Home Prevention Uterus removal. What can and cannot be done after hysterectomy Consequences of abdominal hysterectomy surgery

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Uterus removal. What can and cannot be done after hysterectomy Consequences of abdominal hysterectomy surgery

In gynecology in the treatment of uterine bleeding in last years Various conservative methods of influencing the uterus are used, for example, hysteroresectoscopic removal of the myomatous node and endometrial ablation, thermal ablation of the endometrium, hormonal suppression of bleeding. However, they often turn out to be ineffective. In this regard, surgery to remove the uterus (hysterectomy), performed both planned and urgently, remains one of the most common abdominal interventions and ranks second after appendectomy.

The frequency of this operation in the total number of gynecological surgical interventions in the abdominal cavity is 25-38% with the average age of women operated on for gynecological diseases 40.5 years and about obstetric complications- 35 years. Unfortunately, instead of trying conservative treatment, among many gynecologists there is a tendency to recommend that a woman with fibroids have her uterus removed after 40 years, citing the fact that her reproductive function has already been realized and the organ no longer performs any function.

Indications for hysterectomy

Indications for hysterectomy are:

Multiple uterine fibroids or a single one larger than 12 weeks with a tendency to rapid growth accompanied by repeated, heavy, prolonged uterine bleeding.
The presence of fibroids in women over 50 years of age. Although they are not prone to malignancy, cancer develops much more often against their background. Therefore, removal of the uterus after 50 years, according to many authors, is desirable in order to prevent the development of cancer. However, such an operation at approximately this age is almost always associated with subsequent severe psycho-emotional and vegetative-vascular disorders as a manifestation of post-hysterectomy syndrome.
Necrosis of myomatous node.
With high risk their torsion on the leg.
, growing into the myometrium.
Widespread polyposis and constant heavy menstruation, complicated by anemia.
and 3-4 degrees.
, or ovaries and associated radiation therapy. Most often, the removal of the uterus and ovaries after 60 years is carried out specifically for cancer. In that age period the operation contributes to a more pronounced development of osteoporosis and a more severe course of somatic pathology.
Prolapse of the uterus of 3-4 degrees or its complete prolapse.
Chronic pelvic pain that cannot be treated with other methods.
Uterine rupture during pregnancy and childbirth, placenta accreta, development of consumption coagulopathy during childbirth, purulent.
Uncompensated uterine hypotension during childbirth or in the immediate future postpartum period accompanied by heavy bleeding.
Gender change.

Although the technical performance of hysterectomy has improved greatly, this method of treatment still remains technically challenging and is characterized by frequent complications during and after surgery. Complications include damage to the intestines, bladder, ureters, the formation of extensive hematomas in the parametrial area, bleeding, and others.

In addition, there are also frequent consequences of hysterectomy for the body, such as:

long-term recovery of intestinal function after surgery;
development (menopause after removal of the uterus) is the most common negative consequence;
development or more severe course of endocrine, metabolic and immune disorders, coronary disease hearts, hypertension, neuropsychiatric disorders, osteoporosis.

In this regard, an individual approach in choosing the volume and type is of great importance. surgical intervention.

Types and methods of hysterectomy

Depending on the volume of the operation, the following types are distinguished:

Subtotal, or amputation - removal of the uterus without or with appendages, but preserving the cervix.
Total, or hysterectomy - removal of the body and cervix with or without appendages.
Panhysterectomy - removal of the uterus and ovaries with fallopian tubes.
Radical - panhysterectomy in combination with resection of the upper 1/3 of the vagina, with removal of part of the omentum, as well as the surrounding pelvic tissue and regional lymph nodes.

Currently, abdominal surgery to remove the uterus is carried out, depending on the access option, in the following ways:

abdominal, or laparotomy (median incision in the tissues of the anterior abdominal wall from the umbilical to the suprapubic region or cross section above the womb);
vaginal (removal of the uterus through the vagina);
laparoscopic (through punctures);
combined.

Laparotomy (a) and laparoscopic (b) access options for hysterectomy surgery

Abdominal access method

It has been used most often and for a very long time. It is about 65% when performing operations of this type, in Sweden - 95%, in the USA - 70%, in the UK - 95%. The main advantage of the method is the possibility of performing surgical intervention under any conditions - both planned and in case of emergency surgery, as well as in the presence of other (extragenital) pathology.

At the same time, the laparotomy method also has a large number shortcomings. The main ones are the serious traumatic nature of the operation itself, a long hospital stay after the operation (up to 1–2 weeks), prolonged rehabilitation and unsatisfactory cosmetic consequences.

A high incidence of complications is also characterized postoperative period, both nearest and distant:

long-term physical and psychological recovery after hysterectomy;
adhesive disease develops more often;
it takes a long time for intestinal function to be restored and the lower abdomen hurts;
high, compared to other types of access, the likelihood of infection and increased temperature;

Mortality with laparotomy access per 10,000 operations averages 6.7-8.6 people.

Vaginal removal

It is another traditional access used for hysterectomy. It is carried out through a small radial dissection of the vaginal mucosa in its upper parts (at the level of the fornix) - posterior and possibly anterior colpotomy.

The undeniable advantages of this access are:

significantly less trauma and the number of complications during surgery compared to the abdominal method;
minimal blood loss;
short duration of pain and feeling better after operation;
rapid activation of the woman and rapid restoration of intestinal function;
short period of hospital stay (3-5 days);
good cosmetic result, due to the absence of an incision in the skin of the anterior abdominal wall, which allows the woman to hide the very fact of surgical intervention from her partner.

The recovery period with the vaginal method is much shorter. In addition, the frequency of complications in the immediate postoperative period is low and there are no complications in the late postoperative period, and mortality is on average 3 times less than with abdominal access.

At the same time, vaginal hysterectomy also has a number of significant disadvantages:

lack of sufficient space surgical field to conduct a visual inspection of the abdominal cavity and manipulation, which significantly complicates the complete removal of the uterus for endometriosis and cancer, due to the technical difficulty of detecting endometriotic foci and tumor boundaries;
high risk of intraoperative complications in terms of injury to blood vessels, bladder and rectum;
difficulties in stopping bleeding;
the presence of relative contraindications, which include, in addition to endometriosis and cancer, significant tumor sizes and previous operations on the abdominal organs, especially on the lower organs, which can lead to changes in the anatomical location of the pelvic organs;
technical difficulties associated with uterine retraction in obesity, adhesions and in nulliparous women.

Due to such restrictions, in Russia vaginal access is used mainly for operations for prolapse or prolapse of an organ, as well as for gender reassignment.

Laparoscopic access

In recent years, it has become increasingly popular for any gynecological operations in the pelvis, including hysterectomy. Its benefits are largely identical to the vaginal approach. These include a low degree of trauma with a satisfactory cosmetic effect, the possibility of cutting adhesions under visual control, a short recovery period in the hospital (no more than 5 days), a low incidence of complications in the immediate and their absence in the long-term postoperative period.

However, there are still risks of such intraoperative complications as the possibility of damage to the ureters and bladder, blood vessels and large intestine. The disadvantage is also the limitations associated with the oncological process and the large size of the tumor formation, as well as with extragenital pathology in the form of even compensated cardiac and respiratory failure.

Combined method or assisted vaginal hysterectomy

It involves the simultaneous use of vaginal and laparoscopic approaches. The method allows you to eliminate the important disadvantages of each of these two methods and perform surgical intervention in women with the presence of:

endometriosis;
adhesions in the pelvis;
pathological processes in the fallopian tubes and ovaries;
myomatous nodes of significant size;
history of surgical interventions on the abdominal organs, especially the pelvis;
difficult uterine descent, including nulliparous women.

The main relative contraindications forcing preference for laparotomy access are:

Common foci of endometriosis, especially retrocervical with growth into the wall of the rectum.
Pronounced adhesive process, causing difficulty in cutting adhesions when using laparoscopic techniques.
Volumetric formations of the ovaries, the malignant nature of which cannot be reliably excluded.

Preparing for surgery

The preparatory period for planned surgical intervention consists of conducting possible examinations at the prehospital stage - clinical and biochemical blood tests, urine tests, coagulogram, determination of blood group and Rh factor, studies for the presence of antibodies to hepatitis viruses and sexually transmitted infectious agents, including including syphilis and HIV infection, ultrasound, fluorography chest and ECG, bacteriological and cytological examination of genital tract smears, extended colposcopy.

In the hospital, if necessary, additional, separate, repeated ultrasound, MRI, sigmoidoscopy and other studies are carried out.

1-2 weeks before surgery, if there is a risk of complications in the form of thrombosis and thromboebolism (varicose veins, pulmonary and cardiovascular diseases, excess body weight, etc.), a consultation with specialized specialists and the use of appropriate medications, as well as rheological agents and antiplatelet agents.

In addition, in order to prevent or reduce the severity of symptoms of post-hysterectomy syndrome, which develops after removal of the uterus in an average of 90% of women under 60 years of age (mostly) and has varying degrees of severity, surgical intervention is planned for the first phase menstrual cycle(if available).

1-2 weeks before the removal of the uterus, psychotherapeutic procedures are carried out in the form of 5-6 conversations with a psychotherapist or psychologist, aimed at reducing the feeling of uncertainty, the unknown and fear of the operation and its consequences. Phytotherapeutic, homeopathic and other medicines are prescribed sedatives, treatment of concomitant gynecological pathology is carried out and cessation of smoking and drinking alcoholic beverages is recommended.

These measures can significantly ease the course of the postoperative period and reduce the severity of psychosomatic and vegetative manifestations provoked by the operation.

In the hospital on the evening before the operation, food should be excluded, only liquids are allowed - loosely brewed tea and still water. In the evening, a laxative and a cleansing enema are prescribed, and a sedative is taken before bedtime. On the morning of the operation, the intake of any liquid is prohibited, the ingestion of any medications is discontinued, and the cleansing enema is repeated.

Before the operation, compression tights and stockings are put on, or the lower extremities are bandaged with elastic bandages, which remain until the woman is fully activated after the operation. This is necessary in order to improve the outflow of venous blood from the veins of the lower extremities and prevent thrombophlebitis and thromboembolism.

Providing adequate anesthesia during surgery is also important. The choice of the type of anesthesia is carried out by the anesthesiologist, depending on the expected volume of the operation, its duration, concomitant diseases, the possibility of bleeding, etc., as well as in agreement with the operating surgeon and taking into account the wishes of the patient.

Anesthesia for hysterectomy can be general endotracheal combined with the use of muscle relaxants, as well as its combination (at the discretion of the anesthesiologist) with epidural analgesia. In addition, it is possible to use epidural anesthesia (without general anesthesia) in combination with intravenous drug sedation. Installation of a catheter in the epidural space can be prolonged and used for postoperative pain relief and faster restoration of bowel function.

The principle of the operation technique

Preference is given to laparoscopic or assisted vaginal subtotal or total hysterectomy with preservation of the appendages on at least one side (if possible), which, among other advantages, helps reduce the severity of posthysterectomy syndrome.

How is the operation performed?

Surgical intervention with a combined approach consists of 3 stages - two laparoscopic and vaginal.

The first stage is:

introduction to abdominal cavity(after insufflation of gas into it) through small incisions of the manipulators and the laparoscope containing a lighting system and a video camera;
performing laparoscopic diagnostics;
separation of existing adhesions and isolation of the ureters, if necessary;
application of ligatures and intersection of round uterine ligaments;
mobilization (release) of the bladder;
the imposition of ligatures and the intersection of the fallopian tubes and the uterine ligaments or the removal of the ovaries and fallopian tubes.

The second stage consists of:

dissection of the anterior vaginal wall;
intersection of the vesicouterine ligaments after displacement of the bladder;
making an incision in the mucous membrane of the posterior vaginal wall and applying hemostatic sutures to it and to the peritoneum;
applying ligatures to the uterosacral and cardinal ligaments, as well as to the vessels of the uterus, with subsequent intersection of these structures;
bringing the uterus into the wound area and cutting it off or dividing it into fragments (if the volume is large) and removing them.
suturing the stumps and the vaginal mucosa.

At the third stage, laparoscopic control is performed again, during which small bleeding vessels (if any) are ligated and the pelvic cavity is drained.

How long does hysterectomy surgery take?

This depends on the method of access, the type of hysterectomy and the extent of surgery, the presence of adhesions, the size of the uterus and many other factors. But average duration The entire operation usually takes 1-3 hours.

The main technical principles for removing the uterus using laparotomy and laparoscopic approaches are the same. The main difference is that in the first case, the uterus with or without appendages is removed through an incision in the abdominal wall, and in the second, the uterus is divided into fragments in the abdominal cavity using an electromechanical instrument (morcellator), which are then removed through a laparoscopic tube (tube ).

Rehabilitation period

Moderate and minor bloody issues after removal of the uterus are possible within no more than 2 weeks. To prevent infectious complications, antibiotics are prescribed.

In the first days after surgery, bowel dysfunction almost always develops, mainly associated with pain and low physical activity. Therefore, the fight against pain, especially in the first day, is of great importance. For these purposes, injectable non-narcotic analgesic drugs are regularly administered. Prolonged epidural analgesia has a good analgesic effect and improves intestinal motility.

In the first 1-1.5 days, physiotherapeutic procedures are carried out, physiotherapy and early activation of women - by the end of the first or at the beginning of the second day they are recommended to get out of bed and move around the department. 3-4 hours after the operation, in the absence of nausea and vomiting, it is allowed to drink still water and “weak” tea in small quantities, and from the second day - to eat food.

The diet should include easily digestible foods and dishes - soups with chopped vegetables and grated cereals, fermented milk products, boiled low-fat fish and meat. Foods and dishes rich in fiber, fatty fish and meats (pork, lamb), flour and confectionery products, including rye bread (wheat bread is allowed on the 3rd - 4th day in limited quantities), chocolate are excluded. From the 5th – 6th day the 15th (general) table is allowed.

One of the negative consequences of any abdominal surgery is the adhesive process. It most often proceeds without any clinical manifestations, but can sometimes cause serious complications. Basic pathological symptoms the formation of adhesions after removal of the uterus is chronic pelvic pain and, more seriously, adhesive disease.

The latter can occur in the form of chronic or acute adhesive intestinal obstruction due to impaired passage of feces through the large intestine. In the first case, it is manifested by periodic cramping pain, gas retention and frequent constipation, moderate bloating. This condition can be resolved with conservative methods, but often requires elective surgical treatment.

Acute intestinal obstruction is accompanied by cramping pain and bloating, lack of stool and flatus, nausea and repeated vomiting, dehydration, tachycardia and initially an increase and then a decrease in blood pressure, a decrease in the amount of urine, etc. In case of acute adhesive intestinal obstruction, emergency resolution is necessary through surgical treatment and intensive care. Surgical treatment consists of cutting adhesions and, often, intestinal resection.

Due to the weakening of the muscles of the anterior abdominal wall after any surgical intervention in the abdominal cavity, the use of a special gynecological bandage is recommended.

How long to wear the bandage after hysterectomy?

Wearing a bandage in at a young age it is necessary for 2 - 3 weeks, and after 45-50 years and with poorly developed abdominal muscles - up to 2 months.

It promotes more fast healing wounds, reducing pain, improving bowel function, reducing the likelihood of hernia formation. The bandage is used only during the daytime, and later - during long walking or moderate walking. physical activity.

Since after the operation the anatomical location of the pelvic organs changes, and the tone and elasticity of the pelvic floor muscles are lost, consequences such as prolapse of the pelvic organs are possible. This leads to constant constipation, urinary incontinence, deterioration of sex life, vaginal prolapse and also to the development of adhesions.

In order to prevent these phenomena, it is recommended to strengthen and increase the tone of the muscles of the pelvic floor. They can be felt by stopping urination or defecation, or by trying to squeeze a finger inserted into the vagina with its walls. The exercises are based on a similar compression of the pelvic floor muscles for 5-30 seconds, followed by their relaxation for the same duration. Each exercise is repeated in 3 approaches, 10 times each.

A set of exercises is performed in different starting positions:

The legs are set shoulder-width apart, and the hands are on the buttocks, as if supporting the latter.
In a kneeling position, tilt your body towards the floor and rest your head on your arms bent at the elbows.
Lie on your stomach, put your head on your bent arms and bend one leg at the knee joint.
Lie on your back, bend your legs knee joints and spread your knees to the sides so that your heels rest on the floor. Place one hand under the buttock, the other on the lower abdomen. While squeezing the pelvic floor muscles, pull your arms up slightly.
Position - sitting on the floor with crossed legs.
Place your feet slightly wider than your shoulders and place your straightened arms on your knees. The back is straight.

In all starting positions, squeeze the pelvic floor muscles inward and upward, followed by relaxation.

Sexual life after hysterectomy

In the first two months, it is recommended to abstain from sexual intercourse to avoid infection and other postoperative complications. At the same time, regardless of them, removal of the uterus, especially during reproductive age, in itself very often becomes the cause of a significant decrease in the quality of life due to the development of hormonal, metabolic, psychoneurotic, autonomic and vascular disorders. They are interconnected, aggravate each other and are reflected directly on sexual life, which, in turn, increases the degree of their severity.

The frequency of these disorders especially depends on the volume of the operation performed and, last but not least, on the quality of the preparation for it, the management of the postoperative period and treatment in the longer term. Anxiety-depressive syndrome, which occurs in stages, is noted in every third woman who has undergone hysterectomy. The timing of its maximum manifestation is the early postoperative period, the next 3 months after it and 12 months after the operation.

Removal of the uterus, especially total with unilateral, and even more so with bilateral removal of the appendages, as well as carried out in the second phase of the menstrual cycle, leads to a significant and rapid decrease in the content of progesterone and estradiol in the blood in more than 65% of women. The most pronounced disorders of the synthesis and secretion of sex hormones are detected by the seventh day after surgery. The restoration of these disorders, if at least one ovary was preserved, is observed only after 3 or more months.

Moreover, due to hormonal disorders Not only does libido decrease, but many women (every 4 to 6 women) develop atrophy processes in the vaginal mucosa, which leads to dryness and urogenital disorders. This also adversely affects sex life.

What medications should be taken to reduce the severity of negative consequences and improve the quality of life?

Considering the staged nature of the disorders, it is advisable to use sedatives, antipsychotic drugs, and antidepressants in the first six months. In the future, their use should be continued, but in intermittent courses.

For preventive purposes, they should be prescribed during the most likely periods of the year for exacerbations of the disease. pathological process- in autumn and spring. In addition, in order to prevent the manifestations or reduce the severity of post-hysterectomy syndrome, in many cases, especially after ovarian hysterectomy, it is necessary to use hormone replacement therapy.

All drugs, their dosages and duration of treatment courses should be determined only by a doctor of the appropriate profile (gynecologist, psychotherapist, therapist) or together with other specialists.

If your hysterectomy was performed under general anesthesia, you may feel nauseous in the first hours after surgery. You will be able to drink water within 1-2 hours after surgery, and eat after 3-4 hours, or when the nausea has passed.

For another 1-2 days after surgery, you may have a catheter in your bladder that will drain urine into an airtight container.

When will it be possible to get out of bed?

It is advisable to get out of bed as early as possible. If during the operation a large incision was made in the skin of the abdomen, then it will be possible to rise on the second day after the operation. If the operation was performed using laparoscopy, then you will be able to get out of bed on the day of the operation, in the late afternoon. The sooner you can get up and walk, the faster your recovery from surgery will be and the lower your risk of complications in the future.

Pain after surgery

After a hysterectomy, pain can be quite severe. This is due to the inflammatory process, which is the very first stage of wound healing. Pain can be felt both in the suture area and inside.

You will be prescribed painkillers to reduce pain. For very severe pain, narcotic analgesics may be required.

Some women report tingling or aching pain in the abdomen for several months after surgery. This is normal and is associated with damage to the nerve endings, without which no surgical intervention can be performed. Usually all these symptoms gradually disappear.

When will they be discharged from the hospital?

How long you will have to stay in the hospital after surgery depends on the type of surgery. After a laparoscopic hysterectomy, you may be discharged from the hospital the next day. If the operation was performed through a large incision on the skin, then you will be discharged from the hospital 2-3 days after the operation. The duration of hospitalization also depends on your diagnosis (reason for hysterectomy), your well-being, and the presence or absence of complications.

How long does it take to recover after hysterectomy?

Recovery from surgery may take several weeks:

after abdominal hysterectomy: 4-6 weeks
after vaginal hysterectomy: 3-4 weeks
after laparoscopic hysterectomy: 2-4 weeks

You can leave town no sooner than 3 weeks after surgery if you do not have a large stitch in your stomach, or no earlier than 6 weeks after your abdominal hysterectomy (if you have a large stitch in your stomach). The same applies to air travel.

How long should you not lift weights after a hysterectomy?

You should not lift anything heavy for at least another 6 weeks, as this may lead to abdominal pain, spotting from the vagina, or even a hernia that will have to be operated on again.

How long can you not have sex after a hysterectomy?

You will have to abstain from sex for at least another 6 weeks after surgery.

How long can you not swim after a hysterectomy?

Diet after hysterectomy surgery

You can return to your normal diet immediately after leaving the hospital. But try to avoid foods that cause bloating (formation of gases in the intestines) at first.

Suture after hysterectomy

After an abdominal hysterectomy, the incision in the skin of the abdomen may be quite large. It needs to be carefully looked after until it heals completely.

If suture material does not resolve on its own, then you will need to return to the hospital in a few days: your surgeon will inform you on what day after the operation the stitches can be removed. If the stitches are supposed to dissolve on their own (your surgeon will tell you this), they will usually dissolve within 6 weeks after surgery.

In the first days after surgery, you will need to additionally treat the suture to reduce the risk of inflammation. Betadine, which can be found at the pharmacy, is suitable for this.

You can take a shower or bath without fear: the skin in the area of the seam can be gently washed with shower gel and then rinsed with water.

The skin around the incision may be itchy due to stretching: to ease the itching, apply lotion or cream to the skin with gentle movements.

Some women report that the skin around the incision “burns” or, conversely, becomes numb. All these phenomena are also normal and usually disappear several months after surgery.

Brown vaginal discharge after hysterectomy

After a hysterectomy, bloody vaginal discharge is almost always observed: it can be dark brown, reddish, light brown or pink. This is all normal.

The discharge usually persists for several weeks after surgery: 4 to 6 weeks. In the first 2 weeks, the discharge will be most noticeable, and then it will become increasingly scarce. The amount of discharge varies from person to person, but almost always depends on physical activity: the more you move, the more discharge.

The discharge may have a specific smell and this is also normal. But if the discharge still smells unpleasant, then you need to contact a gynecologist. After removal of the uterus, local vaginal immunity may be reduced, which is accompanied by a slightly increased risk of inflammation. A foul-smelling discharge will be the first sign that something is wrong.

If the discharge is heavy, as during normal periods, or comes out with blood clots, then you should also consult a doctor. This symptom may indicate that one of the vessels is bleeding and the bleeding will not stop without the help of a gynecologist.

Temperature after hysterectomy

In the first days after surgery, your body temperature may be slightly elevated. During this time, you will still be under medical supervision and will be prescribed antibiotics if necessary.

After being discharged home, you may also notice that your body temperature remains around 37C, or rises to 37C in the late afternoon. And that's okay. You should consult a doctor if your body temperature is above 37.5C.

Removal of the uterus and menopause

If during a hysterectomy not only the uterus, but also the ovaries were removed, then already in the first weeks after the operation you may notice symptoms of menopause: hot flashes, mood swings, excessive sweating, insomnia, etc. This is due to a sudden decrease in the level of female sex hormones in the blood: previously they were produced by the ovaries, but now there are no ovaries. This condition is called surgical or artificial menopause.

Surgical menopause is no different from natural menopause (when menopause occurs on its own), and nevertheless, after surgery, menopause symptoms may be more pronounced. If you cannot cope with the symptoms of menopause on your own, contact your gynecologist. Your doctor may prescribe you a course of hormone replacement therapy, which will help you transition to menopause more smoothly (the only exception is women who have had their uterus removed due to cancer, – in this situation, hormones are contraindicated).

If during the operation only the uterus was removed, but the ovaries remained, then the only difference you will notice after the operation is the absence of menstruation. At the same time, hormones will be produced in the ovaries, which means there will be no other symptoms of menopause. However, it has been noted that even if the ovaries remain, removal of the uterus “accelerates” the onset of menopause: in many women, the first symptoms of menopause (sweating, mood swings, etc.) appear within the first 5 years after hysterectomy.

Our website has a whole section dedicated to menopause problems:

What complications are possible after removal of the uterus?

Complications of a hysterectomy are rare, but you need to be aware of them so you can seek medical help promptly.

In the first weeks or months after surgery, the following complications are possible:

Inflammation of the wound: the skin around the suture becomes red, swollen, very painful or pulsating, body temperature rises to 38C or higher, observed bad feeling, headaches, nausea.
Bleeding: After surgery, some blood vessels may open again and begin to leak blood. In this case, profuse bleeding from the vagina appears. The blood is usually red or dark red in color and may come out with clots.
Inflammation of the urethra or bladder: Some women experience pain or stinging when urinating after the catheter is removed. This is due to mechanical damage to the mucous membranes urinary catheter. Usually, after 4-5 days the pain goes away. If the symptoms do not go away and intensify, then you need to consult a doctor again.
Thromboembolism: this is a blockage of blood vessels with blood clots or blood clots. To prevent this complication, it is recommended to get out of bed and move as soon as possible after surgery.

In the following months or years after surgery, the following complications are possible:

The onset of menopause: even if the ovaries were not removed along with the uterus, menopause may occur after the operation. See Hysterectomy and Menopause.
Prolapse of the vaginal walls: manifested by sensation foreign body in the vagina, urinary or fecal incontinence. It is available on our website.
Urinary incontinence: an unpleasant consequence of hysterectomy, which is most often associated with prolapse of the anterior vaginal wall. It is available on our website.
Chronic pain: This is a rare complication that can develop after any surgery. Chronic pain can last for years, affecting quality of life. To deal with this problem, you need to see a doctor who treats pain.

Surgical intervention to amputate the uterus is a necessary measure in situations where there are no other ways to cure serious illness. Experienced doctor will try to save reproductive function and will suggest, depending on the disease, the most gentle method of treatment, for example, embolization of the uterine arteries.

Please note that this text was prepared without the support of our website.

In rare cases, a hysterectomy may be performed at a woman's request for contraceptive purposes. Patients who are preparing for surgery are concerned about what to do after removal of the uterus and what are the consequences of the operation. High-quality removal of the uterus, the consequences of which are absent, allows us to give an optimistic prognosis.

Removal of the uterus: causes and types of surgery

Hysterectomy is prescribed in the most difficult cases or when conservative treatment methods do not work:

with multiple myomatous nodes in the uterus;
with large fibroids;
during an oncological process in an organ, when a benign tumor degenerates into a malignant tumor;
with endometriosis;
with prolonged and heavy bleeding.

Surgery can be performed in several ways, the use of which is determined by the diagnosis, severity of symptoms and complications:

radical hysterectomy is the most extensive intervention in which the appendages are excised, The lymph nodes and uterus;
total hysterectomy involves amputation of the body and cervix;
A subtotal hysterectomy is an operation to remove the body of the uterus.

A surgical solution to the problem is necessary in extreme cases, since the uterus is an organ that unites all organs of the reproductive system. After removal of the uterus, consequences arise if medical recommendations are not followed in the postoperative period. To undergo an examination, you can visit leading specialists who will make a diagnosis and suggest treatment options for the disease.

Preparing for a hysterectomy

Hysterectomy, like other surgical procedures, requires extensive preparation and evaluation current state women. Before surgical treatment, the patient must undergo an examination, based on the results of which the gynecologist, together with the surgeon, concludes that she is ready for amputation. Preoperative examination includes:

electrocardiogram;
ultrasonography;
laboratory blood tests for sexually transmitted infections, HIV infection;
determination of blood group and Rh factor;
fluorography;
diagnostic scraping of the uterus.

Before the operation, the psychological state of the woman is important. To do this, the gynecologist must justify the importance of using this procedure, warn about possible consequences, talk about the features of the rehabilitation period. A confidential conversation will set the woman up for the procedure and familiarize the patient with the rules for its implementation.

The degree of trauma is determined not only by the type of operation, but also by the method of surgical access. Surgeons consider abdominal surgery to be the most radical method; access is through an incision in the abdominal wall. To remove the uterus, the vaginal method is also used, in which an incision is made in the vagina. The safest method is laparoscopic using a special device. With this operation, consequences occur less frequently.

Rehabilitation after hysterectomy: general principles

The rehabilitation period after hysterectomy lasts from the moment the operation is stopped until full recovery performance. Postoperative recovery, as with other surgical interventions, occurs in two stages: early and late rehabilitation.

During abdominal surgery, bed rest lasts up to 7 days, during which time the woman is under the supervision of a doctor. Removal of sutures and discharge of the patient is possible no earlier than after 9-12 days. With laparoscopic surgery, this period is reduced to 4 days. At the early stage of rehabilitation, the efforts of doctors and medical personnel are aimed at eliminating pain and other symptoms, preventing bleeding, preventing the development of the inflammatory process and suture dehiscence.

Late rehabilitation is performed by the woman independently at home. The duration of this stage without complications can be up to 30 days, if there are consequences - up to 45 days. During this period, it is necessary to ensure the strengthening of the immune system, restoration of damaged tissues, improvement of condition, psychological stability and restoration of performance.

Early recovery after hysterectomy

There are rules that a woman must follow in early rehabilitation period after amputation of the uterus. They are aimed at eliminating complications, inflammation, internal bleeding and eliminating pain.

Doctors carry out the following activities in the first 24 hours after surgery:

anesthesia of the incision site. In the abdominal area after amputation of the uterus, a woman may experience natural pain; painkillers are prescribed to eliminate them;
security proper nutrition. In the patient's diet for Get well soon and exceptions for problems with bowel movements include: high fiber foods, soups, cereals, meat, rye bread, vegetables and fruits;
activation of body systems. The efforts of doctors in the postoperative period are aimed at normalizing blood circulation and intestinal function.

To prevent inflammatory processes in the uterus, a woman should not allow hypothermia. Bed rest will help the patient recover faster in the first days, so she should get enough sleep and rest. A week later, the stomach stops hurting after removal of the uterus, at which time you should begin short walks. After the stitches have healed, you can introduce lungs into your daily routine. physical exercise that help strengthen the body.

After surgery, drug therapy may be prescribed:

To exclude infection, antibiotics are used, the course of which varies from 5 to 8 days;
to normalize blood circulation, infusion influence is carried out using intravenous droppers;
The formation of blood clots in the vessels is prevented by anticoagulants, which are administered for 2-3 days.

Along with the restoration of the physical component of the patient’s life, measures should be taken to solve psychological problems associated with the absence of an organ. A woman should regularly visit a psychotherapist who will help overcome depression and understand that a normal life is possible after surgery.

Late rehabilitation after hysterectomy

After discharge from medical institution The second stage of rehabilitation begins. During the first months, pressure in the abdominal cavity should not be allowed to increase in order to prevent the sutures from coming apart. Sexual rest after surgery is indicated for up to two to three months, since the vagina after removal of the uterus must recover and the sutures must heal.

A healthy and balanced diet accelerates the healing process of wounds, improves general condition patients and normalizes intestinal function. After surgery, fatty, salty, sweet, smoked and spicy foods should be excluded from the diet. Gradually, soups, cereals, vegetables and fruits, herbs, and fermented milk products should be introduced into the daily diet. Drinking alcohol during the rehabilitation period is also unacceptable. Many women wonder why they need to diet after hysterectomy. This is due to the fact that during this period there is a high probability of recruitment excess weight, and it is also important to prevent constipation and bloating.

At late rehabilitation Women are prohibited from taking hot baths, visiting solariums, saunas, baths. It is also important to limit swimming in open water to eliminate the risk of developing an inflammatory process.

During this rehabilitation period, it is important to carry out activities aimed at returning the woman to normal life, providing her psychological support and preventing complications. Depending on the scope of the intervention, the doctor may prescribe special medications, the action of which is aimed at suppressing the symptoms of surgical menopause.

Early and late rehabilitation measures are important to follow for a positive prognosis for recovery after surgery, since modern technology intervention has been sufficiently developed and is performed at a high level. In women of reproductive age, removal of the uterus is possible only if urgent need, since this is an irreversible procedure.

Removal of the uterus: consequences and reviews from patients

At the stage of early rehabilitation, the first complications may arise:

the inflammatory process in the area of damaged tissue manifests itself in the form of redness, purulent discharge, and swelling. In this condition, seam divergence is possible;
a violation of the urination process is characterized by pain when visiting the toilet and pain. This complication is usually the result of damage to the mucous membrane of the urinary canal;
pain syndrome in most cases occurs due to adhesions; in case of severe pain, the doctor prescribes appropriate medications;
fistulas occur when sutures are of poor quality and become infected. To solve this problem, specialists perform additional operations to remove fistulas;
hematomas are associated with damage to small vessels, so they often occur in the area of scar formation;
peritonitis is an inflammatory process in the peritoneum, the danger of which is rapid damage internal organs and sepsis. Peritonitis is treated by administering a combination of antibiotics. If drug treatment does not produce the desired effect, repeated surgery is required to remove the uterine stump. After its completion, the abdominal cavity is washed and drainage is installed;
External and internal bleeding may occur due to improper hemostasis during amputation. External bleeding may have a brown, dark red, scarlet tint, and clots often come out.

With a hysterectomy, prolapse of the vaginal walls is also possible, and therefore the reviews left by women after removal of the uterus may be negative. At this complication woman shown performing therapeutic exercises to strengthen the pelvic muscles, as well as wearing a special vaginal ring.

After removal of the uterus, heavy mucous or bloody discharge often occurs. You must inform your doctor about their appearance, who will conduct an examination and determine the cause of their occurrence, and then prescribe treatment.

A negative consequence of uterine amputation may be urinary incontinence due to the fact that the ligamentous apparatus has weakened or, in the absence of ovaries, the production of sex hormones has ceased. The main methods of treatment for this problem are the use of hormonal drugs and the purpose of physical education. In this case, the woman does not need repeated surgery.

Removal of the uterus and ovaries: consequences

The most noticeable are the consequences of surgery to remove the uterus and ovaries. This is explained by the fact that the ovaries produce hormones, so in their absence complications may arise:

the occurrence of menopause in a woman and its accompanying features;
a lack of female hormones– estrogens – affects the functioning of the cardiovascular system;
lack of testosterone can lead to a deterioration in the quality of sexual life;
weight gain due to hormonal imbalance.

To solve these problems, it is recommended to take hormonal medications after hysterectomy. The use of various patches and tablets that regulate hormonal levels is widespread. Thanks to this treatment method, a woman after surgery can return to normal life.

Woman after hysterectomy: early menopause

Removal of the uterus, reviews of which in most cases are negative, has a number of consequences. A very long-term consequence is menopause. This condition occurs sooner or later in every woman. The onset of menopause naturally occurs when only the uterus is amputated, since the ovaries, which produce hormones, were preserved.

After removal of the uterus and appendages, surgical menopause occurs. It is more difficult for women to tolerate, since in the case of natural menopause, the production of hormones stops gradually. During surgical menopause, hormonal levels change quickly.

After removal of the uterus, the patient is prescribed hormone replacement therapy with therapeutic purpose. Before prescribing it, the doctor must consider individual characteristics patients, severity of symptoms, medical history and research results. Hormonal therapy is part of a set of measures recommended for postmenopause; this method acts symptomatically. Physical activity in combination with taking medications, it allows you to correct menopausal disorders.

Sex life after hysterectomy

The question of when to start sex life after removal of the uterus, causes controversy among gynecologists. However, the opinions of most experts agree that no radical changes occur after surgery. It is recommended to abstain from sexual intercourse for a month after hysterectomy.

Problems that occur in sexual life after amputation can be classified as psychological. Those women whose desire has disappeared and their sex life has deteriorated consider themselves inferior after a hysterectomy. Some women note an improvement in their sex life, this is explained by the fact that they were exhausted by the disease.

A woman’s sensitivity after the intervention is not impaired, since the areas responsible for perception are located in the vagina and external genitalia. Formation of sexual desire in female body is a complex process, which explains the lack of reliable data on the relationship between hysterectomy and sexual sensations.

Opposite opinion of experts

Endovascular surgeon B.Yu. Bobrov and obstetrician-gynecologist D.M. Lubnin have extensive experience in treating various women's diseases. Experts are of the opinion that hysterectomy is not the only in an effective way treatment of gynecological diseases. After all, after removal of the uterus, thyroid and breast cancer may develop after some time. In addition, the blood supply to the ovaries is disrupted, which leads to the development of posthysterectomy syndrome. The condition of women during this period is similar to the manifestation of menopause.

Modern gynecologists must treat diseases and preserve reproductive health women, where possible, using safe methods. Thus, in the treatment of uterine fibroids, an effective procedure is uterine artery embolization. Removal of the uterus for fibroids often has negative consequences, reviews from patients.

Mechanism this method is to overlap blood vessels, which feed the neoplasm. The blood supply to the uterus is carried out by the uterine and ovarian arteries. For fibroids, the cessation of blood supply through the uterine arteries is destructive, but this does not affect the condition of healthy uterine tissue. To stop the blood supply, safe particles - emboli - are injected into the uterine arteries.

The result of the procedure is a reduction in fibroid volume by 65% per year. After uterine artery embolization, a woman does not need to take any medications or use rehabilitation procedures. Contact qualified professionals for assistance.

Removal of the uterus can have negative consequences for the body, so before deciding to undergo it, the doctor should carefully study the available data and determine the possibility of performing other procedures that will help preserve reproductive function. In cases where this is not possible, the gynecologist must provide full information about the operation and possible consequences.

Bibliography

Lipsky A. A.,. Gynecology // encyclopedic Dictionary Brockhaus and Efron: in 86 volumes (82 volumes and 4 additional). - St. Petersburg. 1890-1907.
Bodyazhina, V.I. Textbook of gynecology / V.I. Bodyazhina, K.N. Zhmakin. - M.: State Publishing House of Medical Literature, 2010. - 368 p.
Braude, I. L. Operative gynecology / I. L. Braude. - M.: State Publishing House of Medical Literature, 2008. - 728 p.

Reproductive organs distinguish women from men. After surgical amputation of the ovaries and uterus, a representative of the fairer sex is actually deprived of her gender. Therefore, radical measures are used in cases where other treatment methods are powerless. After the operation, the woman faces a difficult recovery period. To avoid negative consequences, it is very important to know what can and cannot be done during this period (for example, sunbathing, playing sports, etc.)

Recovery period

The process of a woman returning to normal life after removal of the uterus and ovaries can be divided into two stages: being in medical institution and home recovery. The duration of rehabilitation depends on the method of surgery. If surgery was performed through the vagina or through an incision in the abdominal wall, then the patient is in the hospital for 8 to 10 days.

If laparoscopic hysterectomy was used, the woman will be discharged after 3-4 days. For the first 24 hours after surgery, the following recommendations are followed:

to avoid blood stagnation, the patient is forced to get out of bed several hours or a day after the operation (laparotomy);
after the elimination of the appendages and uterus, only a gentle diet is allowed: you can eat broths, pureed vegetables, drink weak tea;
all women feel intense painful sensations in the suture area and lower abdomen, so they must be prescribed painkillers (Ketonal).

A woman’s activity during the rehabilitation period helps her recover faster and reduces the risk of complications. After open surgery the patient needs 6-8 weeks for rehabilitation. For a woman, there are certain recommendations on what to do during the recovery stage:

After total removal of the ovaries and uterus, many women experience post-castration syndrome. Usually, psycho emotional condition is impaired in young patients. Symptoms of the syndrome include:

The syndrome disappears on its own as the body adapts to the absence reproductive organs(2-3 months).

If a woman is positive, then no radical measures will have to be taken. Gradually, the body will adapt, the physical and emotional state will stabilize in order to move on with life.

Intimate life and sports

Sexual relations are allowed only 1.5-2 months after removal of the appendages and/or uterus. Women fear that sexual desire will disappear, their intimate life will cease to be the same as it was before the amputation of the reproductive organs. These fears are unfounded.

All sensory cells are located at the entrance to the vagina. Sex life After removal of the uterus, some patients feel much brighter because they are no longer afraid of accidentally becoming pregnant.

The orgasm does not disappear anywhere, but pain during sex cannot be ruled out if the patient has undergone hysterectomy. In this case, after surgery, a scar remains on the vagina.

If a woman has undergone amputation of the appendages, vaginal dryness and minor pain may occur. This is due to a stop in estrogen production. What to do in such a situation? You can use special intimate lubricants (Divigel) and increase the period of foreplay. In order to have a normal sexual life after removal of the ovaries, hormonal replacement therapy(Zhanine, Klimonorm, etc.).

It is impossible to get pregnant after total removal of the uterus and ovaries. Menstruation also stops. Immediately after amputation, the woman experiences bleeding for 10 days; this can easily be explained by the healing of the sutures.

If the operation went without complications, after 3 months you can try to play sports. It is recommended to do yoga, Pilates, and bodyflex exercises. Simple exercises Kegels will help the patient prevent complications after surgery of the appendages and uterus:

constipation;
adhesions;
haemorrhoids;
blood clots;
urinary incontinence;
discomfort during intimacy.

How to do Kegel exercises correctly:

You can live after amputation of the ovaries and uterus as before, the main thing is to follow the doctors’ instructions: take medications, eat right and distribute the load.

Regime and diet

Immediately after surgery to remove the uterus and ovaries, you need to go on a diet that limits certain foods. After anesthesia, bloating, intestinal dysfunction, and stomach upset occur. In addition, after amputation of appendages, hormonal levels change. The body breaks down fats more slowly, so women quickly gain excess weight.

To maintain your normal weight, you should not eat:

You cannot eat legumes (beans, peas, lentils, cabbage, grapes and radishes). These foods cause flatulence and bloating. Alcoholic and carbonated drinks, strong coffee and tea are prohibited.

If you choose the right products for daily menu, the body will quickly recover. To maintain weight, you can eat:

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.

General rules for the mode:

At first, a woman will have to get used to living by the new rules, but do not be afraid, over time the body will return to normal.

Consequences and complications of the operation

There is no disability after a hysterectomy, so women continue to live normal lives. But, as with any operation, early or late complications are possible. When the ovaries or uterus are removed, the first possible complication: adhesions. They are formed in 90% of cases.

If adhesions form, then unpleasant symptoms will follow:

aching pain in the abdomen;
urinary disturbance;
difficulty with bowel movements;

To prevent the formation of adhesions, antibiotics (Azithromycin) and blood thinners (Ascorutin) are prescribed. For prevention, you can turn on your side in the first 24 hours. Sometimes electrophoresis with Lidaza or Longidaza is used.

bleeding;
cystitis;
thromboembolism;
wound infection.

One of the common late complications is vaginal prolapse. The more extensive a woman’s surgery was, the higher the risk of damage to the vaginal ligaments.

For prevention, it is necessary to do Kegel exercises and limit lifting weights in the first 2 months after surgery. Since living with such a complication is extremely uncomfortable, in severe cases plastic surgery and fixation of the vaginal ligaments is performed.

Other late consequences that interfere with living a full life:

Urinary incontinence. Caused by ligament weakness and low level estrogen after oophorectomy.
Fistula tracts at the sutures. To eliminate the pathology, doctors are forced to perform additional surgery.
After removal of the reproductive organs, menopause occurs 5 years earlier. Signs appear after 2 weeks:
- profuse sweating;
- emotional instability;
- the appearance of wrinkles on the face, skin of the hands and neck;
- hot flashes;
- cardiopalmus;
- dryness of the vaginal mucosa;
- brittle nails or hair;
- urinary incontinence when laughing or coughing;
- decreased libido.

Living with early menopause is difficult, especially for young women who might still have children. But lose heart and plunge into depressive state There is no point in talking about lost youth.

Modern drugs ( hormonal pills, homeopathic remedies containing phytoestrogens) effectively eliminate the signs of menopause and facilitate its course.

To prevent serious consequences of a hysterectomy or oophorectomy, it is necessary to follow the instructions of your doctor and be examined by a gynecologist every 6 months.

Losing a uterus does not mean ceasing to be a woman. Sometimes the diseases that require the removal of reproductive organs are so serious that surgery means liberation and healing.

Content

If a gynecologist recommends removing the uterus, this can cause fear and confusion in a woman. But sometimes this is the only way to get rid of a serious illness or save life. Millions of women have undergone hysterectomy (another name for this operation) and learned to live and enjoy life in new circumstances. How is a hysterectomy performed? What are the indications for conducting data surgical procedures?

Hysterectomy is a common gynecological operation around the world. Once the uterus is removed, a woman will stop menstruating and will no longer be able to become pregnant. This operation is even performed abroad healthy women after 40 years of age to prevent the development of cancer and fibroids. In our country, the indications for hysterectomy are:

cancer of the uterus, ovaries, cervix;
fibrosis, fibroids;
endometriosis;
many polyps;
prolapse/prolapse of the uterus;
pelvic pain caused by uterine pathology.

Large fibroid

It's called fibroid benign education from muscle and connective tissue. Often a tumor forms in the uterus. There are fibroids different sizes. If the myomatous nodes of the tumor are more than 6 cm and the uterus is the same size as at the 12th week of pregnancy, then such a benign formation is considered large. To remove fibroids, one of several types of operations may be prescribed: laparoscopic or abdominal myomectomy, hysterectomy. Removal of the uterus for this disease is prescribed as a last resort, when other methods are not effective or the woman is over 40 years old.

Endometriosis

The growth of the lining of the uterus in the ovaries, peritoneum, fallopian tubes and other places where it should not be is called endometriosis. This disease is accompanied by inflammation of the organs on which the endometrium grows, pain during menstruation, and vaginal discharge. Sometimes with endometriosis it is necessary to remove the uterus. But this does not always help to completely get rid of the disease. Removal of the uterus for this disease is recommended for women who do not plan to have any more children.

Cervical cancer

To save a woman's life, doctors may recommend a hysterectomy for cervical cancer. In this case, a radical operation is often performed, removing the cervix, upper part of the vagina, uterus, the fallopian tubes, ovaries and nearby tissues, lymph nodes. After hysterectomy and removal malignant tumor the patient is prescribed a course radiation therapy, radiotherapy. During the operation, the operation can prevent further development oncological processes in the body.

Preparing for hysterectomy surgery

If a woman decides to have a hysterectomy, she will need to undergo a full examination and tests to confirm the diagnosis. In this case, ultrasonic and X-ray methods. If the doctor considers it appropriate, he will also prescribe a biopsy before the operation. The day before removal of the uterus, a woman is recommended to have a special diet No. 1, which includes ground food and an enema to cleanse the intestines.

How to prepare for surgery? Preoperative preparation will depend on the reason for which the hysterectomy is planned. So, if the indication for hysterectomy is a large number of fibroids, then several months before surgery the patient will be prescribed hormonal medications that will reduce the size of the formation. In other situations, you may need to take antibiotics before surgery to prevent infection.

So that the patient calms down, does not worry and is not afraid, before the hysterectomy she is given an injection with sedative. On the day of surgery, a catheter is inserted into the bladder. Before undergoing surgery, a woman needs to talk with an anesthesiologist so that the doctor can find out which drugs cannot and can be used during the operation.

How is the operation performed and how long does it last?

Hysterectomy can be performed using different methods. Depending on the progression of the disease, the doctor will recommend the type of surgery. According to the technique of hysterectomy, the following types are distinguished: open cavity, vaginal, laparoscopic. Depending on the number of organs removed, the operation can be total, subtotal, radical, or performed using the method of hysterosalpingo-oophorectomy.

in a total operation, the surgeon removes the uterus along with the cervix;
with a subtotal hysterectomy, only the uterus is removed;
during hysterosalpingo-oophorectomy, the uterus and appendages are removed;
at radical surgery The uterus, appendages, cervix, part of the vagina, surrounding tissues with lymphatic tissue are removed.

Abdominal surgery

To gain access to the uterus during abdominal surgery, the surgeon makes an incision in the abdominal cavity. After completing all stages of the hysterectomy, the doctor will stitch the wound and apply a sterile dressing. Although this type of operation is often used, it has several disadvantages. These include the woman being more traumatic, and the large size of the scar on the abdomen that remains after this type of surgery to remove the uterus. How long does hysterectomy surgery take? The duration of abdominal hysterectomy is 40 minutes - 2 hours.

Laparoscopic

A gentle type of hysterectomy is the laparoscopic method of performing the operation. This type of surgery is performed without large incisions in the abdomen. Special instruments and equipment are used to perform laparoscopic surgery. First, gas is injected into the abdominal cavity through a special tube called a cannula. This is necessary so that the abdominal wall rises above the organs and the surgeon gains access to the uterus. Then the operation itself begins.

To remove the uterus or other adjacent organs, the surgeon inserts tubes into the abdominal cavity through small incisions in the abdomen. Through them, a video camera and surgical instruments are lowered into the body. Laparoscopic hysterectomy lasts 1.5-3.5 hours. The advantage of this method is that the incision is small, which means there is no unsightly seam left on the abdomen.

Immediately after surgery, a woman often feels nausea, which is a consequence of the use of general anesthesia. The patient will be allowed to drink some water after 1-2 hours, and eat food after 3-4 hours after surgery. The catheter will be removed from the bladder 1-2 days after the hysterectomy. If abdominal surgery was performed, then the woman will be able to get out of bed on the 2nd day. After laparoscopic removal of the uterus, the patient will be able to walk within a few hours.

The consequence of a hysterectomy is often pain in the suture area and inside the abdomen, so the woman is prescribed painkillers. She will be discharged from the hospital 2-3 days after abdominal surgery or the next day after laparoscopic hysterectomy. In the first case, a large seam remains, which must first be treated with special preparations to reduce the risk of developing inflammatory processes.

Recovery and rehabilitation

After a hysterectomy, special attention is paid to the prevention of inflammation, normalization of water-electrolyte balance and blood composition, harmonization psychological state women. Recovery after surgery to remove the uterus using the abdominal method is 4-6 weeks, and when using the laparoscopic method of surgery - 2-4 weeks.

If carried out vaginal hysterectomy, then rehabilitation after removal of uterine fibroids will last 3-4 weeks. The time for suture resorption during abdominal surgery is 6 weeks. To prevent adhesions, a woman may be prescribed physiotherapy (for example, magnetic therapy). If necessary, the doctor will prescribe suppositories, injections or tablets to eliminate complications after surgery. After a hysterectomy, a woman is entitled to sick leave for 25-45 days.

Diet after surgery

An important point during the postoperative recovery period is diet. After a hysterectomy, a woman will have to adhere to some restrictions when compiling her menu. You should not include foods that irritate the mucous membranes in your diet. Porridge, fermented milk products, meat broths, nuts - all this should be on the patient’s menu. It is also important to eat vegetables and fruits to prevent constipation. And coffee, confectionery, tea, chocolate, and white bread should be excluded from the daily menu.

Physical exercise

Operated women are not recommended to lift heavy objects for another 6 weeks after discharge from the hospital. You cannot be sexually active for the same amount of time. Women are allowed to visit the pool no earlier than 6-8 weeks after removal of the uterine body. Despite the fact that the sutures dissolve within 6 weeks, doctors recommend starting to play sports or go to the gym only 6 months after abdominal surgery, when a scar has formed. A woman’s personal doctor will tell her about exercises for light exercise.

Possible complications and consequences

If two ovaries are removed along with the uterus, then after the operation the woman will feel symptoms of menopause in the form of insomnia, hot flashes, mood swings and sweating. This condition is called surgical/medical menopause. If the ovaries were not removed during a hysterectomy, then the only symptom of menopause a woman will experience is the absence of menstruation.

Doctors' observations show that after the removal of one uterus, menopause occurs within 5 years after surgery. Women who have undergone removal of the uterine body often develop atherosclerosis, osteoporosis, and sometimes experience a decrease in libido and a burning sensation. After a hysterectomy, the following complications may occur in the first days, weeks, months, years:

Inflammation of the skin at the suture site. At the same time, the temperature rises, nausea appears, a headache occurs, the wound becomes purple in color, becomes swollen and pulsates.
Heavy bleeding. The discharge may be in the form of clots and have a dark red, scarlet tint.
Inflammatory process in the bladder caused by the use of a catheter. At the same time, the woman experiences sharp pains when urinating.
The occurrence of thromboembolism as a result of blockage of veins by blood clots or thrombi.
Vaginal prolapse.
Pain caused by bleeding and the formation of adhesions.

Approximate cost of the operation

How much should I pay for a hysterectomy? The price of the operation depends on many factors. Firstly, its size is influenced by the region of residence of the patient, the level of the hospital and doctor, the scale of the operation and duration, and the conditions of the hospital stay. Secondly, the cost of a hysterectomy depends on what type of surgery a woman has. For example, laparoscopic extirpation in private clinics will cost the patient 16,000-90,000 rubles, and vaginal removal of the uterus costs from 20,000 to 80,000 rubles.