RESUMEN
Introduction The National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of the menopause states that women who are likely to go through the menopause as a result of surgical treatment should be offered information about the menopause and the importance of starting hormonal replacement therapy before they have their treatment. Objectives To determine compliance with NICE guidelines at the Royal Derby Hospital. Study design We undertook a retrospective review of all pre-menopausal women undergoing bilateral salpingo-oophorectomy for benign pathology between 1 January 2016 and 30 June 2016. Results Thirty-six cases were reviewed. Women were aged between 32.5 and 49.8 years old (median 45.13, inter-quartile range 42.6-47.6). The commonest indications for bilateral salpingo-oophorectomy were dysfunctional uterine bleeding (36.1%), chronic pelvic pain (30.5%), complex cyst (13.9%), and pre-menstrual syndrome (13.9%). Fifteen women (41.7%) did not have hormonal replacement therapy discussed. Only two (5.6%) had hormonal replacement therapy discussed pre-operatively. The remaining 19 had hormonal replacement therapy discussed post-operatively, either on the ward prior to discharge (n = 3) or, more commonly, in clinic six to eight weeks later. Although hormonal replacement therapy was only contraindicated in one woman (3%), it was only prescribed to five (24%). Results were slightly better for women under 40 but still only 28.6% had hormonal replacement therapy discussed with them pre-operatively. Conclusion This audit has demonstrated that compliance with the NICE guidelines is poor. We suspect similar results might be found in other gynaecology departments nationally. A hospital guideline to aid clinicians and a patient information sheet to educate women has been devised. A re-audit is planned six months after ratification of these documents.
Asunto(s)
Adhesión a Directriz , Terapia de Reemplazo de Hormonas , Trastornos de la Menstruación/cirugía , Ovariectomía/efectos adversos , Educación del Paciente como Asunto , Salpingectomía/efectos adversos , Adulto , Dolor Crónico/cirugía , Femenino , Humanos , Auditoría Médica , Persona de Mediana Edad , Quistes Ováricos/cirugía , Dolor Pélvico/cirugía , Guías de Práctica Clínica como Asunto , Premenopausia , Cuidados Preoperatorios/normas , Estudios RetrospectivosRESUMEN
The importance of good sexual function for individuals, patients and their general health and well-being is well recognised. Testosterone is contributory to a healthy sexual life for both women and men. The British Society for Sexual Medicine (BSSM) has initiated and led the development of guidelines for the assessment and use of testosterone deficiency in both women and men for use within the UK and beyond. Clinical awareness of the possibility of testosterone deficiency and the impact this may have on an individual's sexual and somatic function and the need to make sufficient enquiry about the sex life of patients attending a broad clinical spectrum is emphasised. The management of testosterone deficiency is outlined in detail for both women and men.
Asunto(s)
Andrógenos/fisiología , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Sexualidad , Testosterona/deficiencia , Femenino , Fertilidad , Humanos , Masculino , Hiperplasia Prostática/etiología , Neoplasias de la Próstata/etiología , Factores de Riesgo , Disfunciones Sexuales Fisiológicas/diagnóstico , Disfunciones Sexuales Fisiológicas/epidemiología , Testosterona/efectos adversosRESUMEN
The importance of good sexual function for individuals is well recognised. Testosterone is contributory to a healthy sex life for both women and men. The British Society for Sexual Medicine (BSSM) has initiated and led the development of these guidelines for the assessment of testosterone deficiency in both women and men, for use within the UK and beyond. Clinical awareness of the possibility of testosterone deficiency and the impact this may have on an individual's sexual and somatic function and the need to make sufficient enquiry about the sex life of patients attending a broad spectrum of clinical services is emphasised. The management of testosterone deficiency is outlined in detail for both women and men.