rahim dipisahkan dari vagina, sementara dan bagian sebelah atas dari mulut rahim dipisahkan dari rahim.
Langkah keempat, rahim disambungkan langsung dengan bagian vagina sementara pembuluh-pembuluh darah rahim tetap dipertahankan.

Pada sebuah konferensi pers, Dr. Tay Eng Hseong, Spesialis Senior bagian Organ Kandungan di Thomson Medical Centre (TMC) Singapura mengatakan : “untuk pasien yang telah mengalami pengobatan dengan radiotherapy sebelumnya, kita cenderung untuk tidak merekomendasikan pembedahan ini karena tingginya tingkat kesulitan operasi sebab setelah terapi kanker dengan radiasi, jaringan-jaringan akan lebih keras, mempersulit pembedahan, dan resiko komplikasinya tinggi”. Tapi untuk dia melakukan operasi untuk kasus ini, setelah diminta oleh Miss Guit (pasien) yang mengetahui adanya prosedur ini dari informasi yang dia cari sendiri.

Endometriosis

Endometriosis is a condition in which the tissue (named “endometrium”), that is normally lining the womb, grows outside the womb and attaches to other organs. Mostly organs in the pelvic area including ovaries, outer surface of womb, bowels, and bladders, are affected; but endometriosis has also been found in the lungs, the brain and even on arms and thighs. The condition afflicts over 70 million women and girls throughout the world, knowing no racial or socio-economic barriers, and affecting women ranging from adolescence to post-menopause.
During the menstrual cycle the thickness of the endometrium increases in readiness for the fertilized egg. If pregnancy does not occur the lining is shed as a 'period'. Similarly, in each menstrual cycle, endometrium that grows outside of the womb, is also built up and then breaks down and bleeds in the same way as the lining of the womb. Such internal bleeding may lead to inflammation, pain, and formation of scar tissues in organs outside of the womb.
Endometriosis is not an infection, not contagious, and not cancer either. Of the theories, the most widely accepted is retrograde menstruation. According to this theory some of the menstrual blood flows backwards down into the pelvis.
The considerations about what type of treatment should depend on age, severity of the symptoms, desire to have children, and severity of the condition. Painkillers, like aspirin, may help relieving the pain. Hormonal treatment designed to interfere with ovulation generally provides effective pain relief, but the recurrence rate following cessation of therapy is high, and this type of treatment will contradict with the woman’s pregnancy. Surgical treatment provides pain relief, improves pregnancy rates, and is the preferred initial treatment for infertility caused by endometriosis. Removal of the womb, ovaries, and all growths is a radical surgery for patients with intractable pain, if childbearing is no longer desired. Complementary therapies, such as acupuncture, aromatherapy, herbal therapy, and nutrition have not been clinically proven to treat endometriosis. However, many women do have improvement of their symptoms whilst using such therapies. It is probably wise to seek help from a qualified practitioner and not self medicate.

Dysmenorrhoea (or "Nyeri pada masa haid" in Indonesian languange)

Dysmenorrhoea is cyclical lower abdominal or pelvic pain, which may also radiate to the back and thighs, occurring prior to or during menstruation, or both. In general, we can classify dysmenorrhoea into two types:
* Primary dysmenorrhoea occurs in the absence of any obvious underlying disease. Cause is unknown.
* Secondary dysmenorrhoea is due to an underlying disease, most commonly endometriosis. Other possible causes are fibroid, adenomyosis, pelvic inflammatory disease, intrauterine device, and cervical stenosis. Secondary dysmenorrhoea usually are often present with other gynaecological symptoms, such as intermenstrual bleeding, painful sexual intercourse, and post-coital bleeding.
Dysmenorrhoea’s management itself is meant to relieve/reduce the pain using the following treatments:
* Drug treatment including Non Steroid Anti Inflamatory Drugs (pain killers), combined oral contraceptive pills (for patient who also requires contraception), and menstrual cycle suppressant (e.g. danazol)
* Non drug and surgical treatment including neurectomy, uterine nerve ablation, and transcutaneus electrical nerve stimulation.