{"id":17079,"date":"2024-05-30T14:43:09","date_gmt":"2024-05-30T14:43:09","guid":{"rendered":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?p=17079"},"modified":"2024-05-30T14:43:15","modified_gmt":"2024-05-30T14:43:15","slug":"llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy","status":"publish","type":"post","link":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/","title":{"rendered":"Polityka LLR Obfite krwawienia miesi\u0105czkowe i wskazania do histerektomii"},"content":{"rendered":"

Niniejsza polityka zawiera wytyczne dotycz\u0105ce zlecania histerektomii w leczeniu obfitego krwawienia miesi\u0105czkowego nie<\/strong> spowodowane nieprawid\u0142owo\u015bciami strukturalnymi lub patologicznymi.<\/p>\n\n\n\n

Ci\u0119\u017ckie krwawienie miesi\u0105czkowe (HMB) definiuje si\u0119 jako nadmiern\u0105 utrat\u0119 krwi menstruacyjnej, kt\u00f3ra wyst\u0119puje w regularnych odst\u0119pach czasu i zak\u0142\u00f3ca funkcjonowanie fizyczne, spo\u0142eczne, emocjonalne i\/lub materialne kobiety.<\/p>\n\n\n\n

jako\u015b\u0107 \u017cycia. Mo\u017ce wyst\u0105pi\u0107 samodzielnie lub w po\u0142\u0105czeniu z innymi objawami. Nie ma \u017cadnej patologii zwi\u0105zanej z obfitym krwawieniem miesi\u0105czkowym.<\/p>\n\n\n\n

Histerektomi\u0119 nale\u017cy rozwa\u017ca\u0107 tylko wtedy, gdy: inne mo\u017cliwo\u015bci leczenia zawiod\u0142y, s\u0105 przeciwwskazane; istnieje pragnienie braku miesi\u0105czki (brak miesi\u0105czki); kobieta (w pe\u0142ni poinformowana) o to prosi; kobieta nie chce ju\u017c zachowa\u0107 macicy i p\u0142odno\u015bci.<\/p>\n\n\n\n

Indywidualna ocena kliniczna b\u0119dzie nadal prowadzona w przypadku podejmowania decyzji o histerektomii z powodu nieprawid\u0142owo\u015bci strukturalnych, takich jak wypadanie macicy, zmiany przednowotworowe, mi\u0119\u015bniaki > 3 cm, utrzymuj\u0105ca si\u0119 adenomioza CIN i endometrioza, kt\u00f3re mog\u0105 by\u0107 r\u00f3wnie\u017c wskazaniami do histerektomii u kobiety z HMB.<\/p>\n\n\n\n

Uprawnienia<\/strong><\/p>\n\n\n\n

Kryteria progowe<\/p>\n\n\n\n

LLR ICB Histerektomia z powodu obfitego krwawienia miesi\u0105czkowego NIE JEST RUTYNOWNIE FINANSOWANA, chyba \u017ce spe\u0142nione s\u0105 WSZYSTKIE poni\u017csze kryteria.<\/strong>
\u00a0<\/strong>
\u00a0
\u2013 Wypr\u00f3bowano dwa zabiegi z Wytycznych Nicei 44 (o ile nie ma przeciwwskaza\u0144) i kontynuowano je przez co najmniej 3 miesi\u0105ce w celu oceny odpowiedzi, chyba \u017ce skutki uboczne s\u0105 nie do zaakceptowania.

\u2013 Nale\u017cy wyra\u017anie zaproponowa\u0107 wszczepienie IUS, poniewa\u017c jest to leczenie pierwszego rzutu w przypadku HMB. Je\u015bli zostanie to odrzucone lub przeciwwskazane, nale\u017cy to wyra\u017anie udokumentowa\u0107. Zaleca si\u0119 trzymanie wk\u0142adki IUS przez 6 miesi\u0119cy w celu oceny skuteczno\u015bci zgodnie z wytycznymi NICE.

\u2013 Zalecamy stosowanie szablonu dzienniczka miesi\u0105czkowego w ocenie HMB i ocenie mo\u017cliwo\u015bci leczenia.

\u2013 Nast\u0119pnie nie uda\u0142o si\u0119 z\u0142agodzi\u0107 objaw\u00f3w (chyba \u017ce jest to nieodpowiednie z medycznego punktu widzenia lub przeciwwskazane)
\u00a0
I
\u00a0
Poni\u017csze metody leczenia albo okaza\u0142y si\u0119 nieskuteczne, nie s\u0105 odpowiednie lub s\u0105 przeciwwskazane zgodnie z wytycznymi Narodowego Instytutu Zdrowia i Doskona\u0142o\u015bci Klinicznej (NICE) NG88 Ci\u0119\u017ckie krwawienia miesi\u0105czkowe:

\u2022 Kwas traneksamowy i\/lub niesteroidowe leki przeciwzapalne (NLPZ), takie jak naproksen

\u2022 Doustne metody hormonalne, takie jak z\u0142o\u017cone doustne \u015brodki antykoncepcyjne, cykliczny doustny progesteron
\u00a0
I
\u00a0
Istniej\u0105 dowody na powa\u017cny wp\u0142yw na jako\u015b\u0107 \u017cycia
\u00a0
LUB
\u00a0
Je\u015bli leczenie jest nieskuteczne, kobieta odmawia leczenia farmakologicznego lub objawy s\u0105 powa\u017cne, rozwa\u017c skierowanie do opieki specjalistycznej w celu: bada\u0144 w celu zdiagnozowania przyczyny HMB, je\u015bli to konieczne, bior\u0105c pod uwag\u0119 wszelkie badania, kt\u00f3re kobieta ju\u017c przeprowadzi\u0142a i alternatywne metody leczenia, w tym : opcje farmakologiczne, kt\u00f3rych jeszcze nie wypr\u00f3bowano (jak poprzednio), alternatywne opcje chirurgiczne<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Wytyczne<\/strong><\/p>\n\n\n\n

https:\/\/www.pms.org.uk\/app\/uploads\/2019\/10\/NAPS-MENSTRUAL-DIARY.docx<\/strong><\/a>
\u00a0<\/strong>
Histerektomia z powodu obfitego krwawienia miesi\u0105czkowego \u2013 EBI (aomrc.org.uk)<\/a>
\u00a0
Ci\u0119\u017ckie miesi\u0105czki \u2013 NHS (www.nhs.uk)
\u00a0
Histerektomia \u2013 NHS (www.nhs.uk)<\/a>
\u00a0
Krwotok miesi\u0105czkowy (obfite krwawienie miesi\u0105czkowe) | Tematy zdrowotne od A do Z | CKS | \u0141ADNY<\/a>
\u00a0
Hormonalna terapia zast\u0119pcza (HTZ) | Informacje dotycz\u0105ce przepisywania | Menopauza | CKS | \u0141ADNY<\/a>
\u00a0
Post\u0119powanie w przypadku nieplanowanego krwawienia w ramach hormonalnej terapii zast\u0119pczej (HTZ) \u2013 Brytyjskie Towarzystwo Menopauzy (thebms.org.uk)<\/a><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Dodatkowe informacje<\/strong><\/p>\n\n\n\n

Wyszukiwarka \u015bcie\u017cek ginekologicznych<\/strong><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Post\u0119powanie w przypadku nieplanowanego krwawienia<\/strong><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Podejrzewana \u015bcie\u017cka patologii endometrium (SEP).<\/strong><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n
Data przegl\u0105du ARP 72: 2027 r<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"

This policy provides guidance on the commissioning of hysterectomy for the treatment of heavy menstrual bleeding which is not caused by a structural or pathological abnormality. Heavy menstrual bleeding (HMB) […]<\/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],"class_list":["post-17079","post","type-post","status-publish","format-standard","hentry","category-policies","tag-gynaecology","tag-not-routinely-funded","tag-threshold"],"yoast_head":"\nLLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy - 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-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/\" \/>\n<meta property=\"og:locale\" content=\"pl_PL\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"LLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy - LLR ICB\" \/>\n<meta property=\"og:description\" content=\"This policy provides guidance on the commissioning of hysterectomy for the treatment of heavy menstrual bleeding which is not caused by a structural or pathological abnormality. Heavy menstrual bleeding (HMB) […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/\" \/>\n<meta property=\"og:site_name\" content=\"LLR ICB\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/NHSLLR\" \/>\n<meta property=\"article:published_time\" content=\"2024-05-30T14:43:09+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-05-30T14:43:15+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1024x717.png\" \/>\n<meta name=\"author\" content=\"Tracy Jesa\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@NHS_LLR\" \/>\n<meta name=\"twitter:site\" content=\"@NHS_LLR\" \/>\n<meta name=\"twitter:label1\" content=\"Napisane przez\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tracy Jesa\" \/>\n\t<meta name=\"twitter:label2\" content=\"Szacowany czas czytania\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minuty\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/\"},\"author\":{\"name\":\"Tracy Jesa\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#\\\/schema\\\/person\\\/a721bf22e073f34efdc6c7f2dd8a5976\"},\"headline\":\"LLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy\",\"datePublished\":\"2024-05-30T14:43:09+00:00\",\"dateModified\":\"2024-05-30T14:43:15+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/\"},\"wordCount\":500,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/wp-content\\\/uploads\\\/2024\\\/05\\\/image-1024x717.png\",\"keywords\":[\"gynaecology\",\"not routinely funded\",\"threshold\"],\"articleSection\":[\"Policies\"],\"inLanguage\":\"pl-PL\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/\",\"url\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/\",\"name\":\"LLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy - LLR ICB\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/wp-content\\\/uploads\\\/2024\\\/05\\\/image-1024x717.png\",\"datePublished\":\"2024-05-30T14:43:09+00:00\",\"dateModified\":\"2024-05-30T14:43:15+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#breadcrumb\"},\"inLanguage\":\"pl-PL\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pl-PL\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#primaryimage\",\"url\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/wp-content\\\/uploads\\\/2024\\\/05\\\/image-1024x717.png\",\"contentUrl\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/wp-content\\\/uploads\\\/2024\\\/05\\\/image-1024x717.png\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"LLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#website\",\"url\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/\",\"name\":\"LLR ICB\",\"description\":\"LLR Integrated Care Board\",\"publisher\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pl-PL\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#organization\",\"name\":\"LLR ICB\",\"url\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pl-PL\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/i0.wp.com\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/wp-content\\\/uploads\\\/2022\\\/06\\\/New-Project-4.jpg?fit=452%2C93&ssl=1\",\"contentUrl\":\"https:\\\/\\\/i0.wp.com\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/wp-content\\\/uploads\\\/2022\\\/06\\\/New-Project-4.jpg?fit=452%2C93&ssl=1\",\"width\":452,\"height\":93,\"caption\":\"LLR ICB\"},\"image\":{\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/NHSLLR\",\"https:\\\/\\\/x.com\\\/NHS_LLR\",\"https:\\\/\\\/www.instagram.com\\\/nhsllr\\\/\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/#\\\/schema\\\/person\\\/a721bf22e073f34efdc6c7f2dd8a5976\",\"name\":\"Tracy Jesa\",\"url\":\"https:\\\/\\\/leicesterleicestershireandrutland.icb.nhs.uk\\\/pl\\\/author\\\/tracy-jesanhs-net\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Polityka LLR Obfite krwawienia miesi\u0105czkowe i wskazania do histerektomii - LLR ICB","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/","og_locale":"pl_PL","og_type":"article","og_title":"LLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy - LLR ICB","og_description":"This policy provides guidance on the commissioning of hysterectomy for the treatment of heavy menstrual bleeding which is not caused by a structural or pathological abnormality. Heavy menstrual bleeding (HMB) […]","og_url":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/","og_site_name":"LLR ICB","article_publisher":"https:\/\/www.facebook.com\/NHSLLR","article_published_time":"2024-05-30T14:43:09+00:00","article_modified_time":"2024-05-30T14:43:15+00:00","og_image":[{"url":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1024x717.png","type":"","width":"","height":""}],"author":"Tracy Jesa","twitter_card":"summary_large_image","twitter_creator":"@NHS_LLR","twitter_site":"@NHS_LLR","twitter_misc":{"Napisane przez":"Tracy Jesa","Szacowany czas czytania":"3 minuty"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#article","isPartOf":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/"},"author":{"name":"Tracy Jesa","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#\/schema\/person\/a721bf22e073f34efdc6c7f2dd8a5976"},"headline":"LLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy","datePublished":"2024-05-30T14:43:09+00:00","dateModified":"2024-05-30T14:43:15+00:00","mainEntityOfPage":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/"},"wordCount":500,"commentCount":0,"publisher":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#organization"},"image":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#primaryimage"},"thumbnailUrl":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1024x717.png","keywords":["gynaecology","not routinely funded","threshold"],"articleSection":["Policies"],"inLanguage":"pl-PL","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/","url":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/","name":"Polityka LLR Obfite krwawienia miesi\u0105czkowe i wskazania do histerektomii - LLR ICB","isPartOf":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#website"},"primaryImageOfPage":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#primaryimage"},"image":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#primaryimage"},"thumbnailUrl":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1024x717.png","datePublished":"2024-05-30T14:43:09+00:00","dateModified":"2024-05-30T14:43:15+00:00","breadcrumb":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#breadcrumb"},"inLanguage":"pl-PL","potentialAction":[{"@type":"ReadAction","target":["https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/"]}]},{"@type":"ImageObject","inLanguage":"pl-PL","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#primaryimage","url":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1024x717.png","contentUrl":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1024x717.png"},{"@type":"BreadcrumbList","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/llr-policy-heavy-menstrual-bleeding-and-indications-for-hysterectomy\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/"},{"@type":"ListItem","position":2,"name":"LLR Policy Heavy Menstrual Bleeding and Indications for Hysterectomy"}]},{"@type":"WebSite","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#website","url":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/","name":"LLR ICB","description":"Zintegrowana Rada Opieki LLR","publisher":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pl-PL"},{"@type":"Organization","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#organization","name":"LLR ICB","url":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/","logo":{"@type":"ImageObject","inLanguage":"pl-PL","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#\/schema\/logo\/image\/","url":"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2022\/06\/New-Project-4.jpg?fit=452%2C93&ssl=1","contentUrl":"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2022\/06\/New-Project-4.jpg?fit=452%2C93&ssl=1","width":452,"height":93,"caption":"LLR ICB"},"image":{"@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/NHSLLR","https:\/\/x.com\/NHS_LLR","https:\/\/www.instagram.com\/nhsllr\/"]},{"@type":"Person","@id":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/#\/schema\/person\/a721bf22e073f34efdc6c7f2dd8a5976","name":"Tracy Jesa","url":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/author\/tracy-jesanhs-net\/"}]}},"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/posts\/17079","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/users\/542"}],"replies":[{"embeddable":true,"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/comments?post=17079"}],"version-history":[{"count":1,"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/posts\/17079\/revisions"}],"predecessor-version":[{"id":17085,"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/posts\/17079\/revisions\/17085"}],"wp:attachment":[{"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/media?parent=17079"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/categories?post=17079"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/wp-json\/wp\/v2\/tags?post=17079"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}