Hysterectomy is a fairly common procedure for women. different ages and the need for it does not depend on status, position in society and age.
Before deciding on such a procedure, it is necessary to undergo a series of examinations and consultation with an experienced specialist in the field of gynecology and obstetrics.
Removal of the uterus or hysterectomy
The scientific name for removing the uterus is hysterectomy., which is often carried out in connection with oncological diseases, fibrosis, infection after childbirth, etc.
If doctors cannot stop the bleeding immediately after birth, emergency hysterectomy is prescribed to prevent various complications. Many diseases require alternative therapeutic treatment, but if the diagnosis is uterine cancer, only hysterectomy is possible.
Removal of the uterus while preserving the ovaries
The procedure has several main subtypes, depending on the severity and complexity surgical intervention.
Among the main types, the most gentle is subtotal hysterectomy, in which the uterus is removed, but the ovaries and cervix remain.
This removal of the uterus is prescribed when a diagnosis of uterine fibroids is made, for example. Then only the uterus is removed and conservative therapy treatment, .
But in this case, women need to be prepared for the fact that she will live with slight pain and inconvenience. The type of surgical intervention that will be chosen directly depends on the reasons for which the operation is prescribed.
Under what circumstances should the uterus be removed?
Among the possible gynecological diseases, removal of the uterus is prescribed in the case of:
If one of the diseases described above is suspected, the woman first undergoes many different examinations to confirm or refute the diagnosis.
Surgical methods
Which method of hysterectomy to choose depends on how serious the woman’s diagnosis is.
Depending on the severity of the surgical intervention and the volume of soft tissue removed during surgery, hysterectomy can be divided into 4 main types:
- Radical involves removal of the uterus with appendages, cervix, lymph nodes, pelvic tissue and upper zone vagina.
- Hysterosalpingo-oophorectomy– a procedure in which the uterus, tubes, ovaries and appendages are removed.
- Total regulates the removal of the uterus and cervix.
- Subtotal– surgery to remove the uterus, which preserves the ovaries and cervix.
The most commonly used procedure is total removal of the cervix, which is performed with a mandatory abdominal section of the abdominal cavity. After this, stitches and a sterile bandage are applied. All events are carried out using general anesthesia so that the patient remains unconscious at all times.
The disadvantages of this type of hysterectomy include the long rehabilitation period and the traumatic nature of this method. To reduce damage after a hysterectomy, some types can be performed through the vaginal cavity. In this case, the cervix is initially removed, and then the uterus itself.
This technique is only available to women who have already given birth to children, due to the fact that they have an enlarged vagina and wider access. Choosing this method of inserting the instrument allows you to get rid of scars after the procedure.
Today, minimally invasive laparoscopic methods of hysterectomy are gaining great popularity. These are methodologies that can significantly reduce the number of incisions and, accordingly, scars on the abdomen. Special laparoscopic equipment inserts tubes into the abdominal cavity, a video camera and additional instruments to carry out the procedure as quickly and painlessly as possible.
Postoperative period
The postoperative period after hysterectomy is divided into two main types:
But the first 1-2 days are especially difficult, when a hysterectomy has already been done. At this time, the woman experiences the following sensations:
Treatment after surgery
Treatment after hysterectomy consists of complex measures:
- Infusion therapy, including drip intravenous infusions on the first day after hysterectomy. These measures allow you to restore the composition and volume of blood.
- Use of antibiotics to prevent the development of infections, inflammation, and to relieve pain. The course of therapy lasts at least 7 days.
- Use of anticoagulants for 3-4 days it makes it possible to thin the blood and prevent the formation of blood clots and thrombophlebitis.
Possible early complications after surgery
Among the most common complications of the early period:
If the nature of the discharge changes, for example, rot appears, you should immediately consult a doctor. This situation may cause the development of inflammation at the seams.
Infection of the suture, accompanied by high temperature, general deterioration well-being. In this case, the patient is prescribed a course of antibiotics and treatment of the sutures with Curiosin solution. This promotes better healing and tissue regeneration.
Removal of the uterus after 40-50 years
Removal of the uterus for women after 40-50 years of age can be prescribed for a variety of reasons:
It is worth knowing that after removal of the uterus in women over 40-50 years of age, the risk of developing vaginal prolapse increases significantly. This is a phenomenon in which top part the vagina descends with a decrease in supporting functions. These are the reasons for repeated surgical procedure.
Consequences after surgery
The consequences after an operation such as hysterectomy can be not only physical, but also emotional, and do not appear immediately, but after a while.
Emotional problems
Uterus is a symbol of femininity and all living things, the true feminine principle. And with its removal, the woman experiences not only physical pain, but also emotional changes, for example, stress, depression and much more:
Women most susceptible to depression are those who have the following: psychological problems:
- Painful symptoms do not go away.
- Serious complications arise.
- Repeated surgery is required.
- We did not understand all the risks before the procedure.
Inability to have children
Separate question– this is the inability to continue one’s family, to give birth to a child after removal of the uterus.
Some women attribute this to the positive characteristics of the procedure, but most people find it disgusting and cause severe deep depression. This is especially a stress factor if the woman is still young or has not yet had children.
Due to the appearance of such factors after surgery, doctors carefully weigh the pros and cons before prescribing hysterectomy. Also, a woman should carefully study and evaluate all the risks and consequences of hysterectomy.
And if it is possible to preserve the reproductive organ, it is necessary to refuse hysterectomy. Even if the uterus was removed but the ovaries were left, a woman can still become a mother through artificial insemination or surrogacy.
You need to know that the hysterectomy procedure is not the end of normal sexual activity, intimate life. However, in postoperative period within 2 months you should give up intimacy and give the body a rest. After this, the body’s tone will return to normal, and full sensitivity will return to normal.
After turning 40, many women and men experience some changes in their sexual desire and libido.
Many experience a significant decrease in activity, and many experience an increased sex drive after hysterectomy.
This difference in sensations is associated with the indications for surgery and compliance with the expected results.
If a woman gets rid of pain after the procedure and there is no longer a need to take care of unwanted pregnancy– libido increases and the infusion becomes significantly higher.
In addition, the hysterectomy procedure has a beneficial effect on the libido of women during menopause.
But it is worth noting that after a surgical procedure to remove the ovaries, women may experience vaginal dryness and a lack of natural lubrication. This makes sexual intercourse much more difficult and requires the use of additional lubricant. In this situation, experts recommend using a synthetic water-based lubricant, a pessary, or an estrogen-based vaginal cream.
Adhesive process
In the process of suturing a peritoneal wound, it leads to disruption of the initially formed fibrous overlays. Due to this, increased adhesion formation occurs.
This post-operative event depends directly on several key characteristics:
Often the risk of formation of adhesions after surgical removal of the uterus occurs due to genetic predisposition patient.
This is due high level production in the body of the genetically determined enzyme N-acetyltransferase. This element dissolves fibrin deposits and is responsible for the risk of formation of adhesions.
The first symptoms of adhesions after surgery can be determined by the following signs:
- Systematic or sudden onset of painful symptoms in the lower abdomen;
- Pain when urinating;
- Inconvenience during bowel movements;
- Diarrhea;
- Dyspeptic symptoms.
The following medications are used as the main measures to prevent the appearance of adhesions:
- Anticoagulants which are involved in blood thinning and prevent adhesions;
- Antibiotics, preventing the development of infection in the peritoneal cavity.
In addition, to prevent adhesions, it is recommended to perform little physical activity on the first day, namely no more than turning from side to side.
After a few days, when the patient can already move normally, physiotherapeutic procedures are prescribed:
- Ultrasound;
- Electrophoresis with Lidase, Hyaluronidase.
Effectively carried out therapy in the postoperative period will prevent the formation of adhesions and other unpleasant consequences.
Other consequences
Few people know, but after such a complex operation on the female reproductive organs, such a syndrome appears as a symptom of surgical menopause. It manifests itself after 14-20 days and is practically no different in symptoms from natural menopause, only it can occur at any age.
When signs of menopause appear, the following symptoms are observed:
To reduce symptoms and adverse effects on the body after surgery, it is necessary to strictly follow the recommendations of the treating specialist.
Life after hysterectomy
Despite all the unfavorable symptoms after the procedure and the severity of the postoperative period, women, of course, are not given disability.
And every patient who has undergone this surgical intervention must learn to live a normal life after this.
But, sooner or later, complications in the late or early postoperative period may arise.
For this purpose, a set of procedures and measures is used, which include the use of hormones, homeopathic medicinal products containing phytoestrogens.
Such measures help to effectively get rid of the symptoms of premature menopause or significantly alleviate its course.
To prevent the consequences of oophorectomy and hysterectomy, patients must strictly follow the doctor’s prescriptions and recommendations. And even when the symptoms postoperative complications will pass and life will return to normal, be examined by a doctor every 6 months.
Women need to clearly understand that removal of the uterus is not a death sentence, it does not mean that she has ceased to be a woman! In some specific situations, the diseases of the female reproductive organs are so great that such a procedure is the only solution that will provide healing and deliverance!
Moderate exercise and Kegel exercises
Numerous reviews confirm the high effectiveness of Kegel exercises. A full range of activities will not make it difficult for a woman; the activities can only be performed in any comfortable position.
But there are a number of indications that must be performed first:
The Kegel exercise is not difficult at all; to quickly restore function, it can be done at home and at work, and even in public transport. It is recommended to do at least 4-5 approaches during the day.
Hormone replacement therapy
2-3 days after the removal of the reproductive organ, the patient experiences significant changes in the body. This is an unfavorable situation for a woman, because this hormone plays a crucial role - it regulates normal level muscle mass bodies.
It is the insufficient level of this hormone that causes a woman to gain significant weight after surgery. It is also worth clarifying that it is the hormone testosterone that is responsible for a woman’s libido level and sexual desire.
To normalize its level in the body during the postoperative period, doctors prescribe additional hormonal medications and specialized supplements, the basis of which is estradiol and testosterone:
- Tablets "Estrimax", allowing to compensate for the lack of estradiol, which should naturally be produced by the ovaries.
- Tablet form "Estrofem""Has a similar effect.
- Medication "Feminal" is effective drug, allowing to delay the early occurrence of menopause and improve the patient’s condition. This is the most preferred drug in the period after removal of the uterus, appendages and ovaries.
- For external use, to eliminate unpleasant symptoms, use “Divigel”, a drug belonging to the group of progestin drugs for stimulating estrogen cell receptors. The drug is effectively used in the presence of osteoporosis or the risk of developing thrombophlebitis.
Divigel
Estrimaks
Estrofem
Hormone replacement therapy is most often prescribed for 5 years after surgery.
The operation is performed under anesthesia, which in turn leads to bloating and imbalance of the intestines. This development of events may also be affected by hormonal disbalance in the postoperative period.
To prevent a woman from gaining weight and normalize the functioning of the gastrointestinal tract, it is necessary to adhere to some rules for forming a diet.
Thus, it is necessary to minimize or completely eliminate following products from the menu:
- pickles, spices, seasonings;
- spicy and fatty foods;
- fresh baked goods;
- confectionery;
- smoked sausages, lard;
- fried food.
It is also worth limiting the consumption of fresh legumes; in no case should you eat grapes, radishes, fresh or processed cabbage.
This is due to the fact that this list of products stimulates increased flatulence, diarrhea and bloating. It is strictly forbidden to consume strong and low-alcohol drinks, strong coffee and black tea.
If you follow all the instructions of a nutritionist and are observed by a specialist, having correctly compiled daily diet nutrition, you can quickly restore the functions of the stomach and establish effective functioning.
To do this, you can include in your diet:
After surgery, dehydration should not be allowed, so women should drink plenty of fluids (green tea, fruit juice, compote, decoctions medicinal plants). Coffee can be replaced with chicory.
You can eat small portions 6-7 times a day. To keep your weight the same, you can reduce the serving size. Your weight will remain normal if you follow a diet for 2 to 4 months after surgery.
The effect of hysterectomy on sex life
Despite popular belief, removal of the uterus and ovaries does not have a significant impact on sex life.
Women are very worried that they are losing their sexual attractiveness and may even become depressed.
Patients can fully expect to have a fulfilling sex life and enjoy sexual intercourse. This type of surgery does not change the ability to have orgasms.
Doctors recommend abstaining from sex for 7-8 weeks after surgery. After this time, sexual intercourse will no longer cause unpleasant and painful sensations. But at first it is better to use lubricant, since the operation leads to increased dryness vagina.
An operation such as hysterectomy is a radical method of treating certain gynecological diseases. It is carried out in a hospital, and its implementation is preceded by a long preparatory stage. Let's take a closer look at this surgical intervention, types, methods, possible complications and consequences after removal of the uterus.
Removal of the uterus - indications for surgery
Hysterectomy of the uterus is the name of the operation to remove the female reproductive organ. It is carried out exclusively according to indications, of which there are many. Among the common ones it is worth noting:
- malignant processes in the uterus;
- cervical oncology;
- , larger than 12 weeks of pregnancy;
- rapid tumor growth - 4 months of pregnancy or more per year;
- necrosis of myomatous node;
- menorrhagia complicated by anemia;
- 3-4 degrees;
- chronic pain syndromes in the pelvis;
- without improvement after conservative (drug) therapy and curettage.
Methods for removing the uterus
When performing surgery, they are used various methods removal of the uterus. The choice of a specific one depends on the type of disorder, the extent of damage to the reproductive organ and its appendages. Based on the ultrasound results, doctors decide to use one or another technique. Often, removal of the uterus is combined with excision of adjacent tissue. Depending on the volume of the operation performed, there are:
- subtotal;
- total;
- panhysterectomy;
- radical.
In addition, depending on the method of access to the reproductive organ during surgery, hysterectomy can be:
- laparotomy - the uterus is removed through an incision in the abdomen;
- removal of the uterus using the laparoscopic method - using a special device through small holes in the abdominal wall;
- vaginal – access to the affected uterus is carried out through the vagina.
Subtotal hysterectomy of the uterus
Subtotal hysterectomy is performed when it is possible to preserve the cervix and there are no lesions in this part of the reproductive organ. The manipulation is carried out with the aim of shortening the time of surgical intervention in case of severe extragenital pathology. TO this method Surgeries are also used for pelvic endometriosis, a pronounced adhesive process in the pelvis. With such pathologies, the risk of damage to the ureter increases. Indications for this type of surgery are:
- absence of pathology of the appendages;
- the presence of sufficient mobility of the uterus;
- the size of the tumor does not exceed the size of the fetus during pregnancy;
- availability of sufficient surgical field.
Total hysterectomy
This type surgical treatment often referred to as hysterectomy. The method is one of the common types of hysterectomy. Access to the organ is gained by opening the abdominal cavity. During this operation, the uterus is removed; if there is no lesion in the cervix, this part is left. An ectomy is performed at the same time fallopian tubes and ovaries. Restorative treatment after a total hysterectomy involves the use of hormones before the onset.
Removal of the uterus with appendages
Such radical surgery is preceded by a special study. It is called hysterosalpingography - patients have no idea what it is, so they ask the doctor. During this examination, the fallopian tubes are diagnosed. A special contrast agent is injected. A series of x-rays are then taken.
If an oncological process is detected in the tubes, spreading to nearby organs and tissues, removal of the uterus is prescribed. Access to the affected organ is through the vagina or anterior abdominal wall. Due to the fact that elderly patients do not tolerate extensive operations well, surgeons often choose the vaginal type. In this case, the uterus and appendages – gonads and tubes – are completely removed.
Radical hysterectomy
This type of uterus removal surgery is performed when the lesion is extensive. reproductive system. They resort to her when malignant tumors pelvis, with numerous metastases. The operation involves removal of the uterus and appendages, the upper third of the vagina, pelvic tissue, and regional lymph nodes. Often this type of treatment is used after numerous conservative techniques. After such surgical treatment, the woman completely loses reproductive system, which requires hormone replacement therapy.
Removal of the uterus - postoperative period
After surgery to remove the uterus, a woman must remain in bed for at least 24 hours, regardless of the type of access (abdominal or vaginal). At the end of this time, doctors allow you to slowly get up and move around. This helps to enhance intestinal motility, eliminating complications such as paresis. In case of severe pain, analgesic drugs are prescribed. In order to exclude infection, a course of antibiotic therapy is carried out.
They can be appointed in parallel. These drugs prevent the development of complications such as internal bleeding. If regeneration proceeds quickly and is not complicated by anything, the external sutures are removed after 8-10 days. When the operation is performed laparoscopically, the patient is allowed to get up after 5-6 hours, and discharge is carried out on 3-5 days. It is mandatory in the early postoperative period to follow a diet - pureed and liquid food to establish stool.
Complications after hysterectomy
Complications after removal of the uterus can be caused by non-compliance with the surgical technique or failure to follow medical recommendations. If in the early postoperative period these are often consequences medical error, then later (after several months) - failure to comply with the prescriptions and instructions of doctors by patients. Frequent complications of operations such as removal of the affected uterus include:
- formation of hematomas;
- bleeding from a postoperative suture;
- injury to nearby organs during surgery - intestines, bladder, ureters;
- thrombophlebitis of the legs;
- vaginal prolapse;
- suppuration of a postoperative wound;
- infection Bladder(result of long-term catheterization);
- peritonitis (inflammation of the peritoneum);
- thromboembolism.
Pain after hysterectomy
Pain after a hysterectomy is localized mainly inside the abdomen, in the area of the sutures. To relieve a pain attack, doctors often prescribe to patients not narcotic analgesics. The duration of the pain syndrome is short. More often, patients complain of the presence of pain in the first 3-4 days. After this time, residual pain may persist in the area of the external sutures when the uterus was accessed abdominally.
Discharge after hysterectomy
Bloody, Brown Discharge after a hysterectomy is normal. They can be observed for 14 days from the date of surgery. The presence of pain and discharge from the reproductive system after this period should be a reason to contact a gynecologist. These symptoms may indicate complications of the postoperative period, including:
- bleeding;
- infectious process in the pelvis.
Bandage after hysterectomy
The abdomen after removal of the uterus needs special attention. Due to the weakening of the muscle structures and abdominal muscles, which is inevitable with abdominal surgery, women have to wear a bandage. This device is often recommended to patients menopausal age who had several pregnancies. The choice of model should be carried out by a specialist. The bandage is worn daily, removing only when showering and before going to bed at night.
Doctors advise giving preference to a bandage made of natural material. When using it, there should be no discomfort. It is also necessary to pay attention to the width of the product. Doctors talk about the need to exceed the width of the scar with a bandage at the top and bottom by at least 1 cm (with lower-median laparotomy). Dressing is done while lying on your back.
Drugs after hysterectomy
What medications to take after removal of the uterus and whether it is necessary to use them is decided by the attending physician. Often, due to the removal of the gonads along with the uterus, there is a need to use hormonal drugs to normalize the functioning of the body. Hormone replacement therapy is especially necessary for women over 50 years of age who have undergone surgery. In this case, progestogen and estrogen drugs are used.
When the reason for the removal of the uterus and appendages is the presence of large myomatous nodes, the patient after surgery is prescribed continuous estrogen monotherapy. The treatment is complex and includes the use various forms medicines:
- tablets for oral administration – Ovestin, Livial, Proginova;
- ointments and gels for external use – Estrogel, Divigel.
If the uterus was removed due to endometriosis, complex therapy with hormones, estrogens and gestagens is carried out. In this case, drugs such as:
- Kliane;
- Proginova.
Replacement therapy hormonal drugs Doctors advise starting 1-2 months after the uterus is removed. This treatment reduces the likelihood of developing cardiovascular diseases and osteoporosis. However, the decision on the need for its use is made solely by the doctor. Full compliance with his prescriptions and recommendations guarantees a quick recovery process.
Life after hysterectomy
Laparoscopic hysterectomy does not affect life expectancy in any way, but significantly improves its quality. Women, having gotten rid of the symptoms caused by the disease, completely forget about the need for contraception. Many patients note an increase in libido. But often the operation forces women long time use hormones. In addition, there is a need for periodic examinations and gynecological examinations. The purpose of these is to control the treatment and the absence of relapse when the reason for removal was a tumor.
Removal of the uterus - consequences for the body
Hysterectomy affects not only the functioning of the reproductive system, but also the body as a whole. After the uterus is removed, the consequences of the operation may be as follows:
- formation of adhesions in the abdominal cavity;
- formation of a keloid scar;
- numbness of the skin in the suture area;
- menopause;
- metabolic disease.
Sex after hysterectomy
Many patients who have undergone surgery are interested in the question of whether it is possible to have sex after removal of the uterus. Doctors answer this question positively. Sexual intercourse will continue to be a pleasure – all sensitive areas are preserved. When the ovaries are preserved, they continue to function, secreting sex hormones. However, pain and discomfort during sex cannot be ruled out.
Such phenomena are possible in women who have undergone hysterectomy (a scar is formed in the vagina) or radical hysterectomy - part of the vagina is excised. However, this problem can be eliminated through trust and mutual understanding between a woman and her partner. By listening to the wishes of his partner, a man can not only receive pleasure, but also give it to his beloved.
Uterus removal surgically is called a hysterectomy. This one is different gynecological surgery called extirpation or amputation of the uterus. Rehabilitation after such surgery takes place using several techniques.
Indications for surgery and types of interventions
This treatment method is used for the following conditions:
- malignant tumors in the ovaries, cervix or uterine body;
- uterine fibroids large sizes or actively growing, as well as multiple fibroids;
- endometriosis;
- bleeding;
- uterine prolapse;
- chronic pelvic pain;
- surgical gender reassignment (in combination with operations to change the breasts and genital organs).
The operation is performed in three ways: laparoscopic, laparotomy and transvaginal.
There are several types of hysterectomy:
- Supravaginal amputation. With this manipulation, the cervix and appendages are preserved.
- Hysterectomy is the removal of the uterus and cervix, which may be accompanied by amputation of the appendages.
Advantages of supravaginal amputation of the uterus with preservation of its cervix:
- Urological disorders develop less frequently after surgery;
- almost not observed sexual dysfunction after operation;
- preservation of the ligamentous apparatus of the uterus.
The choice of a specific access and extent of surgical intervention depends on several parameters:
- underlying disease (reason for surgery);
- patient's age;
- results of examination for the presence of malignant cells.
Complications of the operation
During surgery and in the postoperative period, the following complications may develop:
- psychological discomfort and development of depression;
- violation of sexual and urinary functions;
- bleeding;
- hematomas in the area of manipulation;
- infection in the suture area, peritonitis;
- allergic reactions to anesthetic drugs;
- sudden cardiac arrest (complication of anesthesia);
- intraoperative injury to surrounding organs, tissues, vessels and nerves;
- infertility;
- when removing the ovaries - surgical menopause;
- phlebitis and thrombophlebitis.
After surgical treatment (total hysterectomy), in 50-80% of cases, the so-called post-castration syndrome occurs, which includes a combination of the following disorders:
- neuropsychic: weakness, tearfulness, nervousness, irritability, memory impairment, sleep disorders;
- vegetative-vascular: feeling of heat, sweating, pain in the head and heart, redness of the face, dizziness, manifestations of fear and lack of air;
- metabolic-endocrine.
Rehabilitation
As a rule, after a hysterectomy, patients are discharged from the hospital after 48 hours; with extended surgery, a few days later.
After laparotomy surgery with open access through the anterior abdominal wall, women resume their normal lives after 6-8 weeks.
After the laparoscopic approach, patients return to normal activities within a few weeks.
For 6 weeks after surgery you cannot:
- lift more than 4.5 kg;
- take baths and swim in ponds;
- engage in sexual relations;
- supercool.
Rehabilitation measures include a diet rich in fruits and vegetables, physiotherapy, physical therapy, and acupuncture. The listed recovery methods can be supplemented.
Indications for physiotherapy
Indications for treatment physical factors are:
- post-castration syndrome;
- edema lower limbs;
- tissue fibrosis;
- hypotension and atony of the bladder.
To facilitate the course of post-castration syndrome and adapt to a new lifestyle, electrosleep is used. The conducted studies prove that this type of treatment can significantly reduce the severity of neuropsychic and vegetative-vascular disorders.
Contraindications to electrosleep therapy:
- focal symptoms;
- neoplasms in the head area;
- high degree of myopia;
- psychical deviations;
- violation of the circulation of spinal fluid.
If urination is impaired due to the development of bladder atony, neuromuscular stimulation with sinusoidal modulated currents of certain parameters is used.
Used to improve blood flow and tissue regeneration low frequency magnetic therapy, which also helps accelerate the resorption of edema and inflammatory infiltrates.
When swelling of the lower extremities develops, it is used, in addition to which patients are selected compression hosiery a certain density.
Hardware physiotherapeutic treatment is complemented by massage of swollen limbs.
Contraindications to physiotherapy
Physiotherapeutic procedures are contraindicated if the patient has the following disorders:
- bleeding and tendency to it;
- blood diseases;
- presence of neoplasms;
- general serious condition of the patients;
- severe cachexia;
- mental disorders;
- acute inflammatory diseases;
- decompensation of chronic pathologies;
- for lymphatic drainage and massage: severe damage to the vascular bed;
- phlebitis and thrombophlebitis up to 6 months.
Physiotherapy
Physical therapy exercises help strengthen muscles and return to normal life after surgery. After removal of the uterus, problems with urination and bowel movements often occur due to the displacement of internal organs. Recovery normal function Kegel exercises must be performed.
To prevent the appearance of adhesions in the pelvis, they are prescribed special complexes physical therapy.
Change in quality of life
After surgery, a woman's life changes better side. Depending on the underlying disease, it:
- gets rid of chronic pain syndrome, malignant or benign neoplasm;
- can lead a normal sex life;
- feels a surge of strength and improved well-being.
Many women of reproductive age report liberation in their sexual life after surgery, which is associated with the disappearance of the fear of an unwanted pregnancy, as well as the absence of pain that bothered patients before surgery.
6-8 weeks after surgery, after receiving permission from the gynecologist, you can continue your sexual life. At first, a woman may be bothered by vaginal dryness and pain during sexual intercourse. In this case, the attention and tenderness of the sexual partner is necessary. It is worth spending more time on foreplay for arousal, then the vaginal mucosa will secrete more lubricant. If this is not enough, you can use special intimate lubricants or oils (an allergic reaction is possible).
As a rule, these symptoms disappear after some time, but it must be remembered that severe discomfort is a reason to be examined by a gynecologist.
When the ovaries are removed during surgery, a woman experiences surgical menopause, which may be accompanied by acute symptoms: hot flashes, mood swings, pressure surges and pulse instability. With such symptoms, hormone replacement therapy is prescribed to improve the patient’s well-being.
Modern methods of diagnosis, treatment and rehabilitation help to recognize the disease in time, treat it with the most effective and minimally invasive means and restore lost functions, allowing you to quickly return to the usual rhythm of life.
Anna Mironova
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Hysterectomy (removal of the uterus) is prescribed only when alternative treatment methods have already exhausted themselves. But still, for any woman it’s like this surgery is a huge stress. Almost everyone is interested in the features of life after such an operation. This is exactly what we will talk about today.
Removal of the uterus: consequences of hysterectomy
Immediately after the operation you may be bothered by painful sensations. This may be due to the fact that after surgery the sutures do not heal well and adhesions may form. In some cases there are bleeding. Recovery period after surgery may be increased due to complications: elevated temperature body, urination disorders, bleeding, inflammation of sutures
etc.
In the case of a total hysterectomy, The pelvic organs can greatly change their location
. This will negatively affect bladder and bowel activity. Since the ligaments are removed during the operation, complications such as vaginal prolapse or prolapse may occur. To prevent this from happening, women are recommended to perform Kegel exercises; they will help strengthen the pelvic floor muscles.
Some women begin to experience symptoms after a hysterectomy. menopause symptoms
. This is explained by the fact that removal of the uterus can lead to a disruption in the blood supply to the ovaries, which naturally affects their functioning. To prevent this, women are prescribed hormone therapy after surgery. They are prescribed medications that contain estrogen. It can be tablets, patch or gel.
Also, women who have had their uterus removed are at risk of developing atherosclerosis and osteoporosis
vessels. To prevent these diseases, it is necessary to take appropriate medications for several months after surgery. 
Life after hysterectomy: women's fears
Apart from some physical discomfort and pain which almost all women experience after such an operation, about 70% experience feeling of confusion and inadequacy
. Emotional depression is indicated by the worries and fears that overcome them.
After the doctor recommends removing the uterus, many women begin to worry not so much about the operation itself as about its consequences. Namely:
- How will life change?
- Will there be a need to change anything radically? , adapt to the functioning of the body, since such an important organ was removed?
- Will the surgery affect my sex life? How to build your relationship with your sexual partner in the future?
- Will the surgery affect your appearance? aging skin, excess weight, growth of hair on the body and face?
There is only one answer to all these questions: “No, there will be no radical changes in your appearance and lifestyle.” And all these fears arise due to established stereotypes: no uterus - no menstruation - menopause = old age. Read:
Many women are sure that after removal of the uterus, an unnatural restructuring of the body will occur, which will cause premature aging, decreased sexual desire and loss of other functions. Health problems will begin to worsen, frequent mood swings will occur, which will greatly affect relationships with others, including loved ones. Psychological problems will begin to improve in response to physical ailments. And the result of all this will be early old age, a feeling of loneliness, inferiority and guilt.
But this stereotype is far-fetched
, and it can be easily dispelled by understanding a little about the characteristics of the female body. And we will help you with this:
- The uterus is an organ designed for the development and bearing of a fetus. She is also directly involved in labor activity. By contracting, it helps expel the child. In the middle, the uterus is lined with endometrium, which in the second phase menstrual cycle thickens so that the egg can attach to it. If fertilization does not occur, then the upper layer of the endometrium peels off and is rejected by the body. It is at this moment that menstruation begins. After a hysterectomy, there is no menstruation because there is no endometrium, and the body simply has nothing to reject. This phenomenon has nothing to do with menopause and is called “surgical menopause.” " Read.
- Menopause is a decrease in ovarian function. They begin to produce less sex hormones (progesterone, estrogen, testosterone), and the egg does not mature in them. It is during this period that strong hormonal changes begin to occur in the body, which can have consequences such as decreased libido, excess weight, and aging skin.
Since removal of the uterus does not entail a malfunction of the ovaries, they will continue to produce all the necessary hormones. Clinical researches showed that after hysterectomy, the ovaries continue to function in the same mode
and the same period of time that is programmed by your body.
Hysterectomy: a woman’s sex life after hysterectomy surgery
As after other genital surgeries, the first 1-1.5 months sexual contacts are prohibited
. This is because the sutures need time to heal.
After the recovery period is over and you feel that you can return to your normal lifestyle, you will have more there will be no obstacles to sexual activity
. Female erogenous zones are not located in the uterus, but on the walls of the vagina and external genitalia. Therefore, you will still be able to enjoy sexual intercourse.
Quite a lot important role Your partner also plays in this process. Perhaps for the first time he will feel some discomfort, they are afraid to make sudden movements, so as not to harm you. His feelings will depend entirely on yours. With your positive attitude towards the situation, he will perceive everything more adequately.
Correct psychological approach to hysterectomy
So that you feel excellent after the operation, the recovery period is as complete as possible. short time, must have correct psychological attitude
. To do this, first of all, you need to completely trust your doctor and be confident that your body will function as well as before the operation.
Also plays a very important role support from loved ones and your positive mood
. No need to give this body of greater importance than it actually is. If the opinions of others are important to you, then do not let unnecessary people know the details of this operation. This is exactly the case when “a lie is for salvation.” The most important thing is your physical and mental health
.
We discussed this problem with women who had already undergone a similar operation, and they gave us some useful advice.
Removal of the uterus - what to do next? Reviews from women about hysterectomy
Tanya:
I had surgery to remove the uterus and appendages back in 2009. To this day I see a full, high-quality life. The main thing is not to despair and start taking replacement therapy in a timely manner.Lena:
Dear women, don't worry. After a hysterectomy, full sexual life is possible. And a man won’t even know about the absence of a uterus unless you tell him about it yourself.Lisa:
I had surgery at 39 years old. The recovery period passed quickly. After 2 months I was already jumping like a goat. Now I lead a full life and don’t even remember about this operation.
Olya: The doctor advised me to remove the uterus along with the ovaries, so that no problems would arise with them later. The operation was successful, there was no menopause as such. I feel great, I even look several years younger.
The postoperative period after removal of the uterus is an important stage in a woman’s treatment, which is fraught with a number of complications and therefore requires a careful and professional approach.
Naturally, when a hysterectomy is performed, the consequences depend on the type of operation and many factors. You can watch videos about how hysterectomy is performed on the official websites of specialized clinics. In general, when a high-quality hysterectomy is performed, the consequences and reviews give no reason to doubt positive result. Even if a good clinic performs the most complex removal of the uterus for fibroids, the consequences and reviews allow us to make a very optimistic prognosis.
The essence of the emerging problem
Surgical operation to remove the uterus or hysterectomy is considered a fairly well-developed and widespread method of surgical treatment for some serious pathologies that threaten serious problems for women's health. World medicine statistics claim that almost 1/3 of all women after 40 years of age are forced to undergo such a procedure.
Any surgical intervention causes injuries of varying severity associated with damage to various vessels and tissues. After surgery to remove the uterus, characteristic damage also remains, and complete tissue restoration requires some time. The duration and scheme of rehabilitation measures depends on individual characteristics the female body, the severity of the disease, the type of operation and the degree of surgical intervention, aggravating circumstances and postoperative complications.
In order for the uterus to be removed, what indications are necessary? The following reasons are highlighted:
- heavy and prolonged uterine bleeding;
- myomatous nodes;
- metroendometritis that cannot be treated;
- oncological diseases;
- endometriosis;
- uterine prolapse.
Depending on the severity of the pathology, the following types of operations can be performed:
- removal of the uterine body only (subtotal amputation);
- removal of the uterus and cervix (total estirpation);
- removal of the uterus with appendages and nearby lymph nodes(radical panhysterectomy).
The degree of traumatization depends not only on the type of operation, but also on the method of its implementation. The most radical is considered to be the abdominal technology associated with opening access by cutting the peritoneal wall. Another option is the vaginal method, where an incision is made in the vagina. Least dangerous way– removal of the uterus using the laparoscopic method, when a special laparoscope is used, which allows making a minimal incision. When a laparoscopic hysterectomy is performed, the consequences are less dangerous.
General principles of postoperative rehabilitation
The postoperative recovery period includes the entire time period from surgical intervention to full restoration of performance, including sex after removal of the uterus. As with any surgical treatment, full postoperative rehabilitation is divided into 2 stages: early and late stage.
The early stage of recovery is carried out in inpatient conditions under the supervision of a doctor. The duration of this stage depends on what consequences after removal of the uterus occurred after surgery.
On average, with a successful abdominal operation, the early period is about 9-12 days, after which the sutures are removed and the patient is discharged from the hospital. Laparoscopic intervention reduces the time of early rehabilitation to 3.5-4 days. The main tasks of the early stage: eliminating bleeding, pain and other symptoms, eliminating infection of the affected area and dysfunction of internal organs, ensuring primary tissue scarring.
The late stage of rehabilitation is carried out at home as prescribed and in consultation with a doctor. When operational impact without complications, this stage lasts on average 28-32 days, and with a complex operation it is extended to 42-46 days. At this stage it is ensured full recovery tissues, improvement general condition and strengthening the immune system, normalizing psychological state, full restoration of functionality.
What measures are taken immediately after surgery?
During the first 24 hours after removal of the uterus, all measures must be taken to exclude the occurrence of complications, blood loss from internal bleeding, the occurrence of inflammatory processes, the penetration of infections and elimination painful symptoms. This period is the most important in the early stages of rehabilitation.
The main activities include the following impacts:
- Anesthesia. After the operation, the woman feels natural pain in the lower abdomen, inside. Strong drugs are used for pain relief.
- Activation of organ functions. Measures are being taken to normalize blood circulation and stimulate the intestines. If necessary, Proserpine is administered by injection to activate intestinal functions.
- Providing diet. It is important to restore normal intestinal motility. The menu is dominated by broths, pureed foods, and drinks. If independent defecation occurs at the end of the first day, then the measures were carried out correctly.
Drug therapy immediately after surgery includes the following:
- antibiotics to exclude infection (course – 5-8 days);
- anticoagulants to prevent blood clots in blood vessels (administered over 2-3 days);
- infusion effect by intravenous drips to normalize blood circulation and restore blood volume.
Main problems during early rehabilitation
At the first stage of rehabilitation after removal of the uterus, the following complications may occur:
- Inflammation of the site of tissue dissection. This phenomenon, when it occurs, is characterized by such signs as redness, swelling, and purulent exudate. Possible seam divergence.
- Disruption of the urinary process. Main manifestations: pain syndrome and pain when urinating. A complication usually occurs when the mucous membrane of the urinary canal is damaged during surgery.
- Internal and external bleeding. Their intensity depends on the correct performance of hemostasis during surgery. External blood discharge may have a scarlet or dark red, brown tint, and blood clots may be released.
- Thromboembolism pulmonary artery. One of the very dangerous complications, which can cause a blood clot in the artery or its branches. The development of pathology can lead to pneumonia and pulmonary hypertension.
- Peritonitis. In case of violations during the operational impact, damage may occur that can cause inflammatory reaction in the peritoneum. The danger of peritonitis lies in rapid spread to others internal organs and the development of sepsis.
- Hematomas. In the area of scarring of damaged tissue, hematomas often occur due to damage to small blood vessels.
- Pain syndrome. Often becomes the result of an adhesive process. For such pain, enzyme agents are administered: Trypsin, Chymotrypsin, Longidaza, Lidaza, Ronidaza.
- Fistula formation. This problem occurs when the sutures are of poor quality and infection occurs. Often it is necessary to carry out additional operation for fistula removal.
An important early postoperative measure is to exclude infection during the first 1-3 days. The penetration of infection is indicated by an increase in temperature to 38.5 0 C. To eliminate the risk of infection, antibiotics are administered and antiseptic treatment of the suture area is carried out. The first change of dressing and treatment of the wound is carried out the next day after exposure. Curiosin provides an antibacterial effect and accelerates the formation of scar tissue, so it is often used to treat sutures.
Fighting peritonitis
When conducting total and radical operations, especially in case of emergency, there is a high probability of developing peritonitis. This pathology is expressed by the following obvious symptoms:
- a sharp deterioration in general health;
- temperature increase to 40.5 0 C;
- intense pain;
- peritoneal irritation.
Treatment includes the active administration of several types of antibiotics. Introduced saline solutions. If the effectiveness of therapy is low, a repeat operation is performed to remove the uterine stump, and abdomen washed with antiseptic preparations and installed a drainage system.
What should be done during late rehabilitation
After discharge from the clinic, a woman should not stop restorative procedures. Rehabilitation for late stage Helps the body fully recover after surgery. The following activities are recommended:
- Wearing a bandage. A supportive corset helps weakened abdominal muscles during the postoperative period. When choosing a bandage, you should adhere to the condition that its width exceeds the length of the wound scar by 12-15 mm from below and from above.
- Exclusion of lifting loads over 2.5 kg and limitation physical activity. Sexual contact should be avoided for 1.5-2 months after surgery.
- Gymnastic exercises and exercise therapy. Kegel exercises are recommended to strengthen the muscles of the vagina and pelvic floor using a special exercise machine called the perineal trainer. Serious sports activities are possible only after 2.5 months after surgery.
- Saunas, steam baths and hot baths are prohibited for the entire period late rehabilitation. Swimming in open waters should be significantly limited.
- Organization proper nutrition. Gentle diet - important element recovery stage. Dietary measures should be taken to prevent constipation and flatulence. It is recommended to include fiber and liquids (vegetables, fruits, coarse bread) in the menu. Alcoholic drinks and strong coffee should be excluded. It is necessary to increase the intake of vitamins.
