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rpwalavalkar
Teale Fenning Administrator
Joined: 20 Jul 2006
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 Posted: Sat Jan 27, 2007 9:29 pm Post subject: vag hyst |
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One of the advantages of vaginal hysterectomy is a lower incidence of sexual dysfunction. --- T / F 
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Dr Miss. Raj Walavalkar MBBS MRCOG
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SR O&G Wessex Region |
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wolverine
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Joined: 16 Jan 2007
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| Posted: Sun Jan 28, 2007 6:20 am Post subject: |
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there is no good evidence to support this
I'm seriously attacked by the teale-fenning disease! It's 6:30 in the morning I've been up all night (I know, very unusual for Dorchester), i'm between twins and retained placenta and I'm still logging in to see what's up from my forum mates! |
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Nick Raine-Fenning
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Joined: 27 May 2006
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Location: Nottingham
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| Posted: Sun Jan 28, 2007 6:25 am Post subject: |
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| wolverine wrote: | | I'm seriously attacked by the teale-fenning disease! It's 6:30 in the morning I've been up all night (I know, very unusual for Dorchester), i'm between twins and retained placenta and I'm still logging in to see what's up from my forum mates! |
I did see ou were logged on when I logged on at 06.00 ish - I have an excuse ... it was past 10 in the morning in Dubai
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Nick Raine-Fenning
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Joined: 27 May 2006
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| Posted: Sun Jan 28, 2007 6:28 am Post subject: |
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| wolverine wrote: | | there is no good evidence to support this |
I agree.
In fact all the old reported data on lubrication and orgasm never had a solid research base.
Lubrication may be less affected due to the mucosal glands of the cervix although how important these are I do not know (not very I guess). Nevertheless I would still mention these things in any essay and just add - 'the evidence is unclear'.  Works all the time 
The RCOG past essay on STAH did specifical mention lubrication was preserved so that's an even more important reason to include it in any discussion.
I would go for false in an MCQ however.
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wolverine
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| Posted: Sun Jan 28, 2007 6:34 am Post subject: |
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Thanks Nick! Obviously you had a nice breakfast and the sun is shinning there! Much better conditions  I'm not jealous at all! Going to get that placenta out! |
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Nick Raine-Fenning
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| Posted: Sun Jan 28, 2007 6:36 am Post subject: |
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The sun is indeed shining
Make sure you follow the rules if tackling a retained placenta!
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wolverine
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| Posted: Sun Jan 28, 2007 6:38 am Post subject: |
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| I tried the 20 units intraumbilically! Rubbish... |
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Nick Raine-Fenning
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| Posted: Sun Jan 28, 2007 6:42 am Post subject: |
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Did you really ... good on you!
Shame it did not work ... where's Bronwyn? I thought she guaranteed an immediate effect You would have impressed the midwives by trying at least.
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rpwalavalkar
Teale Fenning Administrator
Joined: 20 Jul 2006
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| Posted: Sun Jan 28, 2007 7:47 am Post subject: |
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hi nick,
both bron and i, have had a 50% success with intra umbilical syntocinon and i think it's probability working rather that the syntocinon...
of course there are people who swear by it..
r
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Dr Miss. Raj Walavalkar MBBS MRCOG
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rpwalavalkar
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| Posted: Sun Jan 28, 2007 7:53 am Post subject: |
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coming back to the vag hyst Q,
i would have gone for False .
it's from the TOG ( answers in vol 7, number 4 ) ----- they say TRUE .
but i guess after the lubrication point in the essay and the TOG answer i'll say true for the mcq/emq exam
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Dr Miss. Raj Walavalkar MBBS MRCOG
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bronwyn
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Location: Alton, Hampshire
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| Posted: Sun Jan 28, 2007 8:32 am Post subject: |
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| rpwalavalkar wrote: | hi nick,
both bron and i, have had a 50% success with intra umbilical syntocinon
r |
Ha ha.....My success now 60% (3/5) and still think it's worth a go......nothing to loose!
Maybe it's just the African in me pulling harder
Come to Poole Wolverine.....slept all night on the night shift!
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Bronwyn Bell
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mridulaben
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Joined: 08 Nov 2006
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Location: Brunei
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| Posted: Sun Jan 28, 2007 11:29 am Post subject: |
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| rpwalavalkar wrote: | coming back to the vag hyst Q,
i would have gone for False .
it's from the TOG ( answers in vol 7, number 4 ) ----- they say TRUE .
but i guess after the lubrication point in the essay and the TOG answer i'll say true for the mcq/emq exam |
TOG vol 7 no 4 says FALSE
Q is about STH there, STH is assctd. with lower incidence of sexual dysfunction postop than total, Ans is FALSE |
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wolverine
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| Posted: Sun Jan 28, 2007 11:48 am Post subject: |
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| I'm looking forward to it Bronwyn! Do you catheterise the umbilical vein with a nasogastric tube to inject the syntocinon to the placenta? (pipingas method) |
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EMAK
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| Posted: Sun Jan 28, 2007 2:02 pm Post subject: |
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| And is 20 iu syntocinon is enough?? |
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bronwyn
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| Posted: Sun Jan 28, 2007 2:57 pm Post subject: |
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| wolverine wrote: | | Do you catheterise the umbilical vein with a nasogastric tube to inject the syntocinon to the placenta? (pipingas method) |
I dilute 20IU syntocinon in 20ml saline and inject it directly into the umbilical vein, then milk the vein upwards moving the cord clamp as close to the intriotus as comfortably possible.....then just wait. If no signs of seperation in 10 minutes i do CCT and it's mostly worked for me. The ones that haven't worked the cord snapped 
Not sure who's method that is 
Apparently misoprostol diluted in saline & introduced via a catheter works well too........
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Bronwyn Bell
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1852
Location: Nottingham
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| Posted: Mon Jan 29, 2007 11:33 am Post subject: |
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| mridulaben wrote: | TOG vol 7 no 4 says FALSE
Q is about STH there, STH is assctd. with lower incidence of sexual dysfunction postop than total,
Ans is FALSE |
So what does TOG say? I am confused.
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mridulaben
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Joined: 08 Nov 2006
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| Posted: Tue Jan 30, 2007 10:33 am Post subject: |
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| TOG says FALSE |
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1852
Location: Nottingham
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| Posted: Tue Jan 30, 2007 12:20 pm Post subject: |
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| mridulaben wrote: | | TOG says FALSE |
Good - I agree with TOG
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