Save the uterus!!
Very difficult to convince a patient for not removing her uterus!!
Mrs nila 28 year old residing in interiors of Madhya Pradesh came with complaints of pain in lower abdomen since last 1 year.She has 2 children both normal vaginal delivery. First one is 8 years old and 2nd child is 5 years old.She is using barrier contraception. Her menstrual cycles are regular.
She came to me one year back for the pain. I examined her, did her transvaginal sonography and prescribed medicines. She did not responded. Since it takes her 14 hours to reach to my hospital she in between took treatment from her local doctors who advised her to remove her uterus. She gave 3-4 visits to my hospital in this last one year and her last visit was after a gap of 6 months.
Since she cannot come often for follow up I suggested laparascopy for her chronic pelvic pain to which the couple agreed. Laparoscopy was done . we inspected her appendix it was normal in appearance. We inspected her uterus, both fallopian tubes and both ovaries and everything was normal in appearance. There was no evidence of endometriosis / koch’s / pelvic inflammatory disease.
I explained to the couple the normal findings of laparoscopy and my diagnosis of her pain as somatisation for which she needs counseling sessions from professional counselor. On my part I advised her meditation and introspection. She said she will try this for couple of months and if there is no relief she will take help of professional counselor.
The couple looked convinced that there is no need for removing uterus. I on my part am happy that I could save one uterus. I hope that this happiness will last for a longer time and she should not get succumbed to local pressure of removing her uterus because it has taken almost 40-50 minute session per consultation to convince her against surgery.
Sometimes it is easy to convince them for surgery than against it. But a good surgeon should know when not to use the knife.and I hope I have done justice to the uterus and to the woman concerned.
SAVE THE UTERUS !!
Save the uterus!!