Having children is a unique ability of the female body. Some diseases of the genital organs lead to disruption reproductive function and demand surgical treatment. Why ovarian resection is performed, how it affects the body and whether pregnancy is possible after it, you will learn from the article.
Every month, one or more follicles are formed in the ovaries, each of which contains a mature egg ready for fertilization. In addition, the ovaries synthesize female sex hormones that affect all types of metabolism and emotional condition women. By virtue of various reasons, tumors, cysts and other diseases arise in them, the treatment of which is only possible surgically.
Complete removal of the gonad leads to hormonal imbalance, early menopause, and infertility. Ovarian resection - what is it? This is the surgical removal of only part of an organ, which helps preserve the woman’s health and her ability to conceive a child.
Methods and indications for use
The attending physician determines the type and extent of the upcoming operation based on the patient’s age, her state of health and the severity of the disease. Resection is indicated for:
- confirmed benign tumors;
- injuries.
Resection is performed using one of the following methods:
- laparoscopic - minimally invasive intervention, access is made through 3-4 small incisions. Manipulators are inserted into the abdominal cavity along them, through which the surgeon performs the operation;
- laparotomy - full abdominal surgery, access through a midline incision in the anterior abdominal wall.
The essence of surgery
For any indication for surgery, resection serves one purpose - to preserve as much as possible healthy tissue organ in which the eggs are located.
The surgeon removes a benign tumor or ovarian cyst in such a way as to minimally affect the gland itself. He opens the lining of the organ and excises the required minimum of tissue to gain access to the tumor. Next, the tumor is isolated from the organ with a blunt instrument and excised. Sutures are not applied to the remaining defect in order to reduce the depth and size of the postoperative scar. Bleeding vessels in the wound are cauterized with a coagulator.
Video: "Technique for performing ovarian resection"
Resection of the ovary in polycystic disease is carried out to stimulate ovulation. To do this, the surgeon either removes part of the dense membrane of the organ, or makes 6-8 incisions on it in different places.
Sometimes a wedge-shaped resection of the ovary is performed - a triangular section of tissue is cut out of it, the base of which faces the organ capsule. In this way, it is possible to remove a significant area of the membrane and preserve a large mass of ovarian tissue.
Surgery for ovarian trauma, rupture of a cyst with hemorrhage into the abdominal cavity (apoplexy) is carried out in order to remove the damaged part of the organ. Removal of the pathological focus is performed sparingly, that is, minimally involving healthy tissue. In some cases, only drain the wound and stop the bleeding with a coagulator.
Sometimes an ovarian biopsy is performed for diagnostic purposes. To do this, the surgeon cuts out a small section of the organ in the form of a wedge, which is then sent to the laboratory for examination. Sutures are not placed at the site of the defect; bleeding vessels are cauterized.
The gland is completely removed when:
- large size benign tumor;
- an abscess that developed after invasive intervention.
Recovery period and possible consequences of ovarian resection
With partial resection of the ovary, the postoperative period is 2 weeks, with complete removal of the ovary - 6-8 weeks.
Complications are the same as with any other operation:
- bleeding;
- organ perforation abdominal cavity;
- side effects of anesthesia;
- adhesive process;
- postoperative hernia;
- wound infection.
With any volume of surgical intervention, there is a decrease in the amount of tissue of the reproductive gland, which contains immature eggs. Stock them in female body limited and averages from 400 to 600 cells. Each ovulation, at least 3-4 of them are consumed, one matures into a full-fledged egg, and 2-3 help it grow. As a result of the operation, the period during which a woman is able to conceive is artificially reduced.
Immediately after surgery, the level of sex hormones decreases significantly, since the damaged organ is not able to produce the same amount. In response to this, the hypothalamic-pituitary system increases the release of follicle-stimulating and luteinizing hormones into the blood, under the influence of which the remaining gland tissue begins to more actively synthesize its own. Restoring the balance takes 2-3 months, and during this period the gynecologist prescribes hormonal contraceptive drug in order to support the process from the outside.
Menstruation after ovarian resection often begins the next day after the operation, as the body’s reaction to it. After two weeks, ovulation occurs and the previous cycle is restored.
When to plan pregnancy?
Sexual activity after laparoscopic ovarian resection is possible from the seventh day postoperative period. Surgery and removal of part of the ovarian tissue do not disrupt the ovulation process, so the woman remains able to conceive a child. For nulliparous women or those who want to have more children, gynecologists recommend planning a pregnancy in the next year or two after surgery.
With polycystic disease, when surgery is performed to stimulate ovulation, the likelihood of conception is greatest in the first six months after surgery. Then the capsule of the gland thickens again and it will be much more difficult to get pregnant, since the egg cannot reach its surface.
If pregnancy does not occur within six months after resection of the ovarian cyst and there are other factors of infertility in one of the spouses, the couple is referred to a reproductive specialist to resolve the issue of IVF (in vitro fertilization). Hormonal stimulation with a limited egg reserve is most often carried out with high doses of drugs during one cycle (short protocol), which allows obtaining a sufficient number of mature follicles. Recently, androgen priming has been used - the introduction of a precisely selected dose of testosterone, which in the female body serves as a precursor to its own sex hormones. This technique allows the eggs to mature more quickly naturally.
Estimated cost
The cost of surgical treatment depends on the volume of the intervention, its technical complexity and the level of the clinic. On average, the price for removal of an ovarian cyst ranges from 30 to 70 thousand rubles, surgical treatment of polycystic disease from 25 thousand and more.
The development of modern surgery is aimed at making the intervention as gentle as possible on the organ, but at the same time effective. This approach is especially relevant when treating diseases of a woman’s reproductive system, because not only the ability to conceive and bear a child, but also her health in general depends on it.
Ovarian resection and pregnancy are completely compatible concepts. Some women of reproductive age who dream of having children face various problems with conception. These can be benign tumors on the ovaries, cysts, polycystic disease, endometriosis and a number of other pathologies. In cases where conservative therapy in the form of drug treatment is powerless, they resort to.
Ovarian resection is the surgical removal of part of the ovary and pathology in it, for example, a cyst. The remaining part of the organ is carefully sutured to preserve, if possible, reproductive function.
Resection is carried out using several methods:
- Laparoscopy. This is a modern and safe technique, the essence of which boils down to the following. Several punctures are made in the woman's abdomen using special equipment. Devices are inserted into the holes: one to carry out excision of part of the affected organ, the other with a special sensor that transmits all actions to the monitor. Thus, it avoids an aesthetically unattractive scar on a woman’s abdomen, recovery period passes much faster, and which are usually observed with standard abdominal surgery, can be minimized.
- . Abdominal surgery, in which a longitudinal incision is made in the abdomen (at least 10 cm), and through this incision part of the ovary is removed. Abdominal surgery is more traumatic and dangerous than laparoscopy, not to mention the fact that it leaves a scar on the abdomen, which can only be removed later with a laser (and not always).
Whatever the method of surgical intervention, its goal is to eliminate the pathology that prevents pregnancy. The doctor tries to carry out the procedure in such a way as to preserve as much ovarian tissue as possible so that the ovary subsequently functions normally. Bleeding vessels are not sutured after the incision; they are cauterized with a special device (coagulation method).
Why pregnancy does not occur and what to do
If a woman cannot become pregnant due to the presence of a large number of follicles that interfere with the normal course of ovulation or lead to it complete absence, talk about availability. Resection of the ovaries for polycystic disease is carried out in order to stimulate ovulation. To do this, several incisions are made on the organ (usually no more than 8), or part of the dense membrane, consisting of an excess number of follicles, is removed. Sometimes the procedure is performed in a wedge-shaped manner - a triangular piece of the membrane is removed, and the reproductive part of the ovary is preserved.
In gynecological practice, there have been cases where a woman is healthy, but pregnancy does not occur due to the fact that the ovaries have too dense a membrane. In this case, a decision may also be made to perform resection. But here a woman must decide for herself whether she is ready for surgery, because surgical intervention- This is always a last resort measure that should be resorted to if there are no other methods of treatment, or they turn out to be ineffective.
Resection of the ovary for the possibility of further pregnancy must be distinguished from oophorectomy (oophorectomy) - complete removal ovary. This operation is a last resort and is performed in the following cases:
- malignant tumors in the ovaries and/or uterus;
- for large cysts, provided that the patient is 40 years old or more, and also if the neoplasm has strong pressure on neighboring organs or there is a high risk of rupture;
- with ovarian abscess;
- with widespread endometriosis, if other treatment methods have not brought the desired result.
How to get pregnant after ovarian resection
If a woman wants to become pregnant after ovarian resection, she should understand that certain difficulties may arise with this. The fact is that a healthy organ produces from 400 to 600 eggs during the entire time a woman is able to have children. When part of the organ is removed, the number of eggs produced decreases. In addition, the reproductive period is shortened. But if the operation was performed in at a young age(up to 30 years), then there is nothing to worry about, since the ovarian reserve is still quite large.
After resection, ovarian stimulation may be performed to restore and increase egg production. This procedure increases the chances of conception, but is performed only when indicated (if pregnancy does not occur for a long time). Stimulation is carried out with hormonal drugs (Puregon, Gonal, etc.) or folk remedies(for example, upland grass, sage, plantain, rose).
Menstruation after resection usually occurs without complications. The first period after surgery may come within a few days. This period can be extended to two weeks. The first menstruation is more painful than usual. This is due to the fact that both internal and external tissues have not yet fully healed. Ovulation is restored during the first cycle, even if resection was performed to treat polycystic disease.
Despite the restoration of ovulation and menstrual cycle, often appears hormonal imbalance. This is another reason why pregnancy may not occur. An ovary that is reduced in size is anatomically unable to produce the same amount of sex hormones as before surgery. Therefore, a woman may be prescribed hormone therapy to artificially replace follicle-stimulating and luteinizing hormones. Under the influence of synthetic hormones, the ovaries begin to produce their own over several cycles.
Pregnancy after ovarian resection often does not occur due to adhesions. These are fibers connective tissue that form after surgery. Adhesions are caused by the body’s ability to self-heal. Damaged tissues rush to recover faster, so adhesions form. They prevent the fertilized egg from entering the uterus. Therefore, there is both a risk of ectopic tubal pregnancy and even problems with conception.
The adhesive process is reversible in most cases. There are special absorbable drugs, and if they are ineffective, they again resort to laparoscopy to excise adhesions.
When to plan to conceive after resection
Pregnancy after ovarian resection should be planned no earlier than six months later, this is how long the late recovery period lasts.
The chances of conceiving a child are much higher if the resection was unilateral, with normal functioning of the second ovary. It does not matter how much ovarian tissue remains in the operated organ. In case of bilateral resection, the chances of conception are significantly reduced. When resection of two ovaries, the number of eggs and ovarian tissue remains in very small quantities, so you should start trying to conceive a child as early as possible. Also, pregnancy should not be delayed if resection was performed to treat polycystic disease. This measure is temporary and the disease may return soon.
Ovarian resection and pregnancy are quite compatible. If a woman plans to have children after surgery, she should be regularly observed not only by a gynecologist, but also examined thyroid gland and liver, treat all infectious and inflammatory diseases in a timely manner.
If, in the absence of complications from resection, it is not possible to conceive a child naturally within a year after the operation, you should examine your partner, or look for other methods of conception (for example, in vitro fertilization).
Ovarian resection is not an obstacle to pregnancy, but a way to speed up conception. Many women do not even know what difficulties can arise after surgery, so they successfully become pregnant after many futile attempts. Therefore, if resection is necessary according to indications, it must be carried out in order to have healthy offspring.
anonymously
Hello! I had it in 2009 emergency surgery- a cyst burst in the ovary (I didn’t know about it). After this, they prescribed hormonal drugs (Logest), they said that the cyst was functional, the one that forms if the follicle does not rupture. As soon as I stopped taking the pills, the cyst formed again. And again they prescribed OK - the cyst went away. And so on all the time. As soon as I stop drinking OK, it forms. I wonder how they can get pregnant in this case if they drink OK all the time. By the way, they said that if I give birth, the cyst will no longer appear. I recently visited a gynecologist after I stopped taking OK - the cyst came back. They offered to take a tumor marker test - I took it, everything is fine. But they still offered to remove the cyst and sent me to a gynecologist-surgeon. Here, I'll go soon. Tell me, please, I already have one ovary cut after the first operation, now I don’t know for sure - either on the same cyst or on the second ovary - does the cut ovary function normally and release eggs? Are there any problems with pregnancy after such operations? If a cyst was removed on both ovaries, wouldn’t it be difficult to get pregnant? Is it necessary to have surgery or are there other methods besides OK? The cyst is now with the septum. I am 24 years old. Thank you. Anna
To determine the tactics of therapy, it is necessary to identify the nature of the cystic formation of the ovary, including according to data from colorectal dosage. If there is a functional ovarian cyst, then it is advisable to carry out therapy using oral contraceptives(before planning pregnancy).
anonymously
Thank you! But I’ve been drinking OK for too long, and as soon as I quit, a cyst immediately appears. My cyst is functional. I took it for a tumor marker - everything is fine. Today I have already gone to a gynecologist-surgeon, she refused to operate, since one of my ovaries has already been operated on, and the cyst is now on the second. Prescribed Duphaston, without OK. After 2 months - control. Is it possible to plan a pregnancy while taking Duphaston and having a cyst? And one more question. I presumably have an adhesive process after abdominal surgery to remove a cyst. Sometimes the lower abdomen hurts and feels tight, and is felt during sexual intercourse. How, besides laparoscopy, can adhesions be detected and how can they be treated? I just read so much about adhesions that I want to find out in advance if I have them. Is it possible to do belly dancing if you have a cyst? I heard that it is good for women reproductive system, that when you do belly dancing, the cysts go away, and then giving birth is easier. What do you think about it? Thank you in advance.
Surgery is often used in gynecology when it is necessary to remove cysts, tumors, adhesions, endometriosis, etc. The most common operation is considered to be ovarian resection - this is partial excision of damaged ovarian tissue while preserving a certain healthy area. After resection, ovarian function is also preserved in the vast majority of cases.
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Indications
Partial ovarian resection may be prescribed in the following situations:
- with a single ovarian cyst that does not respond to drug treatment, and when its dimensions exceed 20 mm in diameter (including with dermoid cysts);
- with hemorrhage in the ovary;
- at purulent inflammation ovary;
- with a diagnosed benign formation in the ovary (for example, cystadenoma);
- in case of mechanical damage to the ovary (including during other surgical interventions);
- with ectopic ovarian attachment of the embryo;
- with torsion or rupture of cystic formations, accompanied by bleeding and pain;
- with polycystic ovary syndrome.
Ovarian resection for polycystic disease
Polycystic disease is a rather complex hormonal disease that occurs when the hypothalamic regulation of ovarian function fails. With polycystic disease, a diagnosis of infertility is often made, so ovarian resection is one way to help a woman still get pregnant.
Depending on the complexity and course of the polycystic process, the following surgical interventions may be performed:
- Ovarian decortication surgery involves removing the hardened outer layer of the ovaries, that is, cutting it off using a needle electrode. After eliminating the compaction, the wall will become more pliable, normal maturation of the follicles will occur with a normal release of the egg.
- The operation for cauterization of the ovaries consists of a circular incision of the ovarian surface: an average of 7 incisions are made to a depth of 10 mm. After this procedure, healthy tissue structures are formed in the area of the incisions, capable of developing high-quality follicles.
- Wedge resection of the ovaries is an operation to remove a specific “wedge” of triangular section of tissue from the ovary. This allows the formed eggs to leave the ovary to meet the sperm. The effectiveness of such a procedure is estimated at approximately 85-88%.
- The ovarian endothermocoagulation procedure involves inserting a special electrode into the ovary, which burns several small holes (usually about fifteen) in the tissue.
- Ovarian electrodrilling surgery is a procedure for removing cysts from the affected ovary using electric current.
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Advantages and disadvantages of laparoscopy for ovarian resection
Ovarian resection, which is performed by laparoscopy, has a number of advantages over laparotomy:
- laparoscopy is considered a less traumatic intervention;
- adhesions after laparoscopy rarely occur, and the risk of damage to nearby organs is minimized;
- recovery of the body after laparoscopic surgery occurs much faster and more comfortably;
- the possibility of disruption of the suture row after surgery is excluded;
- the risk of bleeding and wound infection is minimized;
- There are practically no postoperative scars.
The disadvantages of laparoscopy include, perhaps, the relatively high cost of the surgical procedure.
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Preparation
Before intervention for ovarian resection, it is necessary to undergo diagnostics:
- donate blood for general and biochemical analysis, as well as for determining HIV and hepatitis;
- check the functioning of the heart using cardiography;
- make a fluorogram of the lungs.
Both laparotomy and laparoscopic resection are operations performed under general anesthesia. Therefore, when preparing for surgery, it is necessary to take into account the stage of preparation for general anesthesia. The day before the intervention, you need to limit yourself in nutrition, eating mainly liquid and easily digestible foods. In this case, the last meal should be no later than 18:00, and the consumption of liquid should be no later than 21-00. On the same day, you should give an enema and cleanse the intestines (the procedure can be repeated the next morning).
You are not allowed to eat or drink on the day of surgery. You should also not take any medications unless prescribed by a doctor.
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Technique for ovarian resection
The ovarian resection operation is performed under general anesthesia: the drug is administered intravenously and the patient “falls asleep” on the operating table. Next, depending on the type of operation performed, the surgeon performs certain actions:
- laparoscopic resection of the ovaries involves three punctures - one in the navel area, and the other two in the projection area of the ovaries;
- Laparotomy resection of the ovary is performed by making one relatively large tissue incision to gain access to the organs.
- frees the operated organ for resection (separates it from adhesions and those located near other organs);
- applies a clamp to the suspensory ovarian ligament;
- carries out the necessary option of ovarian resection;
- cauterizes and sutures damaged vessels;
- suturing damaged tissue catgut;
- conducts a diagnostic examination reproductive organs and assesses their condition;
- if necessary, eliminates other problems in the pelvic area;
- installs drains to drain fluid from surgical wound;
- removes instruments and sutures external tissues.
In some cases, a planned laparoscopic operation can transform into a laparotomy along the way: it all depends on what changes in the organs the surgeon sees with direct access to them.
Resection of both ovaries
If both ovaries are removed, the operation is called an oophorectomy. It is usually carried out:
- in case of malignant organ damage (in this case, resection of the uterus and ovaries is possible, when the ovaries, tubes and part of the uterus are removed);
- with significant sizes cystic formations(for women who do not plan to have more children - usually after 40-45 years);
- with glandular abscesses;
- with total endometriosis.
Resection of both ovaries can also be performed unscheduled - for example, if another, less severe diagnosis was made before laparoscopy. Often the ovaries are removed from patients after 40 years of age to prevent their malignant degeneration.
The most common procedure is resection of both ovaries for bilateral endometrioid or pseudomucinous cysts. For papillary cystoma, resection of the uterus and ovaries can be used, since such a tumor has a high probability of malignancy.
Partial resection of the ovary
Ovarian resection is divided into total (complete) and subtotal (partial). Partial resection of the ovary is less traumatic for the organ and allows maintaining normal ovarian reserve and the ability to ovulate.
Partial resection is used in most cases for single cysts, inflammatory changes and compaction of ovarian tissue, and ruptures and torsions of cysts.
This type of surgical intervention allows the organs to quickly recover and resume their function.
One of the options for partial resection is wedge resection of the ovary.
Repeated ovarian resection
Repeated surgery on the ovaries may be prescribed for polycystic disease (no earlier than 6-12 months after the first resection), or if a recurrence of the cyst is detected.
Some patients have a tendency to form cysts - this predisposition may be hereditary. In such cases, cysts often recur, and surgery has to be resorted to again. It is especially important to carry out re-resection if a dermoid cyst measuring more than 20 mm is detected, or if a woman for a long time can't get pregnant.
If surgery is performed for polycystic disease, then repeated resection gives the woman additional chances to conceive a child - and it is recommended to do this within six months after surgery.
Contraindications for carrying out
Doctors share possible contraindications to ovarian resection into absolute and relative.
An absolute contraindication to surgery is the presence of malignant neoplasms.
Relative contraindications include infections of the urinary system and genital area in the acute stage, fever, bleeding disorders, and intolerance to anesthesia medications.
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Complications after the procedure
The period after surgery for partial resection of the ovary usually lasts about 2 weeks. After complete removal of the ovary, this period extends to 2 months.
Complications after such an operation can occur, as after any other surgical intervention:
- allergies after anesthesia;
- mechanical damage to the abdominal organs;
- bleeding;
- the appearance of adhesions;
- infection in the wound.
With any type of ovarian resection, part of the glandular tissue that contains the reserve of eggs is removed. Their number in a woman’s body is strictly defined: usually it is about five hundred such cells. Every month during ovulation, 3-5 eggs mature. Removing part of the tissue reduces the volume of this reserve, which depends on the extent of resection. This leads to a decrease in a woman's reproductive period - the time during which she is able to conceive a child.
In the first time after resection of the ovaries, a temporary decrease in the amount of hormones in the blood is observed - this is a kind of response of the body to damage to the organ. Restoration of ovarian function occurs within 8-12 weeks: during this period the doctor may prescribe supportive care. hormonal drugs– replacement therapy.
Menstruation after ovarian resection (in the form of spotting bloody discharge) can resume as early as 2-3 days after the intervention - this is a kind of stress reaction of the reproductive system, which in this situation is considered the norm. The first postoperative cycle can be either anovulatory or normal, with ovulation. Full recovery cyclicity of menstruation is observed after a few weeks.
Pregnancy after ovarian resection can begin to be planned 2 months after surgery: monthly cycle is restored, and the woman retains the ability to conceive. If resection was performed for a cyst, then best time for trying to get pregnant - this is the first 6 months after surgery.
Sometimes tingling sensations are observed after resection of the ovary - most often they appear as a result of poor circulation in the organ after surgery. Such sensations should disappear within a few days. If this does not happen, you need to visit a doctor and undergo diagnostics (for example, ultrasound).
If the resection was performed by laparoscopy, then during the first 3-4 days the woman may feel pain in the chest, which is related to the features this method. This condition is considered absolutely normal: the pain usually goes away on its own, without the use of medications.
The ovary may hurt for another 1-2 weeks after resection. After this, the pain should go away. If the ovary hurts after resection, and a month or more has passed since the operation, you should consult a doctor. Pain can be caused by the following reasons:
- inflammation in the ovary;
- adhesions after resection;
- polycystic disease
Sometimes pain in the ovary can appear during ovulation: if such sensations are unbearable, then you should definitely see a doctor.
After a week, the surgeon removes the stitches. Total duration rehabilitation period after ovarian resection is usually 14 days.
For a month after surgery, it is advisable to use shapewear or wear a bandage belt. All this time it is necessary to adhere to sexual rest and minimize physical activity.
Rehabilitation period after ovarian resection
Laparoscopic ovarian resection is most often performed, so we will consider the course and rules of the rehabilitation period for this surgical option.
After laparoscopic resection, you must listen to the following advice from doctors:
- you should not resume sexual intercourse earlier than 1 month after resection (the same applies to physical activity, which are increased gradually, little by little bringing them to the usual level);
- for 12 weeks after resection you should not lift loads exceeding 3 kg;
- within 15-20 days after surgery, it is necessary to make minor adjustments to the diet, excluding spices, herbs, salt and alcoholic beverages from the menu.
The monthly cycle after resection often recovers independently and without special problems. If the cycle goes astray, it may take two or three months, no more, to restore it.
To prevent the recurrence of cysts, your doctor may prescribe prophylactic appointment drugs, according to individual therapeutic regimens.
The body of the patient who underwent ovarian resection completely recovers after the operation within 1-2 months.
26.04.2017
Myoma is a benign formation in the uterus associated with an abnormal increase in muscle tissue.
Pathology occupies a leading position in the list of the most common women's diseases genital area.
For this reason, a considerable part of the “strong” half of humanity is interested in the question of the reality of pregnancy after removal of uterine fibroids. Goodness pathological processes in the uterus allows doctors to delay surgical intervention as much as possible and try to cope with the problem using conservative methods.
But the rapid increase in volume of the muscles of the uterine body often forces doctors to resort to surgical intervention, the scale of which is directly determined by the stage of the process and the area of its localization.
The effect of a tumor on a woman’s reproduction
Exactly muscle layer The uterus in the vast majority of cases, about 85%, is the location of the benign tumor in question, and only occasionally (15% of patients) the disease affects the uterine cervix. The process of conception does not pose any problems for most patients, in addition, they feel great throughout the 9 months of pregnancy.
Decisive factor in in this case is the localization of the pathology. It happens that overgrown formations block the fallopian tubes or completely prevent the attachment of the fertilized testicle to the uterine cavity. The likelihood of premature termination of pregnancy in such patients is higher compared to healthy women.
It is also necessary to take into account the absolute unpredictability of the pathology in question during pregnancy. At this time, the transforming hormonal background in a woman becomes the main thing.
In medical practice There have been cases when the uterus was completely cleared of muscle nodes due to the effects of sex hormones. No reappearance of tumors was observed after this. But basically, rapid muscle growth occurs, leading to the risk of miscarriage, and sometimes to damage to the uterus itself.
Moreover, the growth of pathology is fraught with complications during childbirth itself, since in this process, even if benign, it turns out negative impact on the contractile functionality of the uterus, and C-section often associated with bleeding that can provoke the removal of the main reproductive organ, which is so important for any woman.
As a result, it turns out that the doctor is faced with a rather difficult dilemma: to immediately prescribe rehabilitation to a patient with such a diagnosis or allow pregnancy.
What operations do modern clinics offer to remove myomatous nodes?
In case of ineffectiveness conservative therapy the doctor usually decides to perform a myomectomy, in other words, resection of the tumor, avoiding amputation of the uterus itself. Today there are quite a few methods for carrying out this operation:
- Laparoscopy. If extirpation of the uterine appendages is required or the scope of the upcoming surgical intervention is significant, then the doctor should choose this method of treatment. Today, laparoscopy is used more often than other operations. medical centers, because of this it is considered the most “debugged” and safe. The use of specialized technology makes it possible to minimize the postoperative period and gives the patient a chance to give birth in the future while preserving the uterus surgical intervention. The likelihood of becoming pregnant after such treatment is much higher than with other types of operations.
- Hysteroscopy. This type of operation is chosen if a woman is diagnosed with a submucosal node. The doctor operates on the uterine cavity using a special apparatus through the cervix. The entire procedure is carried out under general anesthesia without any mechanical impact on skin the patient, simply put, after the operation she will not have scars. Surgeons mainly perform hysteroscopy mechanically, but if necessary, it is possible to use both an electrosurgical removal method and a laser. Moreover, regardless of the method of removal, the operation itself is not technically complicated and takes a maximum of 15 minutes.
- Arterial embolization. The safest method, characterized by minimal physical intervention in the body when removing a tumor or its nodes. It is carried out by filling the uterus (with all the arteries, veins, appendages) with a special substance that blocks the vessels in a specific area, which makes it possible to “turn off” the supply of the tumor localization zone. Deprived of blood supply, the tumor gradually shrinks in size and after some time completely dies.
Why is myomectomy dangerous for future pregnancy?
Basically, today's obstetricians-gynecologists, when diagnosing an intrauterine tumor in a patient, prefer to treat according to the first two treatment methods described above.
This is due to the guaranteed removal of the tumor, as well as the ability to control the likelihood of malignancy of the procedure. But, for a pregnancy planned for the future, these methods are quite dangerous.
According to world statistics, only 50% of women who underwent such an operation were able to conceive a child and then give birth. The figure is very symbolic and thought-provoking. We cannot remain silent about other dangers that await expectant mothers who decide to undergo surgery:
- The most important thing is that hysteroscopy and laparoscopy are associated with a fairly significant risk of the occurrence and further progression of the adhesive process, which can disrupt normal development precious pregnancy, and for this it is not even necessary to have nodes on the uterus;
- None of these methods guarantees that the disease has completely disappeared. In 15 - 18% of operated patients, re-formation of lesions was noted;
- Complications during childbirth are not uncommon. Intrauterine bleeding and ruptures along the scar are still almost the most dangerous problems obstetrics;
- It must be taken into account that all interventions in the female genital area can cause the following complications: ectopic pregnancy, abnormal development of the fetus due to destabilization of the blood supply to the uterus, miscarriages.
In addition to the above dangers, it is very important to consider such points as:
- the number of scars on the operated uterus;
- whether an autopsy was performed on the operated organ;
- the risk of scar tissue growing at the onset of labor.
Without all this, it is impossible to safely carry a child and avoid dangers to your health and the baby during childbirth.
Now medical institutions It is strongly recommended to remove fibroid formations using arterial embolization. It is believed that such a solution will be the most physiological and gentle for the patient; in addition, in the statistics of complications during pregnancy, it is mentioned less than all other surgical methods. Almost all the latest research in this area shows that the choice of doctors is quite justified, but be that as it may final decision remains with the patient and her attending physician.
Postoperative period
Rehabilitation after myomectomy is no different from the postoperative period after a traditional opening of the cavity, therefore, it must be treated accordingly.
First of all, you need to ask yourself the question of diet. Constipation with this disease must be avoided in every possible way, and as you know, disturbed stool is normal phenomenon after operation.
To enhance intestinal motility, it is very important for a woman in this case to enrich her diet with fiber. In addition, the diet must include buckwheat, in turn, you must abstain from rice, jelly, and strong tea for this time. It would also be a good idea to stock up on chamomile and string. Microclysters from these herbs are a good help at this time.
Physical activity must be selected in such a way that the impact on the pelvis and operated organs is completely excluded. Swimming, leisurely walks, and exercise therapy are allowed. During the first 2 months of the postoperative period, it is strictly forbidden to neglect the bandage; it will help prevent excessive physical impact to the operated area.
The condition of the abdominal cavity should be constantly monitored by the woman, the same applies to scars of the uterine wall and pelvic organs. Strict adherence to all these instructions will directly determine the success of future conception.
Is it possible to become a mother after fibroid removal?
- Volume of myomectomy;
- The condition of the patient’s reproductive organs after surgery;
- Reliability of scars on the operated organ.
It is these 3 factors that determine whether a woman will be able to experience pregnancy after removal of uterine fibroids. Almost all doctors agree that scrupulously following the doctor’s recommendations, taking the issue of diet seriously and restructuring your rhythm of life will significantly increase a woman’s chances of conceiving and then carrying a normal child.
An important condition is that at least a year must pass after the operation. Doctors also have a number of additional requirements for patients who are already pregnant; in particular, they recommend walking in a bandage throughout the entire period of pregnancy in order to reduce stress on the scar.
To summarize
The diagnosis of a myotic tumor on the uterus and its subsequent removal today is not a reason for a woman to despair and forget about motherhood. More than half of all operated women are able to give birth after this disease.
The most important thing is to always remember that the success of pregnancy and birth of a new person directly depends on the coherence of the actions of the doctor and the expectant mother.
