ABDOMINAL HYSTERECTOMY

. Abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Your uterus or womb is where a baby grows if you're pregnant. Sometimes a hysterectomy includes removal of one or both ovaries and fallopian tubes. Hysterectomy is one of the most common surgical procedures among women
FIBROID Hysterectomy is the only certain, permanent solution for fibroids benign uterine tumors that often cause persistent bleeding, anemia, pelvic pain or bladder pressure. Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. SIGN AND SYMPTOMS:

Uterine Fibroid Symptoms

Most fibroids dont cause symptomsonly 10 to 20 percent of women who have fibroids require treatment. Depending on size, location and number of fibroids, they may cause:

Heavy, prolonged menstrual periods and unusual monthly bleeding, sometimes with clots. This can lead to anemia. Pelvic pain and pressure Pain in the back and legs Pain during sexual intercourse Bladder pressure leading to a frequent urge to urinate Pressure on the bowel, leading to constipation and bloating Abnormally enlarged abdomen

Prevalence of Uterine Fibroids

Twenty to 40 percent of women age 35 and older have uterine fibroids of a significant size. African American women are at a higher risk for fibroids: as many as 50 percent have fibroids of a significant size. Uterine fibroids are the most frequent indication for hysterectomy in premenopausal women and, therefore, are a major public health issue. Of the 600,000 hysterectomies performed annually in the United States, one-third are due to fibroids

Surgical Treatments for Fibroids

Gynecologists perform hysterectomy and myomectomy surgery. Hysterectomy is the removal of the uterus and is considered major abdominal surgery. It requires three to four days of hospitalization and the average recovery period is six weeks.

Depending on the size and placement of the fibroids, myomectomy can be an outpatient surgery or require two to three days in the hospital. However, myomectomy is usually major surgery that involves cutting out the biggest fibroid or collection of fibroids and then stitching the uterus back together. Most women have multiple fibroids and it is not physically possible to remove all of them because it would remove too much of the uterus. While myomectomy is frequently successful in controlling symptoms, the more fibroids the patient has, generally, the less successful the surgery. In addition, fibroids may grow back several years later.
NURSING INTERVENTION

1. Take it easy for a while. This means no strenuous activities, no exercises like jogging, weight lifting or swimming. Lifting heavy objects is also disallowed. Your muscles need time to heal, and that means not putting any strain on them. Leave household chores to be done by other people, or plan who does what in advance before your operation. 2. No sexual activity for at least four to six weeks. You might want to warn your partner of this before your operation, but this must be followed as well. Like exercise, sexual activity puts a strain on your muscles and will also expose you a risk of infection. Worse, it can displace your organs. When your doctor gives you a signal to go ahead, then you can resume normal sexual activities. 3. Once your doctor gives you the go signal, you can start with easy exercises. Leisurely walking on an even ground, and simple stretching can help your body recover better. 4. Expect hormonal mood swings. A hysterectomy can have a big effect on your hormone levels, and it may cast you in a pit of depression. Ask help and understanding from your friends and family. It would also be good if you worked it out within yourself, that it is not really you talking, just your hormones. 5. Because of depression that takes place after a hysterectomy, many women look for support groups. You can do this too, by looking for an online support group or a local support group for women who have undergone hysterectomy. 6. Report excessive spotting or blood flow to your doctor immediately. 7. Monitor the healing of your incisions. Incisions that ooze blood or pus, or are warm and tender to the touch should be reported to the doctor immediately. 8. Take your time. A hysterectomy is still a surgical procedure, and like with any other surgical procedure, puts stress and trauma on your body. Be good to yourself and be sensible with your recovery so that you can go back to a healthy, normal lifestyle as soon as possible.
RISK RELATED TO:

Risks
By Mayo Clinic staff

Hysterectomy is generally very safe, but with any major surgery comes the risk of complications. Risks associated with abdominal hysterectomy include:

Blood clots Infection Excessive bleeding Adverse reaction to anesthesia Damage to your urinary tract, bladder, rectum or other pelvic structures during surgery, which may require further surgical repair Early onset of menopause Rarely, death

Risk factors
By Mayo Clinic staff

There are few known risk factors for uterine fibroids, other than being a woman of reproductive age. Other factors include:

Heredity. If your mother or sister had fibroids, you're at increased risk of also developing them. Race. Black women are more likely to have fibroids than are women of other racial groups. In addition, black women have fibroids at younger ages, and they're also likely to have more or larger fibroids.

Areas of research Research examining other potential risk factors continues in these areas:

Obesity. Some studies have suggested that obese women are at higher risk of fibroids, but other studies have not shown a link. Oral contraceptives. So far, strong data exist showing that women who take oral contraceptives have a lower risk of fibroids. This is generally true for all women, except those who start oral contraceptives between ages 13 and 16. Pregnancy and childbirth. Researchers have also looked at whether pregnancy and giving birth may have a protective effect, and so far pregnancy and childbirth seem to have a protective effect.

Type 2 diabetes - risk factors

Symptoms
Often, people with type 2 diabetes have no symptoms at all. If you do have symptoms, they may include:

Blurred vision Erectile dysfunction Fatigue Frequent or slow-healing infections Increased appetite Increased thirst Increased urination

OBESITY

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might tip the balance include your genetic makeup, overeating, eating high-fat foods and not being physically active. Being obese increases your risk of diabetes, heart disease, stroke, arthritis and some cancers. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases.

You have a higher risk for diabetes if you have any of the following:

Age greater than 45 years Diabetes during a previous pregnancy Excess body weight (especially around the waist) Family history of diabetes HDL cholesterol under 35 mg/dL High blood levels of triglycerides, a type of fat molecule (250 mg/dL or more) High blood pressure (greater than or equal to 140/90 mmHg) Impaired glucose tolerance ETHNIC GROUP, HISPANICS, NATIVE AMERICAN POPULATIONS, AFRICAN AMERICAN

NURSING DIAGNOSIS