{"id":16034,"date":"2024-03-14T12:27:00","date_gmt":"2024-03-14T12:27:00","guid":{"rendered":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?p=16034"},"modified":"2024-12-03T11:16:21","modified_gmt":"2024-12-03T11:16:21","slug":"llr-sterilization-female-and-male-policy","status":"publish","type":"post","link":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-sterilization-female-and-male-policy\/","title":{"rendered":"Sterylizacja LLR \u2013 polityka dotycz\u0105ca kobiet i m\u0119\u017cczyzn"},"content":{"rendered":"<p><strong>Kategoria<\/strong><\/p>\n\n\n\n<p>Kryteria progowe<\/p>\n\n\n\n<p>Zar\u00f3wno sterylizacj\u0119 kobiet, jak i m\u0119\u017cczyzn uwa\u017ca si\u0119 za trwa\u0142\u0105, a odwr\u00f3cenie sterylizacji ju\u017c tak<strong> NIE RUTYNOWNIE FINANSOWANE <\/strong>przez LLR ICB.<\/p>\n\n\n\n<p>Badania wykazuj\u0105 wi\u0119ksz\u0105 cz\u0119sto\u015b\u0107 wyst\u0119powania \u017calu w\u015br\u00f3d m\u0142odszych kobiet poddawanych sterylizacji, dlatego te\u017c nale\u017cy zwr\u00f3ci\u0107 szczeg\u00f3ln\u0105 uwag\u0119 na d\u0142ugo dzia\u0142aj\u0105ce, odwracalne \u015brodki antykoncepcyjne, poniewa\u017c wykazano, \u017ce s\u0105 one r\u00f3wnie skuteczne.<\/p>\n\n\n\n<p>Kobiety, kt\u00f3re zg\u0142aszaj\u0105 potrzeb\u0119 sterylizacji i spe\u0142niaj\u0105 poni\u017csze kryteria, nale\u017cy skierowa\u0107 do plac\u00f3wki \u015bwiadcz\u0105cej opiek\u0119 specjalistyczn\u0105.<\/p>\n\n\n\n<p>M\u0119\u017cczy\u017ani zg\u0142aszaj\u0105cy si\u0119 do sterylizacji (wazektomii) i spe\u0142niaj\u0105cy poni\u017csze kryteria powinni zosta\u0107 skierowani do plac\u00f3wki podstawowej opieki zdrowotnej wazektomicznej, je\u015bli jest to klinicznie uzasadnione. Us\u0142uga wazektomii podstawowej opieki zdrowotnej zapewnia wazektomi\u0119 w ramach <strong>ZNIECZULENIE MIEJSCOWE<\/strong>. M\u0119\u017cczyzn, kt\u00f3rzy maj\u0105 przeciwwskazania do znieczulenia miejscowego i\/lub wsp\u00f3\u0142istniej\u0105 schorzenia urologiczne, kt\u00f3re mog\u0105 wymaga\u0107 operacji moszny, np. du\u017cy wodniak lub du\u017ca torbiel naj\u0105drza, nale\u017cy skierowa\u0107 do lekarza specjalisty urologii, aby mo\u017cliwe by\u0142o wykonanie obu zabieg\u00f3w w tym samym czasie.<\/p>\n\n\n\n<p><strong>Uprawnienia<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>LLR ICB sfinansuje t\u0119 procedur\u0119, je\u015bli zostan\u0105 spe\u0142nione nast\u0119puj\u0105ce kryteria<\/strong><br><br> \u2013 Je\u015bli kobieta jest pewna, \u017ce jej rodzina jest kompletna lub \u017ce nigdy nie chce mie\u0107 dzieci<br><br><strong>I<\/strong><br><br> \u2013 Kobieta zosta\u0142a poinformowana o dost\u0119pnych mo\u017cliwo\u015bciach, w tym o rozwa\u017ceniu wszystkich innych form antykoncepcji d\u0142ugo dzia\u0142aj\u0105cej. Je\u015bli ona ma partnera, czy rozwa\u017ca\u0142 wazektomi\u0119<br><br><strong>I<\/strong><br><br> \u2013 Kobieta jest w pe\u0142ni sprawna umys\u0142owo<br><br><strong>I<\/strong><br><br> \u2013 Kobieta stosowa\u0142a przez co najmniej 12 miesi\u0119cy d\u0142ugo dzia\u0142aj\u0105c\u0105, odwracaln\u0105 antykoncepcj\u0119, np. system domaciczny lewonorgestrelu, etonogestrel, implant podsk\u00f3rny lub zastrzyk Depot Medroksyprogesteronu octanu lub wk\u0142adk\u0119 domaciczn\u0105 z miedzi\u0105 u kobiet, kt\u00f3re w przesz\u0142o\u015bci chorowa\u0142y na raka piersi lub inny nowotw\u00f3r hormonalny<br><br><strong>LUB <\/strong><br>Kobieta po konsultacji odmawia wypr\u00f3bowania d\u0142ugo dzia\u0142aj\u0105cej, odwracalnej antykoncepcji<br><br><strong>LUB<\/strong><br>Kobieta ma schorzenie, kt\u00f3re sprawia, \u017ce ci\u0105\u017ca jest niebezpieczna<br><br><strong>I<\/strong><br><br> \u2013 Wiek 25 lat lub wi\u0119cej<br>\u00a0<br><strong>Je\u017celi BMI przekracza 35<\/strong><br>\u00a0<br>Nale\u017cy skierowa\u0107 pacjenta do s\u0142u\u017cby zarz\u0105dzania wag\u0105 poziomu 2 zgodnie z kryteriami skierowania. Pacjent\u00f3w mo\u017cna skierowa\u0107 do s\u0142u\u017cby, ale nale\u017cy ich poinformowa\u0107, \u017ce sterylizacja laparoskopowa prawdopodobnie nie jest odpowiedni\u0105 metod\u0105 antykoncepcji i zalecamy poradnictwo dotycz\u0105ce ryzyka zwi\u0105zanego ze znieczuleniem.\u00a0\u00a0<br>\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Wyj\u0105tki od tej zasady<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>W przypadku, gdy sterylizacja ma nast\u0105pi\u0107 w czasie innego zabiegu, tj. ci\u0119cia cesarskiego<\/li>\n\n\n\n<li>Je\u017celi istnieje przeciwwskazanie do stosowania d\u0142ugo dzia\u0142aj\u0105cej, odwracalnej antykoncepcji<\/li>\n\n\n\n<li>Je\u017celi istnieje bezwzgl\u0119dne przeciwwskazanie do zaj\u015bcia w ci\u0105\u017c\u0119<\/li>\n<\/ul>\n\n\n\n<p><strong>Kwalifikacja do sterylizacji m\u0119skiej (wazektomii)<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>LLR ICB sfinansuje t\u0119 procedur\u0119, je\u015bli zostan\u0105 spe\u0142nione nast\u0119puj\u0105ce kryteria. Je\u017celi jest to klinicznie uzasadnione, procedur\u0119 t\u0119 nale\u017cy wykona\u0107 w plac\u00f3wce podstawowej opieki zdrowotnej.<\/strong><br>&nbsp;<br> \u2013 M\u0119\u017cczyzna jest pewien, \u017ce jego rodzina jest kompletna lub \u017ce nigdy nie chce mie\u0107 dzieci<br> \u2013 M\u0119\u017cczyzna jest zdrowy psychicznie<br> \u2013 Otrzyma\u0142a porad\u0119 dotycz\u0105c\u0105 trwa\u0142o\u015bci zabiegu i zbadania innych opcji antykoncepcyjnych<br>&nbsp;<br>Je\u015bli m\u0119\u017cczyzna nie kwalifikuje si\u0119 do poddania si\u0119 wazektomii w ramach podstawowej opieki zdrowotnej, us\u0142uga wazektomii w ramach podstawowej opieki zdrowotnej u\u0142atwi skierowanie do opieki specjalistycznej.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Wyj\u0105tki od tej zasady<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gdy sterylizacja ma odbywa\u0107 si\u0119 w tym samym czasie, co inny zabieg w mosznie<\/li>\n\n\n\n<li>Je\u017celi u m\u0119\u017cczyzny wyst\u0119puj\u0105 przeciwwskazania do znieczulenia miejscowego<\/li>\n\n\n\n<li>Gdy u m\u0119\u017cczyzny wsp\u00f3\u0142istnieje problem urologiczny<\/li>\n<\/ul>\n\n\n\n<p><strong>Przewodnictwo<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><a href=\"https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/consent-advice\/consent-advice-3-2016.pdf\">https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/consent-advice\/consent-advice-3-2016.pdf<\/a><br>&nbsp;<br><a href=\"https:\/\/www.fsrh.org\/documents\/cec-ceu-guidance-sterilisation-cpd-sep-2014\/\">https:\/\/www.fsrh.org\/documents\/cec-ceu-guidance-sterilisation-cpd-sep-2014\/<\/a><br>&nbsp;<br><a href=\"https:\/\/www.nhs.uk\/conditions\/contraception\/female-sterilisation\/\">Sterylizacja kobiet \u2013 NHS (www.nhs.uk)<\/a><br>&nbsp;<br><a href=\"https:\/\/www.nhs.uk\/conditions\/contraception\/vasectomy-male-sterilisation\/\">Wazektomia (sterylizacja m\u0119\u017cczyzn) \u2013 NHS (www.nhs.uk)<\/a><br>&nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Data przegl\u0105du ARP 89: 2027 r<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"<p>Category Threshold Criteria Both female and male sterilisation is regarded as permanent and reversal of sterilisation is NOT ROUTINELY FUNDED by the LLR ICB. Research demonstrates a higher incidence of [&hellip;]<\/p>\n","protected":false},"author":542,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[57],"tags":[64,79,83,76],"class_list":["post-16034","post","type-post","status-publish","format-standard","hentry","category-policies","tag-gynaecology","tag-not-routinely-funded","tag-threshold","tag-urology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>LLR Sterilization \u2013 Female and Male Policy - LLR ICB<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-sterilization-female-and-male-policy\/\" \/>\n<meta property=\"og:locale\" content=\"pl_PL\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"LLR Sterilization \u2013 Female and Male Policy - LLR ICB\" \/>\n<meta property=\"og:description\" content=\"Category Threshold Criteria Both female and male sterilisation is regarded as permanent and reversal of sterilisation is NOT ROUTINELY FUNDED by the LLR ICB. 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