1st International Conference on Advances in Obstetrics & Gynaecology : PART II - POSTERSSultan Qaboos University, 4–6 December 2013

Since its introduction in 1948, spending on the UK National Health Service (NHS), as a share of national income, has more than doubled, rising by an average of 4% a year in real terms. This period of rapid growth has now ended, but funding pressures on the NHS continue to rise igniting a debate on the most cost-effective way of offering treatment. In this context, we audited subtotal abdominal hysterectomy (STAH) and laparoscopic-assisted supra-cervical hysterectomy (LASH) for benign gynaecological indications in a large district general hospital. A retrospective audit was undertaken of records of patients who had STAH or LASH for benign conditions at Wishaw General Hospital between August and July 2012. Twenty-five patients for each procedure were identified from the theatre information system. As three sets of notes could not be traced, there were 22 patients in the STAH group and 25 in LASH group. The mean operating time for STAH was 61 min (34–85 min) and 145 min (75–237 min) for the LASH group. There was one major complication in the STAH group (1,000 ml blood loss) compared to five in the LASH group (a pelvic infection, two wound infections and two patients with neuropathic pain at port sites). The mean hospital stay in the STAH group was 2.5 nights (2–4 nights) and 2 nights for patients undergoing LASH (1–4 nights). Costs were £2,213.40 (= OMR 1420) for STAH and £2,613.80 (= OMR 1677) for LASH. In this study, complication rates and apparent costs seemed comparable. Shorter hospital stays and possibly quicker recovery are areas where the laparoscopic approach scores over open surgery. In days of austerity for the NHS, surgery options need careful consideration. Open surgery’s shorter operating times will help tackle long waiting lists but, if the impact on post-operative recovery and time off work are considered, the laparoscopic approach might be better. Endometriosis affects over 70 million women worldwide and is more common than breast cancer and diabetes. Endometriosis is a gynecological disorder characterised by the presence and growth of endometrial tissue outside the uterine cavity. Considering the high prevalence of the disease and its difficult diagnosis and therapeutic management as a result of its complex pathogenesis, which is yet to be fully clarified, a question has been raised as to whether women affected by endometriosis have certain nutritional peculiarities. The purpose of this review was to assess a possible association between dietary components and endometriosis from the existing literature. A search for relevant studies was conducted in CINAHL, Medline plus, Science Direct, SCOPUS and PubMed for the period 2003–2013 using the following search terms: endometriosis and related factors like diet, fat, dairy products, fish, coffee and antioxidants. Twelve articles were included for the review. The findings revealed that there is an association between endometriosis and dietary fat intake, calcium fibre, antioxidants and caffeine. Based on these results, we can suggest that health education should be improved in regard to dietary management in endometriosis in order to improve the quality of life of women with this condition. Nurses and other health professionals in primary care play an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. There is an urgent need to improve the understanding of the impact of dietary components on the risk of endometriosis in order to modify and/or prevent this prevalent gynaecological disease.