Early obesity in women may be linked with difficulty in becoming pregnant. Women who became obese by age 18 and participated in a weight-loss surgery study showed higher rates of infertility and polycystic ovarian syndrome (PCOS).

Forty-two percent of the women in the study trying to conceive experienced infertility, but pregnancy was more likely for women who became obese after age 18. The good news is, surgical weight loss may increase fertility.

The study, the Longitudinal Assessment of Bariatric Surgery (LABS), provided information on the fertility of obese women considering surgical weight loss procedures.

Obesity can interfere with a woman’s hormone levels, making it difficult to become pregnant. This also makes vitro procedures less likely to work. Even in the event of conception, there are major health risks to both mother and child. Not only are miscarriage rates higher, but there are also a higher rates of premature and still-births.

Weight loss surgery, also known as bariatric or metabolic surgery, which includes gastric bypass surgery and lap banding, may help obese women trying to conceive. Many women don't know that having such a procedure is an option.

Research shows that bariatric surgery can reduce pregnancy complications for obese women, and LABS participants were no exception. Roughly 62 percent of LABS participants who underwent surgery who hoped to conceive experienced at least one live birth after infertility.

After weight loss surgery, doctors advise women to wait at least 18 months after surgery (6 months after banding) before trying to become pregnant. They also suggest using contraceptives while waiting for the body to become more stable.

“As the incidence of obesity increases in the United States, women’s health care practitioners are likely to care for a substantial number of patients who will undergo bariatric surgery,” says Dr. William Gibbons of the American Society for Reproductive Medicine. “Studies like this one are extremely useful to help us determine how to advise these patients and best meet their needs.”

Find more information about pregnancy after bariatric surgery, or test your knowledge with Healia’s Pregnancy Quiz.

It may be in your best interest to postpone surgery until regular OR hours. According to a study appearing in The Journal of Bone and Joint Surgery, patients with after-hours operations have 24 percent more unplanned follow-up operations than those who went under the knife during regular office hours.

“Although everyone wants to be treated immediately… it is not always best to rush a patient to the OR in the middle of the night,” explains Dr. William M. Ricci MD, Associate Professor of Orthopaedic Surgery at the Washington University School of Medicine.

The study followed 203 patients who underwent orthopaedic surgery—surgery on bones and joints. While there was no significant difference between radiation exposure, healing time or actual treatment, there was a noticeable disparity between operations that occurred between the daytime and nighttime shifts.

All operations used intramedullary nail fixation to mend tibial or femoral fractures. This is a procedure in which a rod, or “nail”, is used to set the bone. The day was divided into two shifts—the morning shift between 6:00 a.m. and 4:00 p.m., and the night shift thereafter.

Second shift patients had shorter operations, but they also had more follow-up operations and more nail removal surgeries—27percent versus 3 percent for patients whose surgeries occurred during regular office hours. Dr. Ricci believes that much of this can be attributed to the long hours many surgeons put in.

“The reality is that the on-call night surgical team may not be well rested as it is likely they had just finished a normal day shift,” Ricci says. Ricci, who is also chief of the Orthopaedic Trauma Service in the Department of Orthopaedic Surgery at W.U., also explains why non-emergency operations should wait.

“We in the healthcare industry don’t have unlimited resources,” Ricci says. “Many hospitals in the U.S. do have a dedicated night team of orthopaedic surgeons who otherwise are without daytime responsibilities. There are surgical teams on-call for those instances when treatment must be immediate.”

Ricci believes giving orthopaedic surgeons more time to operate on trauma patients can help reduce the risk of minor complications from nail fixation surgeries. He encourages patients to wait for surgery if possible, but insists that actions be taken immediately in urgent situations: “Naturally, when the medical condition is emergent and time is a critical factor, immediate surgery should proceed regardless of time of day.”

Older men who use drugs to treat urinary retention may be at higher risk for complications following cataract surgery, according to a new study published in The Journal of the American Medical Association. The researchers reported that men who use tamsulosin hydrochloride are more than twice as likely to develop serious complications following cataract surgery than those who do not take the medication.

Tamsulosin hydrochloride treats urinary problems caused by an enlarged prostate by relaxing prostate and bladder smooth muscle tissue, allowing urine to be more easily expelled. But the study found that the medication also relaxes the smooth muscle in the eye’s iris. This can lead to iris detachment and swelling of the eye, causing complications during surgery.

Patients who had taken tamsulosin hydrochloride within two weeks of the date of cataract surgery were at the highest risk for complications. Patients who had taken the drug in the past, but not within 14 days of the operation, were significantly less likely to experience adverse events following surgery.

Nearly three quarters of men have enlarged prostates that effect urination by the time they are 70 years old. Tamsulosin hydrochloride is a commonly prescribed treatment for the condition. However, many older males also develop cataracts for which surgical intervention is recommended. To avoid complications during surgery, the researchers recommend patients tell their doctors about any urinary medications they are currently using.

To talk to other patients with enlarged prostates, contribute to the Healia Prostate Diseases Online Health Community and Support Group. Visit the Healia Cataracts Online Health Community and Support Group to share your cataract story.


_{Photo: Piddy77, Flickr, Creative Commons}