We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
Vols saber com serà la teva estada a l’Hospital Universitari Vall d’Hebron? Aquí trobaràs tota la informació.
Chronic pelvic pain is defined as "chronic or persistent pain in the structures related to the pelvis in both men and women". It commonly impacts on cognitive, sexual and emotional behaviour. It often manifests as gynaecological, sexual, intestinal or pelvic floor dysfunction. A MULTIDISCIPLINARY approach must therefore be taken to treatment.
Chronic pelvic pain lasts for six months or more and affects the pelvic area, the abdominal wall of the bellybutton and below, the lumbosacral area of the back and/or buttocks and is of sufficient intensity to cause disability in the patient and/or require medical attention.
This has a clear effect on the quality of life of people suffering from the condition.
Its origin is unknown, but we do know that it is exploited by multiple biological/organic, psychological and environmental conditions, which interact in a non-linear way and predispose the patient to present with the condition. There is a clear trend for patients to attend multiple specialists, with requests for complementary testing, which can become iatrogenic, with the patient often feeling misunderstood and ill-treated by the healthcare system.
As it is more of a clinical condition rather than a diagnosis as such, the symptoms can vary a lot, but they always centre around persistent pain. It has a major impact on women of reproductive age and its impact on quality of life varies depending on the causes. It is worth remembering that it gravely impacts on patients’ sex lives and this can cause very significant psychological issues.
According to research, the prevalence of pelvic pain in epidemiology is vary variable. This almost certainly has to do with sociocultural aspects. According to the latest studies, it could be as much as 6.4-25.4% in women and lower in men, at around 2-17%. It is very likely that in the case of men there is an underestimation of this prevalence as there is less willingness to look at problems that also affect the sexual sphere.
Diagnosis is clinical. An appropriate clinical history needs to be conducted with the patient and/or relatives by a specialised healthcare professional. There are different scales to assess the severity of symptoms or associated comorbid disorders, and neuropsychological tests that evaluate cognitive difficulties in terms of attention and concentration. There are also some useful complementary tests to rule out organic causes and make a good diagnosis.
A multi-modal approach is required: psychoeducation, psychological treatment and pharmacological treatment. If the condition is also affecting the patient’s sexuality, we must consider tackling the issue with the patient’s partner as a priority. Several drugs have been shown to help control the symptoms. It very important for treatment to create a good doctor/patient relationship, avoiding unnecessary and iatrogenic complementary testing.
Clinical history. Psychological interview. Neuropsychological examination. Blood test, vital signs, weight and height. Neuroimaging. Scans.
Work with healthcare professionals from the different specialisms that treat chronic pelvic pain. Schedule regular appointments and manage requests for complementary tests and medical interventions to prevent iatrogenic illness. Do regular physical exercise, try to rest well at night, stay active and take part in employment and/or leisure activities, practise relaxation therapies such as mindfulness and avoid consuming toxic substances. Rehabilitation physiotherapy.
Psiquiatría: Dr. J A Navarro Sanchis
These syndromes are a group of diseases characterised by insufficient blood cell production (anaemia, neutropenia and thrombocytopenia), constitutional malformations and the risk of cancer.
They are usually diagnosed in childhood but there some cases diagnosed in adults. Specifically, these syndromes are: Fanconi anaemia, dyskeratosis congenita or selectively severe congenital neutropenia, Diamond-Blackfan anaemia, Diamond-Shwachman syndrome, and amegakaryocytic thrombocytopenia.
Malformations caused by inherited bone marrow failure syndromes affect the skin, bones, heart and digestive system as well as the urinary system, the central nervous system, and others. They may also affect the area around the bone marrow.
Besides this, they also increase the predisposition to cancers such as acute myeloid leukaemia, myelodysplastic syndrome and squamous carcinoma of the head, neck and reproductive organs.
These syndromes have important biological pathways in common related to cell growth and division such as the activation of the p53 gene that is responsible for halting the cell cycle, cell ageing and cell death. In addition, mutations have been identified in more than 80 genes.
Although this is treated in childhood, once the patient reaches adulthood monitoring is very important. Early diagnosis of these syndromes is essential to ensure the patient receives appropriate treatment. The aim is to minimise toxicity at the same time as allowing genetic counselling, and implementing strategies for cancer prevention and monitoring. This treatment should focus on treating the bone marrow failure, but also any constitutional malformations and extra-haematological manifestations, in addition to cancer treatment.
A multidisciplinary team of specialists with extensive experience of these diseases is necessary to ensure optimum patient care.
The first symptoms are related to a lack of blood cell production:
There are also signs related to malformations such as:
Estimated incidence rates of the different syndromes are:
The usual tests to detect inherited bone marrow failure are:
The following methods are used to treat these pathologies:
To prevent these diseases it is important to avoid smoking, alcohol, sun exposure, and to have a balanced diet. In addition, a cancer prevention programme should be followed with regular visits to the Cancer Prevention Unit and the Ear, Nose and Throat, Maxillofacial and Gynaecology departments.
Laparoscopic myomectomy is a surgical intervention used to remove uterine fibroids (or myomas), which are almost always benign tumours that appear inside the wall of the uterus.
The prevalence of uterine fibroids is high, around 30%. In most cases, they are asymptomatic and no treatment is necessary.
In those patients where fibroids do cause symptoms, these include hypermenorrhea, pain and infertility. Myomectomy is a valid treatment option.
Until recently, a laparotomy was the usual procedure. The indication of laparoscopic myomectomy as an alternative to laparotomy has been assessed in various studies. It requires seasoned surgeons with experience in the technique and expert handling of the endoscopic suture.
Laparoscopic myomectomy offers advantages over the laparotomy, such as: reduced postoperative recovery times, decreased postoperative pain and shorter hospital stays. However, it entails longer surgery and requires adequate preoperative evaluation, since the size, number and location of the fibroids can be a limiting factor when choosing a laparotomic approach.
Since June 2009, at the Vall d'Hebron University Hospital we have the Da Vinci robotic system that has been important in assisting in the suture of fibroids in hard-to-reach places, or when the endometrial cavity is affected and must be repaired. In these cases, the Da Vinci system has meant we have been able to offer greater numbers of closed surgeries on our unit.
This treatment is offered by the Gynaecology Department.
In addition to providing multidisciplinary care for patients of all ages who suffer this condition, the objectives of Vall d’Hebron Hospital’s Hereditary Angioedema Unit include teaching and research in this field.
The Hereditary Angioedema Unit (UAEH) of Vall d’Hebron University Hospital’s Allergology Department has been treating patients with this disorder for more than 25 years.
UAEH outpatients are treated by allergology specialists in a multidisciplinary manner in the Outpatient Clinic in the Old Nursing School and in the Children’s and Women’s Hospital, ensuring transference and continuity of care from childhood through to adulthood for this genetic, lifelong condition.
The main purpose of the Gynaecology Department is to offer constant, up-to-date expert service to all women in our area of influence. On the other hand, as are a level three hospital, we are leaders in high-level techniques and technologies.
Our Department is one of the finest in the country, especially for oncology, for cancer of the breast and lower female genitalia. These are complex pathologies whose treatment must take a multidisciplinary approach. Thanks to the support we receive from multiple specialists, we are proud to offer a high-quality service.
In addition to the subspecialties that are traditionally related to the field, the Gynaecology Department at Vall d'Hebron University Hospital has for several years now also incorporated gynaecological endoscopic surgery: laparoscopy and hysteroscopy. These account for almost 50% of the scheduled operations performed by the Department and most of them are carried out as outpatients, in the day hospital.
This Unit carries out diagnosis, treatment and monitoring of benign gynaecological pathologies that require surgical treatment using laparoscopic treatment.
The Major Outpatient Surgery Unit is located on the 3rd floor of the Maternity and Children's Hospital, next to the three operating theatres where the Endoscopy Unit and Post-Surgical Resuscitation Division carry out most of their operations.
The Gynaecological Oncology and Lower Genital Tract Pathology Unit is a part of the Gynaecology Department. It treats all genital cancer diseases in the Hospital's catchment area, as well as more complex cases with requirements that exceed the capacity of other health centres in Catalonia.
Our mission is to provide effective, efficient and quality healthcare in the treatment of diseases. Our guiding principle is comprehensive care, where treatment, teaching and research combine to offer the public the highest quality competitive service.
Residents in Obstetrics and Gynaecology undergo ongoing and tutored learning throughout their training, enabling them to acquire in-depth knowledge of the physiology and pathology of the lower female genitalia, pregnancy and birth.
Obstetrics and gynecology training itinerary
The Obstetrics and Gynaecology Teaching Unit trains residents in the physiological and pathological aspects of human reproduction, and also pregnancy, birth and post-partum care, and their disorders. It also deals with the organs that make up the female genital tract and breast care. Related preventative, psychic, and social aspects are also within its scope.
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