{"id":42824,"date":"2025-05-30T07:53:56","date_gmt":"2025-05-30T07:53:56","guid":{"rendered":"https:\/\/www.theconservative.online\/rozvijejici-se-pristup-irska-k-endometrioze"},"modified":"2025-05-30T07:53:56","modified_gmt":"2025-05-30T07:53:56","slug":"rozvijejici-se-pristup-irska-k-endometrioze","status":"publish","type":"post","link":"https:\/\/www.theconservative.online\/cs\/rozvijejici-se-pristup-irska-k-endometrioze","title":{"rendered":"Rozv\u00edjej\u00edc\u00ed se p\u0159\u00edstup Irska k endometri\u00f3ze"},"content":{"rendered":"
Endometri\u00f3za nen\u00ed zanedbateln\u00fd gynekologick\u00fd probl\u00e9m. Jedn\u00e1 se o syst\u00e9mov\u00e9 z\u00e1n\u011btliv\u00e9 onemocn\u011bn\u00ed, kter\u00e9 ni\u010d\u00ed \u017eivoty des\u00edtek tis\u00edc irsk\u00fdch \u017een. Navzdory tomu byla dosavadn\u00ed reakce Irska p\u0159inejlep\u0161\u00edm ambivalentn\u00ed a bezv\u00fdrazn\u00e1. <\/div>\n
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Jedn\u00e1 se o stav, kdy tk\u00e1\u0148 podobn\u00e1 d\u011blo\u017en\u00ed v\u00fdstelce roste tam, kde by nem\u011bla, v\u010detn\u011b vaje\u010dn\u00edk\u016f, st\u0159ev, mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e, a dokonce i plic. Zp\u016fsobuje ochromuj\u00edc\u00ed bolest, jizven\u00ed a v z\u00e1va\u017en\u00fdch p\u0159\u00edpadech i nevratn\u00e9 po\u0161kozen\u00ed org\u00e1n\u016f. Jedn\u00e1 se o onemocn\u011bn\u00ed, kter\u00e9 vy\u017eaduje nal\u00e9havou a specializovanou p\u00e9\u010di, ale je skute\u010dn\u011b c\u00edtit, \u017ee teprve ned\u00e1vno p\u0159istoupil irsk\u00fd \u00da\u0159ad pro zdravotn\u00ed slu\u017eby (HSE) k tomuto probl\u00e9mu s takovou v\u00e1\u017enost\u00ed, jakou si zaslou\u017e\u00ed. <\/div>\n
Jak bylo uvedeno v\u00fd\u0161e, endometri\u00f3za postihuje nejm\u00e9n\u011b jednu z deseti \u017een v reproduk\u010dn\u00edm v\u011bku (po zapo\u010dten\u00ed nediagnostikovan\u00fdch p\u0159\u00edpad\u016f m\u016f\u017ee \u010dinit a\u017e 15 %). To jsou des\u00edtky tis\u00edc irsk\u00fdch \u017een, od teenagerek a\u017e po t\u0159ic\u00e1tnice a \u010dty\u0159ic\u00e1tnice, kter\u00e9 bojuj\u00ed s chronickou bolest\u00ed, neplodnost\u00ed a vy\u010derp\u00e1n\u00edm. <\/div>\n
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P\u0159\u00edznaky jsou brut\u00e1ln\u00ed. Bolesti p\u00e1nve, kter\u00e9 mohou \u017eenu p\u0159iv\u00e9st a\u017e do stavu, kdy se zdvojn\u00e1sob\u00ed, menstruace tak siln\u00e1 a mu\u010div\u00e1, \u017ee naru\u0161uje pr\u00e1ci a vztahy, a \u00fanava, kter\u00e1 v podstat\u011b znemo\u017e\u0148uje pokra\u010dovat v pr\u00e1ci. <\/div>\n
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Dopad na ekonomiku a produktivitu m\u016f\u017ee b\u00fdt skute\u010dn\u011b v\u00fdrazn\u00fd. Jedna rozs\u00e1hl\u00e1 studie proveden\u00e1 v roce 2017, The Effect of Endometriosis Symptoms on Absenteeism and Presenteeism in the Workplace and at Home (Vliv symptom\u016f endometri\u00f3zy na absenci a prezenci na pracovi\u0161ti a doma), odhaduje ro\u010dn\u00ed n\u00e1klady spojen\u00e9 s absenc\u00ed a prezenc\u00ed (dostaven\u00ed se do pr\u00e1ce p\u0159i poci\u0165ov\u00e1n\u00ed st\u0159edn\u011b siln\u00e9 a\u017e siln\u00e9 bolesti) v celkov\u00e9 v\u00fd\u0161i 45,4 miliardy dolar\u016f ro\u010dn\u011b v USA. <\/div>\n
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Je zar\u00e1\u017eej\u00edc\u00ed, \u017ee v Irsku je pr\u016fm\u011brn\u00e9 zpo\u017ed\u011bn\u00ed v diagnostice dev\u011bt let. Dev\u011bt let. To znamen\u00e1, \u017ee mnoho mlad\u00fdch \u017een, kter\u00e9 sotva ukon\u010dily z\u00e1kladn\u00ed \u0161kolu, mus\u00ed pro\u017e\u00edvat t\u00e9m\u011b\u0159 desetilet\u00e1 muka, ne\u017e se jim dostane odpov\u00eddaj\u00edc\u00ed p\u00e9\u010de. <\/div>\n
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Velmi znepokojiv\u00e9 je, \u017ee v t\u00e9 dob\u011b ji\u017e nemoc \u010dasto pokro\u010dila a zanechala za sebou sr\u016fsty, poruchy funkce org\u00e1n\u016f a sn\u00ed\u017eenou plodnost. Existuje siln\u00fd d\u016fvod domn\u00edvat se, \u017ee nejde jen o l\u00e9ka\u0159skou nedbalost, ale o zradu poloviny populace. <\/div>\n
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To by m\u011blo b\u00fdt z\u0159ejm\u00e9 u\u017e ze samotn\u00fdch \u010d\u00edsel. Studie z roku 2016 v \u010dasopise Human Reproduction Update odhaluje slo\u017eitost endometri\u00f3zy a upozor\u0148uje na jej\u00ed rozmanit\u00e9 projevy a pot\u0159ebu pokro\u010dil\u00e9ho zobrazov\u00e1n\u00ed a odborn\u00fdch znalost\u00ed k odhalen\u00ed hlubok\u00fdch infiltruj\u00edc\u00edch l\u00e9z\u00ed. P\u0159esto irsk\u00e1 HSE a\u017e doned\u00e1vna nel\u00e9\u010dila s prokazatelnou nal\u00e9havost\u00ed. <\/div>\n
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Zku\u0161enosti mnoha \u017een jsou takov\u00e9, \u017ee se pohybuj\u00ed mezi praktick\u00fdmi l\u00e9ka\u0159i a gynekology, z nich\u017e mnoz\u00ed nemaj\u00ed dostate\u010dn\u00e9 vzd\u011bl\u00e1n\u00ed ani n\u00e1stroje pro diagnostiku a l\u00e9\u010dbu t\u00e9to besti\u00e1ln\u00ed nemoci. Ty \u0161\u0165astn\u011bj\u0161\u00ed mohou dostat doporu\u010den\u00ed ke specialistovi, ale i tak se \u010dasto setkaj\u00ed se zastaral\u00fdmi protokoly. <\/div>\n
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Soci\u00e1ln\u011b-ekonomick\u00e1 da\u0148 je tak\u00e9 ohromuj\u00edc\u00ed. \u017deny s endometri\u00f3zou p\u0159ich\u00e1zej\u00ed o pracovn\u00ed dny, kari\u00e9ru a mo\u017enost v\u00fdd\u011blku, proto\u017ee jsou uv\u011bzn\u011bny v kolob\u011bhu l\u00e9ka\u0159sk\u00fdch prohl\u00eddek a vysiluj\u00edc\u00ed bolesti. N\u00e1klady na l\u00e9\u010dbu v zahrani\u010d\u00ed se mohou vy\u0161plhat na tis\u00edce eur. <\/div>\n
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Ned\u00e1vn\u00e9 fanf\u00e1ry HSE o nadregion\u00e1ln\u00edch klinik\u00e1ch pro l\u00e9\u010dbu endometri\u00f3zy, jako je ta, kterou otev\u0159ela ministryn\u011b zdravotnictv\u00ed Jennifer Carroll MacNeillov\u00e1 na klinice Lee v Corku, maj\u00ed znamenat pokrok. Vl\u00e1da od roku 2021 vrhla na person\u00e1ln\u00ed zaji\u0161t\u011bn\u00ed t\u011bchto slu\u017eeb 5 milion\u016f eur, z toho 2,175 milionu eur jen v leto\u0161n\u00edm roce a 1,7 milionu eur speci\u00e1ln\u011b pro Cork od roku 2022. Zn\u00ed to p\u016fsobiv\u011b, ale ve skute\u010dnosti to sotva \u0161kr\u00e1be povrch. Pokud lze v\u011b\u0159it politick\u00e9 opozici, za\u010d\u00edn\u00e1 b\u00fdt tak\u00e9 jasn\u00e9, \u017ee tyto kliniky jsou na rozsah krize \u017ealostn\u011b m\u00e1lo p\u0159ipraven\u00e9. Kritici, pacienti i obh\u00e1jci je ozna\u010duj\u00ed za nevhodn\u00e9 pro dan\u00fd \u00fa\u010del, proto\u017ee jim chyb\u00ed vy\u0161kolen\u00ed odborn\u00edci, kte\u0159\u00ed jsou pot\u0159ebn\u00ed pro \u0159e\u0161en\u00ed slo\u017eit\u00fdch p\u0159\u00edpad\u016f. <\/div>\n
Centrum v Corku, kter\u00e9 provozuje Cork University Maternity Hospital (CUMH), je krok spr\u00e1vn\u00fdm sm\u011brem, ale je t\u0159eba dos\u00e1hnout mnohem v\u00edce.<\/div>\n
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Dr. Mairead O’Riordanov\u00e1, konzultantka v CUMH, ozna\u010duje toto centrum za „v\u00fdznamn\u00fd miln\u00edk“. Profesor John R. Higgins, klinick\u00fd \u0159editel irsk\u00e9ho Ji\u017en\u00edho \u0159editelstv\u00ed pro \u017eeny a kojence, jej ozna\u010duje za slu\u017ebu „sv\u011btov\u00e9 \u00farovn\u011b“. Ministr Carroll MacNeill tvrd\u00ed, \u017ee jde o „nov\u00fd model p\u00e9\u010de“, kter\u00fd zajist\u00ed „v\u010dasn\u00fd a spravedliv\u00fd p\u0159\u00edstup“. Obavy v\u0161ak vzbuzuje fakt, \u017ee se jedn\u00e1 o \u0161ablonovit\u00e9 sliby, kter\u00e9 jsme ji\u017e sly\u0161eli. <\/div>\n
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Skute\u010dnost je takov\u00e1, \u017ee excizn\u00ed operace, kter\u00e1 je zlat\u00fdm standardem l\u00e9\u010dby endometri\u00f3zy a je podporov\u00e1na celosv\u011btov\u00fdm konsenzem odborn\u00edk\u016f, je v Irsku sotva dostupn\u00e1. Tato operace, kter\u00e1 spo\u010d\u00edv\u00e1 v pe\u010dliv\u00e9m odstran\u011bn\u00ed endometri\u00e1ln\u00edch l\u00e9z\u00ed s jasn\u00fdmi okraji, m\u016f\u017ee sn\u00ed\u017eit bolest, zachovat plodnost a obnovit kvalitu \u017eivota. Vy\u017eaduje v\u0161ak chirurgy se vz\u00e1cn\u00fdmi odborn\u00fdmi znalostmi, opera\u010dn\u00ed s\u00e1ly a specializovan\u00e9 n\u00e1stroje. To jsou v\u0161echno zdroje, kter\u00e9 HSE doposud nedok\u00e1zala poskytnout v dostate\u010dn\u00e9 m\u00ed\u0159e. M\u00edsto toho jsou \u017een\u00e1m nab\u00edzena polovi\u010dat\u00e1 opat\u0159en\u00ed, jako je hormon\u00e1ln\u00ed l\u00e9\u010dba nebo l\u00e9ky proti bolesti, kter\u00e9 sv\u011btov\u00ed odborn\u00edci opakovan\u011b vyvr\u00e1tili jako nedostate\u010dn\u00e9 pro z\u00e1va\u017en\u00e9 p\u0159\u00edpady. <\/div>\n
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To m\u011bl zm\u011bnit tolik op\u011bvovan\u00fd N\u00e1rodn\u00ed r\u00e1mec pro endometri\u00f3zu, kter\u00fd HSE vypracoval spole\u010dn\u011b s N\u00e1rodn\u00edm programem zdrav\u00ed \u017een a kojenc\u016f (NWIHP).<\/div>\n
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Sliboval definovanou klinickou p\u00e9\u010di s nadregion\u00e1ln\u00edmi klinikami v Corku a Tallaghtu podporovan\u00fdmi region\u00e1ln\u00edmi centry. Ale kde to je? Sl\u00edbeno na rok 2024, ale st\u00e1le nikde, tak\u017ee pacienti a obh\u00e1jci z\u016fst\u00e1vaj\u00ed v nejistot\u011b. Absence r\u00e1mce je p\u0159\u00edznakem hlub\u0161\u00edho neduhu: zdravotnick\u00e9ho syst\u00e9mu, kter\u00fd up\u0159ednost\u0148uje optiku p\u0159ed v\u00fdsledky. \u017den\u00e1m se st\u00e1le \u0159\u00edk\u00e1, \u017ee jejich bolest je \u201epsychosomatick\u00e1\u201c nebo \u201eprost\u011b pat\u0159\u00ed k \u017een\u00e1m\u201c, co\u017e podkop\u00e1v\u00e1 d\u016fv\u011bru a nech\u00e1v\u00e1 je v izolaci. Pro mnoh\u00e9 z nich znamen\u00e1 dev\u00edtilet\u00e9 diagnostick\u00e9 zpo\u017ed\u011bn\u00ed, \u017ee str\u00e1v\u00ed l\u00e9ta sv\u00e9ho \u017eivota bojem s nemoc\u00ed, kterou bylo mo\u017en\u00e9 zvl\u00e1dnout v\u010dasn\u00fdm z\u00e1sahem. D\u016fsledky v\u010detn\u011b sr\u016fst\u016f, dysfunkce org\u00e1n\u016f a neplodnosti nejsou jen zdravotn\u00ed, ale i psychicky katastrof\u00e1ln\u00ed. <\/div>\n
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Ministr Carroll MacNeill sice mluv\u00ed o \u201ep\u0159eklenut\u00ed propasti\u201c, ale ta z\u016fst\u00e1v\u00e1 propast\u00ed. Je prakticky jist\u00e9, \u017ee kliniky HSE nebudou schopny zvl\u00e1dnout objem nebo slo\u017eitost p\u0159\u00edpad\u016f. <\/div>\n
\u017deny s hlubokou infiltruj\u00edc\u00ed endometri\u00f3zou pot\u0159ebuj\u00ed v\u00edc ne\u017e jen dob\u0159e nalad\u011bn\u00fd multidisciplin\u00e1rn\u00ed t\u00fdm; pot\u0159ebuj\u00ed chirurgy vy\u0161kolen\u00e9 v pokro\u010dil\u00fdch technik\u00e1ch excize, radiology kvalifikovan\u00e9 v odhalov\u00e1n\u00ed l\u00e9z\u00ed na magnetick\u00e9 rezonanci nebo ultrazvuku a specialisty na bolest, kte\u0159\u00ed ch\u00e1pou syst\u00e9movou povahu onemocn\u011bn\u00ed.<\/div>\n
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Irsko nem\u00e1 dostatek t\u011bchto odborn\u00edk\u016f a to, \u017ee HSE neinvestuje do \u0161kolen\u00ed nebo nemotivuje odborn\u00edky, je do o\u010d\u00ed bij\u00edc\u00ed nedopat\u0159en\u00ed. M\u00edsto toho, jak bylo uvedeno v\u00fd\u0161e, jsou \u017eeny nuceny sh\u00e1n\u011bt tis\u00edce, aby vyhledaly p\u00e9\u010di v zahrani\u010d\u00ed, \u010dasto v zem\u00edch, jako je Rumunsko nebo Spojen\u00e9 kr\u00e1lovstv\u00ed, kde je excize dostupn\u011bj\u0161\u00ed. <\/div>\n
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Je t\u0159eba zm\u011bnit p\u0159\u00edstup Irska k endometri\u00f3ze. Pot\u0159eba \u0161irok\u00e9ho p\u0159\u00edstupu ke specializovan\u00fdm zobrazovac\u00edm protokol\u016fm, jako je magnetick\u00e1 rezonance a ultrazvuk, kter\u00e9 prov\u00e1d\u011bj\u00ed vy\u0161kolen\u00ed odborn\u00edci, aby bylo mo\u017en\u00e9 onemocn\u011bn\u00ed p\u0159esn\u011b zmapovat, je z\u0159ejm\u00e1. <\/div>\n
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Prakti\u010dt\u00ed l\u00e9ka\u0159i, kte\u0159\u00ed jsou ji\u017e nyn\u00ed pod obrovsk\u00fdm tlakem exponenci\u00e1ln\u00edho r\u016fstu popt\u00e1vky po jejich slu\u017eb\u00e1ch, by nem\u011bli b\u00fdt ponech\u00e1ni napospas diagnostick\u00e9 rulet\u011b. To znamen\u00e1, \u017ee syst\u00e9m zrychlen\u00e9ho odes\u00edl\u00e1n\u00ed ke specialist\u016fm, a\u0165 u\u017e v Irsku nebo v zahrani\u010d\u00ed, je neoddiskutovateln\u00fd. Zadruh\u00e9, jak ji\u017e dlouho prosazuj\u00ed \u00fa\u010dastn\u00edci kampan\u011b, Irsko mus\u00ed z\u0159\u00eddit centrum excelence pro chirurgickou excizi endometri\u00f3zy, v n\u011bm\u017e by pracovali gynekologov\u00e9, radiologov\u00e9, kolorekt\u00e1ln\u00ed chirurgov\u00e9 a specialist\u00e9 na bolest, kte\u0159\u00ed by pracovali ve vz\u00e1jemn\u00e9 shod\u011b. <\/div>\n
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Pro dosa\u017een\u00ed tohoto c\u00edle je z\u00e1sadn\u00ed spolupr\u00e1ce s mezin\u00e1rodn\u00edmi odborn\u00edky, kte\u0159\u00ed budou \u0161kolit irsk\u00e9 chirurgy, \u010d\u00edm\u017e se sn\u00ed\u017e\u00ed z\u00e1vislost na zahrani\u010dn\u00edch syst\u00e9mech. Navzdory rostouc\u00edmu pov\u011bdom\u00ed ve\u0159ejnosti p\u0159etrv\u00e1v\u00e1 z\u00e1sadn\u00ed nesoulad mezi politickou r\u00e9torikou a zku\u0161enostmi pacient\u016f. \u017den\u00e1m je st\u00e1le nespr\u00e1vn\u011b diagnostikov\u00e1na IBS, \u00fazkost nebo je zcela odm\u00edt\u00e1na l\u00e9ka\u0159i, kte\u0159\u00ed nejsou obezn\u00e1meni se slo\u017eitost\u00ed tohoto onemocn\u011bn\u00ed. Bolest je normalizov\u00e1na, obavy o plodnost jsou minimalizov\u00e1ny a b\u0159emeno sebeobhajoby je kladeno p\u0159\u00edmo na ty, kte\u0159\u00ed jsou ji\u017e fyzicky a emocion\u00e1ln\u011b vy\u010derpan\u00ed. Dokud nebude diagnostick\u00fd proces standardizov\u00e1n, dokud nebude povinn\u00e9 \u0161kolen\u00ed l\u00e9ka\u0159\u016f a dokud nebude prosazena odpov\u011bdnost cel\u00e9ho syst\u00e9mu, \u017e\u00e1dn\u00fd r\u00e1mec – bez ohledu na to, jak dob\u0159e je navr\u017een – nep\u0159inese zm\u011bnu, kter\u00e1 byla irsk\u00fdm \u017een\u00e1m opakovan\u011b slibov\u00e1na a b\u011b\u017en\u011b odp\u00edr\u00e1na. <\/div>\n
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V neposledn\u00ed \u0159ad\u011b je t\u0159eba odstranit zbytky stigmatizace menstrua\u010dn\u00edho zdrav\u00ed. Je to mor\u00e1ln\u00ed a l\u00e9ka\u0159sk\u00fd imperativ. <\/div>\n","protected":false},"excerpt":{"rendered":"

Endometri\u00f3za nen\u00ed zanedbateln\u00fd gynekologick\u00fd probl\u00e9m. Jedn\u00e1 se o syst\u00e9mov\u00e9 z\u00e1n\u011btliv\u00e9 onemocn\u011bn\u00ed, kter\u00e9 ni\u010d\u00ed \u017eivoty des\u00edtek tis\u00edc irsk\u00fdch \u017een. Navzdory tomu byla dosavadn\u00ed reakce Irska p\u0159inejlep\u0161\u00edm ambivalentn\u00ed a bezv\u00fdrazn\u00e1. Jedn\u00e1 se o stav, kdy tk\u00e1\u0148 podobn\u00e1 d\u011blo\u017en\u00ed v\u00fdstelce roste tam, kde by nem\u011bla, v\u010detn\u011b vaje\u010dn\u00edk\u016f, st\u0159ev, mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e, a dokonce i plic. Zp\u016fsobuje ochromuj\u00edc\u00ed bolest, jizven\u00ed […]<\/p>\n","protected":false},"author":51,"featured_media":42772,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[199],"tags":[],"editorial-positions":[],"regions":[],"types":[],"class_list":["post-42824","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"yoast_head":"\nRozv\u00edjej\u00edc\u00ed se p\u0159\u00edstup Irska k endometri\u00f3ze - The Conservative<\/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:\/\/www.theconservative.online\/cs\/rozvijejici-se-pristup-irska-k-endometrioze\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Rozv\u00edjej\u00edc\u00ed se p\u0159\u00edstup Irska k endometri\u00f3ze - The Conservative\" \/>\n<meta property=\"og:description\" content=\"Endometri\u00f3za nen\u00ed zanedbateln\u00fd gynekologick\u00fd probl\u00e9m. 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