Sažetak | Tumori mogu biti maligni i benigni. Ako je riječ o malignom tumoru, on uništava zdravo tkivo. Da bi oporavak od tumora bio što uspješniji potrebno ga je čim prije otkriti. Ginekološki tumori su tumori koji se nalaze u ženskim reproduktivnim organima. Jedni su od najčešćih i najsmrtonosnijih oboljenja kod žena.
Ženski spolni organi se dijele na vanjske i unutarnje. Anatomija ženskih spolnih organa se mijenja starenjem. Dno male zdjelice oblikuju mišići koji daju stabilnost i potporu trbušnim i zdjeličnim organima, utječu na intraabdominalni tlak, omogućuju seksualne funkcije, potpomažu kontroli mokrenja i defekacije. Na području ženskih spolnih organa se nalaze mnogi živci koji inerviraju to područje. Ginekološki tumori mogu zahvatiti tijelo maternice, jajnik i jajovod, stidnicu, rodnicu i vrat maternice.
Na pojavnost tumora ovisi socijalno – ekonomski status žene, te godine i način života. Tumori često metastaziraju na okolna mjesta. Prvi simptomi tumora su često zanemareni. Kod uzimanja dijagnoze je bitno uzimanje anamneze, cjelokupni ginekološki pregled s PAPA testom uz dodatnu daljnju obradu. Najčešće se provodi operativno liječenje, zračenje i kemoterapija. Moguće je i provođenje hormonske terapije radi smanjenja mogućnosti metastaziranja tumora.
Nakon ginekološkog operativnog zahvata bolesnici je potrebna individualna isplanirana fizioterapija. Prvi dio fizioterapije se provodi zbog prevencije postoperativnih komplikacija, a kasnije je cilj na jačanju mišića i vraćanju bolesnice u stanje prije operacije. Ciljevi rehabilitacije su aktivirati cirkulaciju i protok dišnih puteva, jačanje mišića i sprečavanje bolova u križima i naposljetku povratak na prethodne aktivnosti. Fizioterapijska procjena radi se po SOAP principu. U prvom dijelu rehabilitacije provodi se respiratorna fizioterapija. Kod vertikalizacije bolesnice potrebno je postupiti oprezno i postepeno. Vježbe cirkulacije se mogu izvoditi u ležećem ili sjedećem položaju. Uz svaku vježbu cirkulacije mogu se izvoditi i vježbe disanja. Kegelove vježbe se provode za jačanje mišića zdjeličnog dna. Potrebno je s njima početi čim prije moguće. Vježbe se izvode kontrakcijom mišića zdjeličnog dna. Mogu se izvoditi brzim i sporim tempom. Potrebno je jačati i trbušnu muskulaturu već dva do tri dana nakon operacije. Kada bolesnica savlada lakše vježbe za jačanje mišića intenzitet vježbi se povećava. Potrebno je jačati sve skupine mišića da bi se smanjila bol u križima i da bi držanje bolesnice bilo pravilno. Tijekom provođenja vježbi ne smije se osjećati bol, no neugodnost može biti prisutna. Kada se izvodi bilo koja vježba dah se ne smije zadržavati. Bez rehabilitacije i vježbanja nakon nje oporavak bolesnice ne može biti potpun. Biofeedback i električni impulsi IFS-a se izvodi u kombinaciji sa Kegelovim vježbama.
Nakon završetka rehabilitacije fizioterapeut mora educirati bolesnicu o njenom načinu života najmanje 3 mjeseca nakon operacije. O obavljanju kućanskih poslova, povratku na posao i normalnim svakodnevnim aktivnostima. Savjetuje se hodanje na dnevnoj bazi.
Ponekad se nakon operacije pojavi limfni edem zbog gomilanje tekućine u mekom tkivu. Limfni edem mogu ublažiti kompresivne čarape i manualna limfna drenaža. |
Sažetak (engleski) | Cancers can be malignant and benign. Malignant cancer destroys healthy tissue. For a successful recovery from the tumor, it's important to detect it as soon as possible. Gynecological tumors are tumors that are found in the female reproductive organs. They are one of the most common and deadly diseases in women.
Female genitals are divided into external and internal parts. The anatomy of the female genitals changes with age. The bottom of the small pelvis is formed by muscles that provide stability and support to the abdominal and pelvic organs, affect intra-abdominal pressure, enable sexual functions and they are helping to control urination and defecation. There are many nerves in the area of the female genitals that innervate that area. Gynecological tumors can affect the body of the uterus, ovary, and fallopian tubes, vulva, vagina, and cervix.
The socio-economic status of a woman, her age, and lifestyle depend on the appearance of the tumor. Tumors often metastasize to surrounding organs. The first symptoms of the tumor are often ignored. When we are making a diagnosis, it is important to take a patient’s anamnesis, a complete gynecological examination with a PAPA test with additional further tests. Most commonly is performed surgical treatment, radiation and chemotherapy. It is also possible to perform hormone therapy to reduce the possibility of tumor metastasis.
After the gynecological operation, the patient needs individually planned physiotherapy. The first part of physiotherapy is performed to prevent postoperative complications, and later the goal is to strengthen the muscles and return the patient to the state before the operation. The goals of rehabilitation are to activate circulation and airway flow, strengthen muscles and prevent low back pain, and ultimately return to previous activities. A physiotherapy assessment is done according to the SOAP principle. In the first part of the rehabilitation, in addition to breathing exercises, coughing exercises are also performed. When verticalizing the patient, it is necessary to act carefully and gradually. Circulation exercises can be performed in a lying or sitting position. Breathing exercises can be performed with each circulatory exercise. Kegel exercises are performed to strengthen the pelvic floor muscles. It is necessary to start with them as soon as possible. The exercises are performed by contracting the pelvic floor muscles. They can be run at a fast and slow pace. It is necessary to strengthen the abdominal muscles as early as two to three days after the operation. When the patient masters lighter muscle strengthening exercises, the intensity of the exercise increases. It is necessary to strengthen all muscle groups to reduce low back pain and to keep the patient in a proper position. No pain should be felt during the exercises, but discomfort may be present. When performing any exercise, the breath must not be held. Without rehabilitation and exercise after it, the patient's recovery cannot be complete. Biofeedback and electrical impulses of IFS are performed in combination with Kegel exercises.
When rehabilitation is done, the physiotherapist must educate the patient about her lifestyle for at least 3 months after surgery. About doing housework, going back to work, and normal daily activities. Walking on a daily basis is advised.
Sometimes lymphedema occurs after surgery due to the accumulation of fluid in the soft tissue. Lymphedema can be relieved by compression stockings and manual lymphatic drainage. |