{"id":49402,"date":"2024-05-29T10:04:50","date_gmt":"2024-05-29T08:04:50","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=49402"},"modified":"2024-05-29T10:05:32","modified_gmt":"2024-05-29T08:05:32","slug":"primar-chronicke-panevni-bolesti-nemusi-byt-strasakem-zen-endometriozu-umime-efektivne-lecit","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=49402","title":{"rendered":"Prim\u00e1\u0159: Chronick\u00e9 p\u00e1nevn\u00ed bolesti nemus\u00ed b\u00fdt stra\u0161\u00e1kem \u017een, endometri\u00f3zu um\u00edme l\u00e9\u010dit"},"content":{"rendered":"\n

Centrum pro l\u00e9\u010dbu endometri\u00f3zy a chronick\u00fdch p\u00e1nevn\u00edch bolest\u00ed p\u0159i Porodnicko-gynekologick\u00e9m odd\u011blen\u00ed Nemocnice AGEL Nov\u00fd Ji\u010d\u00edn se nov\u011b \u0159ad\u00ed mezi n\u011bkolik m\u00e1lo unik\u00e1tn\u00edch pracovi\u0161\u0165 v \u010cR. Nab\u00edz\u00ed komplexn\u00ed diagnostiku a l\u00e9\u010dbu a chronick\u00fdch bolest\u00ed v p\u00e1nvi u \u017eeny, zejm\u00e9na endometri\u00f3zy, kter\u00e1 je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou t\u011bchto obt\u00ed\u017e\u00ed. Nejen o endometri\u00f3ze jsme si pov\u00eddali s\u00a0prim\u00e1\u0159em <\/strong>gynekologicko-porodnick\u00e9ho odd\u011blen\u00ed Nemocnice AGEL Nov\u00fd Ji\u010d\u00edn a.s. a odborn\u00fdm garantem nemocnic Skupiny AGEL v oboru porodnictv\u00ed a gynekologie MUDr. Martinem Trhl\u00edkem.<\/strong><\/p>\n\n\n\n

Pane prim\u00e1\u0159i, mohl byste n\u00e1m p\u0159ibl\u00ed\u017eit, jak dlouho trv\u00e1 diagnostika endometri\u00f3zy a kter\u00e1 vy\u0161et\u0159en\u00ed mus\u00ed pacientka postupn\u011b podstoupit?<\/strong><\/p>\n\n\n\n

Je celosv\u011btov\u011b zn\u00e1mo, \u017ee pacientky trp\u00edc\u00ed endometri\u00f3zou se k odborn\u00e9 p\u00e9\u010di a l\u00e9\u010db\u011b dost\u00e1vaj\u00edc\u00ed v pr\u016fm\u011bru po 7 letech nejr\u016fzn\u011bj\u0161\u00edch obt\u00ed\u017e\u00ed. V r\u00e1mci vy\u0161et\u0159ovac\u00edho procesu obvykle absolvuj\u00ed standardn\u00ed gynekologick\u00e9 vy\u0161et\u0159en\u00ed, vy\u0161et\u0159en\u00ed pomoc\u00ed vagin\u00e1ln\u00edho ultrazvuku a v p\u0159\u00edpad\u011b pot\u0159eby navazuje specializovan\u00e9 vy\u0161et\u0159en\u00ed magnetickou rezonanc\u00ed a krevn\u00ed odb\u011bry. Po objedn\u00e1n\u00ed pacientky je cel\u00fd vy\u0161et\u0159ovac\u00ed proces dokon\u010den v\u011bt\u0161inou v pr\u016fb\u011bhu n\u011bkolika t\u00fddn\u016f.<\/p>\n\n\n\n

Jak\u00e9 jsou nej\u010dast\u011bj\u0161\u00ed p\u0159\u00edznaky endometri\u00f3zy? Jak rozli\u0161it projevy od b\u011b\u017en\u00fdch bolest\u00ed b\u0159icha?<\/strong><\/p>\n\n\n\n

Nej\u010dast\u011bj\u0161\u00edm p\u0159\u00edznakem endometri\u00f3zy je bolest v p\u00e1nvi, kter\u00e1 se zhor\u0161uje v pr\u016fb\u011bhu menstruace, a to sp\u00ed\u0161e na jej\u00edm konci. D\u00e1le bolesti v p\u00e1nvi \u2013 p\u0159i intimn\u00edm styku, p\u0159i stolici, p\u0159i mo\u010den\u00ed s vazbou nebo bez vazby na m\u011bs\u00ed\u010dky. V extr\u00e9mn\u00edch p\u0159\u00edpadech se m\u016f\u017ee objevit i krev ve stolici nebo mo\u010di. Jin\u00fdm obrazem endometri\u00f3zy m\u016f\u017ee b\u00fdt dlouhodob\u00e1 neschopnost ot\u011bhotn\u011bt.<\/p>\n\n\n\n

Mohou b\u00fdt p\u0159\u00edznakem endometri\u00f3zy i neidentifikovateln\u00e9 bolesti p\u00e1nve?<\/strong><\/p>\n\n\n\n

Pom\u011brn\u011b typick\u00fdm obrazem jsou k\u0159e\u010dovit\u00e9 bolesti v p\u00e1nvi, kter\u00e9 se objevuj\u00ed spont\u00e1nn\u011b, ni\u010d\u00edm nevyprovokov\u00e1ny, nemus\u00ed b\u00fdt v\u00e1z\u00e1ny na pohyb, \u010di fyzickou aktivitu pacientky. Pot\u00ed\u017ee v\u011bt\u0161inou trvaj\u00ed n\u011bkolik m\u011bs\u00edc\u016f, neustupuj\u00ed, pravideln\u011b se vrac\u00ed a pro v\u011bt\u0161inu koleg\u016f l\u00e9ka\u0159\u016f z jin\u00fdch obor\u016f nemaj\u00ed vysv\u011btlen\u00ed.<\/p>\n\n\n\n

Co endometri\u00f3za v t\u011ble zp\u016fsobuje? A jak\u00fdmi zp\u016fsoby lze tlumit jej\u00ed projevy?<\/strong><\/p>\n\n\n\n

Za rozvojem endometri\u00f3zy stoj\u00ed zvl\u00e1\u0161tn\u00ed stav, kdy tk\u00e1\u0148 velmi podobn\u00e1 d\u011blo\u017en\u00ed sliznici (kterou pacientka pravideln\u011b menstruuje a menstrua\u010dn\u00ed krev odt\u00e9k\u00e1 p\u0159irozen\u00fdmi cestami z t\u011bla \u017eeny) se objevuje na jin\u00e9m m\u00edst\u011b kdekoli v mal\u00e9 p\u00e1nvi \u2026 na vaje\u010dn\u00edku, pob\u0159i\u0161nici, v okol\u00ed d\u011blohy, na st\u011bn\u011b tlust\u00e9ho st\u0159eva, mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e \u010di na dal\u0161\u00edch m\u00edstech v p\u00e1nvi. Chov\u00e1 se p\u0159itom stejn\u011b jako d\u011blo\u017en\u00ed sliznice s t\u00edm rozd\u00edlem, \u017ee mal\u00e9 mno\u017estv\u00ed krve, kter\u00e9 vznik\u00e1 p\u0159i menstruaci nem\u00e1 kam odt\u00e9ct a vytv\u00e1\u0159\u00ed patologick\u00e1, v\u011bt\u0161inou bolestiv\u00e1 lo\u017eiska nebo cysty. Tento ne\u017e\u00e1douc\u00ed stav je mo\u017en\u00e9 \u0159e\u0161it bu\u010f tzv. konzervativn\u011b, tedy neopera\u010dn\u011b pomoc\u00ed hormon\u00e1ln\u00ed l\u00e9\u010dby, kdy se zastav\u00ed menstrua\u010dn\u00ed cyklus, nebo pomoc\u00ed operace, kdy se chirurgicky patologick\u00e1 lo\u017eiska endometri\u00f3zy odstran\u00ed.<\/p>\n\n\n\n

Jak\u00e9 jsou nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010diny vzniku endometri\u00f3zy?<\/strong><\/p>\n\n\n\n

P\u0159\u00ed\u010din je mnoho, dodnes nem\u016f\u017eeme jednozna\u010dn\u011b vznik endometri\u00f3zy vysv\u011btlit. Za vznikem endometri\u00f3zy stoj\u00ed odkl\u00e1d\u00e1n\u00ed t\u011bhotenstv\u00ed do vy\u0161\u0161\u00edho v\u011bku pacientek, civiliza\u010dn\u00ed faktory, nebo\u0165 v\u00edme, \u017ee endometri\u00f3za je nemoc\u00ed materi\u00e1ln\u011b dob\u0159e zaji\u0161t\u011bn\u00fdch vrstev obyvatelstva (tzv. socio-ekonomick\u00fd faktor) a existuje i spousta dal\u0161\u00edch d\u00edl\u010d\u00edch faktor\u016f.<\/p>\n\n\n\n

V jak\u00e9m v\u011bku se nejv\u00edce vyskytuje a \u010d\u00edm je podm\u00edn\u011bna?<\/strong><\/p>\n\n\n\n

Prvn\u00ed zn\u00e1mky endometri\u00f3zy u na\u0161ich pacientek se objevuj\u00ed ji\u017e kolem v\u011bku 20 let, ale v\u011bt\u0161ina z\u00e1va\u017en\u011bj\u0161\u00edch posti\u017een\u00ed endometri\u00f3zou se objevuje nej\u010dast\u011bji ve v\u011bkov\u00e9 skupin\u011b 25-40 let.<\/p>\n\n\n\n

M\u00e1 vliv na vznik endometri\u00f3zy i d\u011bdi\u010dnost?<\/strong><\/p>\n\n\n\n

Jednozna\u010dn\u011b d\u011bdi\u010dn\u00fd p\u0159enos endometri\u00f3zy prok\u00e1z\u00e1n doposud nebyl.<\/p>\n\n\n\n

Ve kter\u00fdch p\u0159\u00edpadech je chirurgick\u00e1 l\u00e9\u010dba jedinou mo\u017enost\u00ed?<\/strong><\/p>\n\n\n\n

L\u00e9\u010dba endometri\u00f3zy opera\u010dn\u011b je velk\u00e9 t\u00e9ma, l\u00e9\u010d\u00edme v\u011bt\u0161inou jinak zcela zdrav\u00e9 a mlad\u00e9 \u017eeny a operace vedouc\u00ed k \u00fapln\u00e9mu odstran\u011bn\u00ed endometri\u00f3zy mohou b\u00fdt technicky velmi obt\u00ed\u017en\u00e9. Proto m\u00e1me vypracov\u00e1na jednozna\u010dn\u00e1 pravidla, kdy pacientce navrhujeme opera\u010dn\u00ed \u0159e\u0161en\u00ed
a na slovo navrhujeme klademe velk\u00fd d\u016fraz.<\/p>\n\n\n\n

M\u016f\u017eete n\u00e1m p\u0159ibl\u00ed\u017eit o jak\u00e1 pravidla konkr\u00e9tn\u011b jde?<\/strong><\/p>\n\n\n\n

Operaci navrhujeme v p\u0159\u00edpadech, kdy m\u00e1 pacientka velk\u00e9 bolesti a osobn\u00ed pot\u00ed\u017ee, jestli\u017ee nem\u016f\u017ee dlouhodob\u011b ot\u011bhotn\u011bt a mysl\u00edme si, \u017ee hlavn\u00edm d\u016fvodem je nel\u00e9\u010den\u00e1 endometri\u00f3za anebo hroz\u00ed po\u0161kozen\u00ed \u017eivotn\u011b d\u016fle\u017eit\u00fdch org\u00e1n\u016f pror\u016fst\u00e1n\u00edm endometri\u00f3zou \u2013 m\u016f\u017ee j\u00edt o pror\u016fst\u00e1n\u00ed do st\u011bny st\u0159eva, mo\u010dovod\u016f, mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e, vaje\u010dn\u00edk\u016f a dal\u0161\u00edch struktur p\u00e1nve. S opera\u010dn\u00edm \u0159e\u0161en\u00edm mus\u00ed pacientka v\u017edy p\u0159edem souhlasit.<\/p>\n\n\n\n

Kdy je vhodn\u00e9 vyu\u017eit\u00ed robochirurgie p\u0159i l\u00e9\u010db\u011b endometri\u00f3zy?<\/strong><\/p>\n\n\n\n

Robotickou chirurgii vyu\u017e\u00edv\u00e1me v posledn\u00edm roce, jde v podstat\u011b o precizn\u00ed variantu ji\u017e d\u0159\u00edve pou\u017e\u00edvan\u00e9 laparoskopick\u00e9 miniinvazivn\u00ed opera\u010dn\u00ed techniky, kter\u00e1 n\u00e1m umo\u017e\u0148uje pracovat nejen p\u0159esn\u011b, ale i za velk\u00e9ho zv\u011bt\u0161en\u00ed opera\u010dn\u00edho pole, tedy \u0161et\u0159it okoln\u00ed tk\u00e1\u0148, kterou nechceme p\u0159i operaci jakkoli po\u0161kodit. Sou\u010dasn\u011b nelze opomenout ani p\u0159\u00edzniv\u00fd kosmetick\u00fd efekt, kdy na b\u0159i\u0161n\u00ed st\u011bn\u011b zanech\u00e1v\u00e1me jen minim\u00e1ln\u00ed jizvi\u010dky.<\/p>\n\n\n\n

Pro\u010d by si pacientky m\u011bly vybrat pr\u00e1v\u011b Nemocnici AGEL Nov\u00fd Ji\u010d\u00edn k l\u00e9\u010db\u011b?<\/strong><\/p>\n\n\n\n

Nemocnice Nov\u00fd Ji\u010d\u00edn, pat\u0159\u00ed mezi v\u016fbec prvn\u00ed centra v \u010cR, kter\u00e1 se opera\u010dn\u00ed a komplexn\u00ed l\u00e9\u010dbou endometri\u00f3zy zab\u00fdvaj\u00ed. Dnes Centrum pro l\u00e9\u010dbu endometri\u00f3zy vstupuje do sv\u00e9ho 18. roku \u010dinnosti. Za tuto dobu z\u00edskalo mnoho zku\u0161enost\u00ed a vytvo\u0159ilo si pevn\u00fd a konsolidovan\u00fd t\u00fdm specialist\u016f z dal\u0161\u00edch obor\u016f (chirurgie, urologie, radiologie, rehabilitace, anesteziologie), kter\u00fd diagn\u00f3ze endometri\u00f3zy rozum\u00ed a ve velmi dobr\u00e9 sou\u010dinnosti se pod\u00edl\u00ed na jej\u00edm \u0159e\u0161en\u00ed. Centrum pro l\u00e9\u010dbu endometri\u00f3zy je nav\u00edc nositelem Evropsk\u00e9 akreditace spole\u010dnosti EuroEndoCert, kter\u00e1 pat\u0159\u00ed mezi nejkvalitn\u011bj\u0161\u00ed akredita\u010dn\u00ed autority v t\u00e9to oblasti a je z\u00e1rukou vysok\u00e9 \u00farovn\u011b dan\u00e9ho pracovi\u0161t\u011b.<\/p>\n","protected":false},"excerpt":{"rendered":"

Centrum pro l\u00e9\u010dbu endometri\u00f3zy a chronick\u00fdch p\u00e1nevn\u00edch bolest\u00ed p\u0159i Porodnicko-gynekologick\u00e9m odd\u011blen\u00ed Nemocnice AGEL Nov\u00fd Ji\u010d\u00edn se nov\u011b \u0159ad\u00ed mezi n\u011bkolik m\u00e1lo unik\u00e1tn\u00edch pracovi\u0161\u0165 v \u010cR. […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":49404,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-49402","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/49402","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=49402"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/49402\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/49404"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=49402"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=49402"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=49402"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}