\u010cT1<\/p>\n\n\n\n
hostem je pan doc. Ji\u0159\u00ed Han\u00e1\u010dek, pov\u00edd\u00e1me si na t\u00e9ma endometri\u00f3za. Je to d\u011bdi\u010dn\u00e9 onemocn\u011bn\u00ed, tak\u017ee kdy\u017e maminka m\u00e1 endometri\u00f3zu, tak m\u00e1 i dcera?<\/p>\n\n\n\n
doc. MUDr. Ji\u0159\u00ed Han\u00e1\u010dek,
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D\u011bdi\u010dnost se uplat\u0148uje asi u 10 % endometri\u00f3z, co\u017e zase nen\u00ed tolik, tak\u017ee d\u011bdi\u010dnost nen\u00ed opravdu dominantn\u00ed, ale je tam ur\u010dit\u011b vy\u0161\u0161\u00ed riziko.<\/p>\n\n\n\n
mluv\u010d\u00ed 2,
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Co j\u00ed vlastn\u011b p\u0159esn\u011b spou\u0161t\u00ed endometri\u00f3zu, m\u016f\u017ee to b\u00fdt t\u0159eba n\u011bjak\u00e1 hormon\u00e1ln\u00ed l\u00e9\u010dba krom t\u00e9 genetick\u00e9 dispozice?<\/p>\n\n\n\n
mluv\u010d\u00ed 8,
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J\u00e1 mysl\u00edm, \u017ee tam je sp\u00ed\u0161 porucha asi imunitn\u00edho syst\u00e9mu, kter\u00fd nen\u00ed schopen tu endometri\u00f3zu rozpoznat jako cizorod\u00fd materi\u00e1l a zni\u010dit tak jako u n\u00e1dor\u016f a samoz\u0159ejm\u011b hormon\u00e1ln\u00ed hladiny jsou k tomu pot\u0159eba. Bez hormon\u016f by vlastn\u011b endometri\u00f3za nebyla.<\/p>\n\n\n\n
mluv\u010d\u00ed 2,
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Pov\u00eddali jsme si o tom, \u017ee endometri\u00f3za zp\u016fsobuje \u0159adu bolest\u00ed, tak m\u00e1 t\u0159eba pacientka, kdy\u017e v\u00ed, \u017ee endometri\u00f3zu m\u00e1, m\u00e1 t\u0159eba v dob\u011b, kdy p\u0159ich\u00e1z\u00ed to obdob\u00ed, kdy se ty bolesti hor\u0161\u00ed, pou\u017e\u00edvat n\u011bjak\u00e9 l\u00e9ky na ti\u0161en\u00ed t\u011bch bolest\u00ed?<\/p>\n\n\n\n
mluv\u010d\u00ed 8,
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Ur\u010dit\u011b. Bu\u010fto se d\u00e1 p\u0159edej\u00edt endometri\u00f3ze pravideln\u00fdm u\u017e\u00edv\u00e1n\u00edm l\u00e1tek, kter\u00e9 jsou hormon\u00e1ln\u00ed povahy a dok\u00e1\u017eete endometri\u00f3zu zastavit, pak kontinu\u00e1ln\u00ed u\u017e\u00edv\u00e1n\u00ed dlouhodob\u00e9, anebo pokud m\u00e1 bolesti a nechce \u0159e\u0161it hormon\u00e1ln\u011b, tak jist\u011b l\u00e9ky na bolest jsou tak jednou z mo\u017enost\u00ed.<\/p>\n\n\n\n
mluv\u010d\u00ed 2,
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Potom jsem se bavili o tom, jak se vlastn\u011b endometri\u00f3za diagnostikuje, ale ob\u010das se tak\u00e9 endometri\u00f3za zam\u011b\u0148uje t\u0159eba s onemocn\u011bn\u00edm mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e, jak by m\u011bla pacientka poznat, co p\u0159esn\u011b se j\u00ed d\u011bje a za kter\u00fdm odborn\u00edkem vyrazit.<\/p>\n\n\n\n
mluv\u010d\u00ed 8,
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J\u00e1 mysl\u00edm, \u017ee to je t\u011b\u017ek\u00fd, \u017ee to \u010dasto nepozn\u00e1 ani odborn\u00edk, tak\u017ee by m\u011bla samoz\u0159ejm\u011b nav\u0161t\u00edvit jak gynekologa, tak urologa, a jeliko\u017e za\u010d\u00edn\u00e1 probl\u00e9my mo\u010dov\u00e9 soustavy, m\u00e1 sp\u00ed\u0161e asi za\u010d\u00edt urologem, jestli se nejedn\u00e1 o infekci mo\u010dov\u00fdch cest, pokud bude vylou\u010den\u00e1, tak asi zam\u011b\u0159it se nejenom na endometri\u00f3zu.<\/p>\n\n\n\n
mluv\u010d\u00ed 2,
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Bavili jsme se o diagnostice, \u017ee se t\u0159eba laparoskopicky odeb\u00edr\u00e1 ur\u010dit\u00fd vzorek, je to bolestiv\u00fd z\u00e1krok?<\/p>\n\n\n\n
mluv\u010d\u00ed 8, mluv\u010d\u00ed 2, mluv\u010d\u00ed 8, mluv\u010d\u00ed 2, mluv\u010d\u00ed 9, mluv\u010d\u00ed 2, mluv\u010d\u00ed 8, mluv\u010d\u00ed 2, mluv\u010d\u00ed 8, mluv\u010d\u00ed 2, mluv\u010d\u00ed 8, mluv\u010d\u00ed 2, mluv\u010d\u00ed 8, mluv\u010d\u00ed 2, ano, a jsou tedy dv\u011b cesty, je to hormon\u00e1ln\u00ed l\u00e9\u010dba, anebo potom tedy podstoupit laparoskopick\u00fd z\u00e1krok, ano. Anebo oplodnit, pokud je probl\u00e9mem neplodnost, tak um\u011bl\u00e9 oplodn\u011bn\u00ed je jednou z cest….<\/p>\n\n\n\n a nem\u016f\u017ee tomu t\u011bhotenstv\u00ed potom vadit ta endometri\u00f3za?<\/p>\n\n\n\n mluv\u010d\u00ed 8, mluv\u010d\u00ed 2, mluv\u010d\u00ed 6, mluv\u010d\u00ed 2, \u010cT1 hostem je pan doc. Ji\u0159\u00ed Han\u00e1\u010dek, pov\u00edd\u00e1me si na t\u00e9ma endometri\u00f3za. Je to d\u011bdi\u010dn\u00e9 onemocn\u011bn\u00ed, tak\u017ee kdy\u017e maminka m\u00e1 endometri\u00f3zu, tak m\u00e1 i dcera? […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":43899,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-59316","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/59316","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=59316"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/59316\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/43899"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=59316"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=59316"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=59316"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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Laparoskopie je v nark\u00f3ze, to znamen\u00e1, \u017ee ta pacientka sp\u00ed, tak\u017ee samotn\u00e1 operace bolestiv\u00e1 nen\u00ed, tam je potom samoz\u0159ejm\u011b to hojen\u00ed, ale laparoskopie, miniinvazn\u00ed metoda, kdy se zav\u00e1d\u00ed trokar velikosti 10 mm, a dole v podb\u0159i\u0161ku p\u011btimilimetrov\u00e9 trokary, tak\u017ee minim\u00e1ln\u00ed posti\u017een\u00ed<\/strong>.<\/p>\n\n\n\n
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A kdy\u017e se tedy odebere ta tk\u00e1\u0148, kdy\u017e vy tam vlastn\u011b jdete s t\u00edm, \u017ee to je diagnostika, ale zjist\u00edte, \u017ee to je endometri\u00f3za, tak to jste schopni odebrat komplet….<\/p>\n\n\n\n
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Tam je dobr\u00e9 m\u00edt tu diagnostiku ud\u011blanou v\u010das p\u0159ed operac\u00ed, abychom v\u011bd\u011bli podle, za prv\u00e9, pot\u00ed\u017e\u00ed pacientky, jestli chce ot\u011bhotn\u011bt, jestli m\u00e1 bolesti a jak\u00fd je p\u0159edb\u011b\u017en\u00fd n\u00e1lez na ultrazvukov\u00e9m nebo magnetick\u00e9m vy\u0161et\u0159en\u00ed a my jsme schopni napl\u00e1novat ten v\u00fdkon, abychom v\u011bd\u011bli, jak dlouho bude trvat a jestli bude pot\u0159eba t\u0159eba chirurgick\u00e9 odstran\u011bn\u00ed \u010d\u00e1sti tlust\u00e9ho st\u0159eva, mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e, a to samoz\u0159ejm\u011b operaci prodlu\u017euje, tak\u017ee my u\u017e p\u0159ed operac\u00ed mus\u00edme v\u011bd\u011bt, jak velk\u00e9 to posti\u017een\u00ed<\/strong> je, proto\u017ee t\u00edm se i stanovuje ta d\u00e9lka operace a i t\u00fdm opera\u010dn\u00ed.<\/p>\n\n\n\n
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A kdy\u017e se potom ta tk\u00e1\u0148 odebere, pos\u00edl\u00e1 se to je\u0161t\u011b na histologii….<\/p>\n\n\n\n
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V\u0161echny tk\u00e1n\u011b, kter\u00e9 se odeberou, se pos\u00edlaj\u00ed, te\u010f je vlastn\u011b modern\u00ed to \u0159e\u0161en\u00ed i robotick\u00e9, ale z posledn\u00edch studi\u00ed vypl\u00fdv\u00e1, \u017ee robot nen\u00ed superiorn\u00ed metodou, oproti laparoskopii vlastn\u011b robotick\u00e9 operace nejsou v\u00fdhodou, a je d\u016fle\u017eit\u00fd sp\u00ed\u0161 ten operat\u00e9r, ne\u017e jestli je to robot nebo laparoskopie.<\/p>\n\n\n\n
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To m\u011b pr\u00e1v\u011b zaj\u00edmalo, jak\u00fd je vlastn\u011b v\u00fdvoj v t\u00e9 l\u00e9\u010db\u011b endometri\u00f3zy, co se zm\u011bnilo za posledn\u00ed roky a jak\u00fd je v\u00fdhled, jak to bude v\u0161echno potom prob\u00edhat d\u00e1l?<\/p>\n\n\n\n
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V\u00fdvoj je, zlep\u0161ila se ur\u010dit\u011b diagnostika, ur\u010dit\u011b v\u00edme v\u00edce o t\u00e9 endometri\u00f3ze, jsme l\u00e9pe p\u0159ipraveni ultrazvukov\u011b, to znamen\u00e1 ne tak invazivn\u00ed jako magnetick\u00e1 rezonance, je to dostupn\u00e9 vy\u0161et\u0159en\u00ed, c\u00edlen\u00e9 vy\u0161et\u0159en\u00ed, tak\u017ee zlep\u0161uje se ur\u010dit\u011b diagnostika, a i ta opera\u010dn\u00ed l\u00e9\u010dba se zdokonaluje. Jsou nov\u00e9 techniky, tak\u017ee i ta opera\u010dn\u00ed l\u00e9\u010dba jde nahoru. Mysl\u00edm si, \u017ee to gr\u00f3 bude sp\u00ed\u0161 v n\u011bjak\u00e9m tom v\u00fdvoji l\u00e9k\u016f, kter\u00fd by dok\u00e1zaly tu endometri\u00f3zu zastavit nebo \u0159e\u0161\u00ed p\u0159\u00edmo trvaj\u00edc\u00ed p\u0159\u00ed\u010dinu, kterou my zat\u00edm nezn\u00e1me.<\/p>\n\n\n\n
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Je tam p\u0159ece jenom, kdy\u017e jsme si pov\u00eddali o tom, \u017ee se odebere ta tk\u00e1\u0148, po\u0161le se na histologii, je tam n\u011bjak\u00e1 mo\u017enost, \u017ee to zvy\u0161uje rakovino, rakovinov\u00e9 riziko?<\/p>\n\n\n\n
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Pokud ta endometri\u00f3za z\u016fst\u00e1v\u00e1 v postmenopauze, anebo i v t\u00fd perimenopauze, tak je tam vy\u0161\u0161\u00ed riziko karcinomu vaje\u010dn\u00edk\u016f, a to je asi kolem \u010dty\u0159, 5 %.<\/p>\n\n\n\n
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Je\u0161t\u011b p\u0159edt\u00edm v tom prvn\u00edm vstupu jsme si pov\u00eddali o tom, jak bychom se m\u011bli chovat, abysme se t\u00e9 endometri\u00f3ze tak tro\u0161i\u010dku vyhnuli. Mysl\u00edm si, \u017ee to je ten zdrav\u00fd, \u017eivotn\u00ed styl, ale asi se j\u00ed nevyhneme \u00fapln\u011b. Ned\u00e1 se to p\u0159esn\u011b ovlivnit. Ale poj\u010fme si zopakovat je\u0161t\u011b, co jsou takov\u00e9 ty z\u00e1kladn\u00ed pravidla.<\/p>\n\n\n\n
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Z\u00e1kladn\u00ed pravidla. Ur\u010dit\u011b strava a v\u00fd\u017eiva jist\u011b a mysl\u00edm si, \u017ee je dobr\u00fd splnit reproduk\u010dn\u00ed funkci, \u010d\u00edm d\u0159\u00edv to jde, nebo pokud to jde, neodkl\u00e1dat t\u011bhotenstv\u00ed, co\u017e se dneska samoz\u0159ejm\u011b d\u011bje a m\u00e1me pr\u016fm\u011brn\u00fd v\u011bk pacientky kolem 35 let, co\u017e vlastn\u011b vy\u0161\u0161\u00ed v\u011bk u\u017e je.
Doporu\u010den\u00ed je mezi 25 a 30 m\u00edt d\u011bti, rodit a neodkl\u00e1dat na pozd\u011bj\u0161\u00ed v\u011bk, kde doch\u00e1z\u00ed u\u017e ke sn\u00ed\u017een\u00ed ovari\u00e1ln\u00ed rezervy a funkce a jsou \u010dast\u011bj\u0161\u00ed chromozom\u00e1ln\u00ed vady u plod\u016f, tak\u017ee jedno z \u0159e\u0161en\u00ed je ur\u010dit\u011b t\u011bhotenstv\u00ed d\u0159\u00edve a neposouvat do dal\u0161\u00edch kategori\u00ed.<\/p>\n\n\n\n
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Pane docente, bavili jsme se o tom, \u017ee se to nej\u010dast\u011bji stane a\u017e po n\u011bkolika menstruac\u00edch. Ano, m\u016f\u017ee se to ale objevit i u t\u0159eba mlad\u0161\u00edch sle\u010den je\u0161t\u011b p\u0159ed tou prvn\u00ed menstruac\u00ed? Ta endometri\u00f3za.<\/p>\n\n\n\n
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To je raritn\u00ed v\u00fdskyt, zcela raritn\u00ed. Byly pops\u00e1ny vlastn\u011b p\u0159\u00edpady t\u011bch d\u011bt\u00ed asi z p\u0159enosu od matky, je\u0161t\u011b vlastn\u011b na konci toho t\u011bhotenstv\u00ed, ale je to opravdu raritn\u00ed v\u00fdskyt.<\/p>\n\n\n\n
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A kdy\u017e jsme se bavili tady, \u017ee kdy\u017e u\u017e m\u00e1me endometri\u00f3zu, tak m\u00e1me ji \u0159e\u0161it v p\u0159\u00edpad\u011b tedy, kdy\u017e n\u00e1m zp\u016fsobuje bolest, anebo p\u0159\u00edpadn\u011b neplodnost, <\/p>\n\n\n\n
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Pokud tam u\u017e to t\u011bhotenstv\u00ed vznikne, tak \u010dasto nevad\u00ed, m\u016f\u017ee b\u00fdt krv\u00e1cen\u00ed b\u011bhem t\u011bhotenstv\u00ed, kdy vlastn\u011b ta dutina b\u0159i\u0161n\u00ed je ve sr\u016fstech, je tam endometri\u00f3za a ob\u010das, jak ta d\u011bloha roste, doch\u00e1z\u00ed k povolen\u00ed sr\u016fst\u016f a ke krv\u00e1cen\u00ed do dutiny b\u0159i\u0161n\u00ed, to neb\u00fdv\u00e1 \u010dasto, ale m\u016f\u017ee se objevit, m\u016f\u017ee adenomy\u00f3za, co\u017e je endometri\u00f3za ve st\u011bn\u011b d\u011blo\u017en\u00ed, ve svalovin\u011b zp\u016fsobit p\u0159ed\u010dasn\u00e9 kontrakce a p\u0159ed\u010dasn\u00fd porod, t\u0159eba.<\/p>\n\n\n\n
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Tak\u017ee je lep\u0161\u00ed vlastn\u011b absolvovat, pokud m\u00e1me podez\u0159en\u00ed, tak absolvovat vy\u0161et\u0159en\u00ed p\u0159edt\u00edm a m\u00edt to asi tak tro\u0161ku po\u0159e\u0161en\u00e9, kdy\u017e by pacientka \u0161la tou neinvazivn\u00ed cestou, to znamen\u00e1, \u017ee by endometri\u00f3zu \u0159e\u0161ila pouze hormon\u00e1ln\u00ed l\u00e9\u010dbou, je to op\u011bt faktor, kter\u00fd by negativn\u011b mohl ovliv\u0148ovat to t\u011bhotenstv\u00ed?<\/p>\n\n\n\n
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mysl\u00edm si, \u017ee to je srovnateln\u00fd s opera\u010dn\u00edm \u0159e\u0161en\u00edm, pokud ot\u011bhotn\u00ed, v\u011bt\u0161inou ty komplikace u\u017e neb\u00fdvaj\u00ed.<\/p>\n\n\n\n
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Pane docente, my v\u00e1m moc d\u011bkujeme. <\/p>\n","protected":false},"excerpt":{"rendered":"