PreOp® Myomectomy Abdominal Fibroid Removal

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Your gynecologist has recommended that you have surgery to remove fibroid tumors from your uterus. But what does that actually mean?

The uterus is part of a woman's reproductive system. It's the organ that contains and protects a growing fetus during pregnancy.

Fibroids are non-cancerous tumors that grow on the inner or outer wall of the uterus. They are quite common - as many as 20% of women over 30 have them. In most cases fibroids do not cause any discomfort and are never detected.

Occasionally, however, fibroid tumors can cause problems. Complications from fibroid growth can include:

    * Pressure on the urinary system.
    * Pressure on the intestines.
    * Interference with the reproductive system
    * Or infection.

Because these tumors can grow to be very large, surgery is usually recommended in order to restore health and to protect the uterus.

Your Procedure:

On the day of your operation, you will be asked to put on a surgical gown.

You may receive a sedative by mouth and an intravenous line may be put in. You will then be transferred to the operating table.

To begin, your groin will be clipped or shaved and the anesthesiologist will begin to administer anesthesia - most probably general anesthesia by injection and inhalation mask. The surgeon will then apply an antiseptic solution to the skin and will place a sterile drape around the operative site. After you are asleep, a horizontal incision will be made across your lower abdomen.

Your doctor will use an instrument called a retractor to pull the skin aside, exposing your abdominal muscles. The surgeon then separates the muscles by making a vertical incision. Another retractor is used to pull aside the muscles and hold them in place. The fibroid will now be visible. Using a pair of forceps, your doctor will take hold of the fibroid and pull it up and away from the wall of the uterus.

Next, you doctor will cut the connection between the fibroid and the uterus. The fibroid is then removed. A series of stitches are used to close incisions. First, the uterine wall is closed. Then, the muscle retractor is removed and the abdominal muscles are sewn together.

Finally, the incision in the skin is closed and a sterile bandage is applied to the site.

Caring for a Male External Urinary Collecting System

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When a man is unable to control his urine for long periods of time he is said to be incontinent.
To avoid soiling his clothes and bed a condom-style sheath can be used to connect the penis to a closed drainage system in which the urine is collected.
This avoids having a catheter inserted into the man's urinary bladder and greatly decreases the risk of bladder infections.
The complete urine collecting system consists of:

* The condom style sheath on the penis
* The plastic drainage tube which is coiled on and attached to the bed to avoid tension on the sheath
* The urine collection bag which is attached to the bed frame below the level of the man's bladder

When taking care of this male external urine collecting system, the responsibilities of the caregiver are to:

* Replace the condom sheath every 24 hours
* Wash and dry the penis
* Inspect the skin of the penis for soreness

Report any problems to your doctor -Patient Education
The equipment that you will need to assemble before starting the care task includes:

* Disposable bed protector
* Gauze squares
* Basin containing warm, soapy water
* Condom external catheter
* Can of adhesive spray
* Clean washcloth
* Two clean towels, one for your hands and one for the penis
* Piece of material and a safety pin
* Plastic storage bag, gallon size and
* Disposable gloves

Wash your hands for at least 10 seconds.
Completely dry them using one of the clean towels.
Put on your disposable gloves.
Place the bed protector under the thighs.
Disconnect the drainage tube from the end of the condom sheath. Hold it up to allow any urine in it to drain back into the collection bag.
Cover the end of the tube with a gauze square and place the covered end on the bed protector away from where you are working.
Remove the condom by rolling it down to the tip of the penis. Place the condom in the plastic storage bag.
Fold the clean washcloth around your hand. Wet it thoroughly in the warm soapy water. Hold the head of the penis up and gently wash the shaft and head of the penis. Drop the washcloth into the warm water.
Use the clean towel to carefully and completely dry the penis.
Ask the man if he feels any soreness and carefully inspect the penis for redness or soreness. Any problem should be noted and reported to your doctor.
Apply a thin spray of adhesive to the whole penis except for the head.
Apply the condom to the end of the penis and roll it down to the base of the penis. Check that the condom is secure at the base.
Gently pull on the end of the condom to make sure it is securely attached to the penis and attach it to the drainage tube.
The connected condom sheath should look like this.
Remove the bed protector. Fold it tight and place it in the plastic storage bag.
Coil the drainage tube on the bed and secure it with a piece of material and a safety pin.
Remove your gloves and place them in the plastic storage bag and seal the bag.

* Drop the plastic storage bag into a thick garbage bag. It can be disposed of in the normal trash.
* Thoroughly wash your hands.
* Wash the used towels and washcloth in the normal laundry system.

In a small notebook, document:

* the date and time
* that the condom sheath has been replaced
* and any observations about the man's penis or his general condition.