Laparaskopija

[Dim]

Good afternoon to all participants of a forum!

I would like to set to dear doctors a little voprsov on a problem interesting me.

To me 32 years, primary sterility or barrenness, three years ago did or made ehosalpingografiju- 1 pipes, the second is passed or taken place;passable, adherent or adhesive process in a small basin, have recommended to make a laparoscopy. Then it has not turned out it or her sdelat-have found series of infections and it was necessary to be treated. Here now *quot; ??ON?a*quot;. But in this connection I had some questions:

1. In one of clinics to me have told or said, that operation will pass or take place in two :1) diagnostic 2) (if necessary) elimination of problems, cost is accordingly doubled, and in other clinic it was a question only of one stage including (probably) all at once. A question: how such operation is usually spent? It is better to agree on two stages or to be limited to one? (the question of cost is very essential to me)

2. What probability of complications in the form of an extrauterine pregnancy or a salpingocuesis at an adhesiotomy in a pipe (pipes)? Whether there are methods of postoperative treatment which could lower it or him?

3. What the approximate probability of what after such operation will be possible to become pregnant? And during what period after operation this probability is highest? Whether Correctly I have understood, what the more time passes or takes place after operation, the the probability to become pregnant decreases because of education of new solderings?



Yours faithfully,

Dim

[boris]

Uv. Dim!



1. In one of clinics to me have told or said, that operation will pass or take place in two :1) diagnostic 2) (if necessary) elimination of problems, cost is accordingly doubled, and in other clinic it was a question only of one stage including (probably) all at once. A question: how such operation is usually spent? It is better to agree on two stages or to be limited to one? (the question of cost is very essential to me)

The principle of a reasonable minimal intervention providing the maximal effect is usual. It is natural, that at presence of adherent or adhesive process in a small basin to you carrying out not only diagnostic, but also (is planned at an opportunity) reconstructive actions. Sometimes it to make it is impossible (or it is not meaningful).



2. What probability of complications in the form of an extrauterine pregnancy or a salpingocuesis at an adhesiotomy in a pipe (pipes)?

Can increase or be enlarged only after the spent intervention. Esteem closely or attentively a subject concerning uterine pipes above in this topic. Many answers to your questions are already stated in them.



Whether there are methods of postoperative treatment which could lower it or him?

Undoubtedly these methods standardly bydut are applied.



3. What the approximate probability of what after such operation will be possible to become pregnant?

All depends on gravity of disturbances. Besides disturbance of permeability of uterine pipes can be not the unique factor of sterility or barrenness. To result or bring concrete digit for you it all the same, what to read tea leaves.



And during what period after operation this probability is highest?

Whether correctly I have understood, what the more time passes or takes place after operation, the the probability to become pregnant decreases because of education of new solderings?

It is valid so. As a rule, if pregnancy nastpaet it happens in peryj after operation year.

[alexdr]

1. In one of clinics to me have told or said, that operation will pass or take place in two :1) diagnostic 2) (if necessary) elimination of problems, cost is accordingly doubled, and in other clinic it was a question only of one stage including (probably) all at once. A question: how such operation is usually spent? It is better to agree on two stages or to be limited to one? (the question of cost is very essential to me)





The principle of a reasonable minimal intervention providing the maximal effect is usual. It is natural, that at presence of adherent or adhesive process in a small basin to you carrying out not only diagnostic, but also (is planned at an opportunity) reconstructive actions. Sometimes it to make it is impossible (or it is not meaningful).



Dear Boris, from your answer for me there was obscure a necessity of two stages of an intervention. About what you write, certainly, all is correct. But what for into stages to divide or share;part?



Dear Dim, I on a speciality am not the -gynecologist, therefore my question to Boris should not be treated in favour of any one tactics of diagnostics/treatment.

[boris]

Dear Boris, from your answer for me there was obscure a necessity of two stages of an intervention. About what you write, certainly, all is correct. But what for into stages to divide or share;part?

That in the price-list to designate cost of each of stages. Speech does not go about tactics of treatment. It is simple naprosto a marketing course.

And it not the worst variant. I met patients at which these stages have been divided or undressed also in time and the repeated operative (medical) intervention was spent in a month after diagnostic. I.e. two operations, two narcosises, two hospitalization. Well accordingly and cost.....

[alexdr]

That in the price-list to designate cost of each of stages. Speech does not go about tactics of treatment. It is simple naprosto a marketing course.



Many thanks for the answer, Boris. So I also thought:)

[Dim]

Boris, many thanks for the detailed answer.

But all the same about two stages I and cannot be defined or determined for myself. How then pass or take place operations which are done or made only in one stage? Or they too are done or made in two stages, but it separately is not informed the patient, and the price for all operation is simply spoken and in that clinic in which she was a question only of one stage twice below?

At conversation on two stages it has been told or said, that the small cut or section all over again is done or made and instruments are entered into it or him for diagnostics, and then (if it is necessary) the cut or section is done or made more and instruments for elimination of defects are entered. Whether it means, what if operation is spent in one stage at once do or make the big cut or section even if business will be limited only to diagnostics?

If has put only in size of a cut or section, I am ready to go that he will be more to not pay double cost for operation, considering, that probability of that in my case business will be limited only to diagnostics all taki is insignificant. Whether as you consider or count reasonably such decision in we wash a case or all the difference in travmatichnosti these two stages is so essential, what it is more expedient to agree all the same on two if is though any probability, what doctors will find or consider, what the second in my case to spend it is not necessary?

[boris]

Boris, many thanks for the detailed answer.

But all the same about two stages I and cannot be defined or determined for myself. How then pass or take place operations which are done or made only in one stage? Or they too are done or made in two stages, but it separately is not informed the patient, and the price for all operation is simply spoken and in that clinic in which she was a question only of one stage twice below?

At conversation on two stages it has been told or said, that the small cut or section all over again is done or made and instruments are entered into it or him for diagnostics, and then (if it is necessary) the cut or section is done or made more and instruments for elimination of defects are entered. Whether it means, what if operation is spent in one stage at once do or make the big cut or section even if business will be limited only to diagnostics?

If has put only in size of a cut or section, I am ready to go that he will be more to not pay double cost for operation, considering, that probability of that in my case business will be limited only to diagnostics all taki is insignificant. Whether as you consider or count reasonably such decision in we wash a case or all the difference in travmatichnosti these two stages is so essential, what it is more expedient to agree all the same on two if is though any probability, what doctors will find or consider, what the second in my case to spend it is not necessary? In your case most likely will be will be executed a reconstructive intervention which by definition is more white travmatichno than diagnostic. A difference not in size, and in quantity or amount of cuts or sections. For diagnostics enough one, for carrying out of manipulations - plus two cuts or sections for manipulators.