How does a woman feel without a uterus. General principles of postoperative rehabilitation. Surgical methods used in gynecology

When a woman is shown removing the uterus, she experiences a real shock. Such news is frightening, but not by the operation, but by the consequences. The fair sex may believe that after the operation the body will quickly age, and sexual life will become a burden.

Amputation of the uterus, and sometimes also of the ovaries, is a common procedure. According to statistics, about a third of all the fair sex after 45-50 years of age underwent an operation of this kind. Let's try to figure out how to quickly recover after removal? What kind possible complications a lady who has undergone a procedure for removing the uterus and appendages should wait? What actions should be taken if the body temperature rises, or if there is discomfort in the peritoneum? What to do so that the rehabilitation period is not unsettled?

When should the uterus be removed?

Hysterectomy is performed only for women who have given birth, especially if they are already over 50. For those who have not yet become a mother, amputation can only be prescribed in last resort and carried out if there is a serious threat to life.

Indications for removal reproductive organ women may have:

• drug treatment has not been effective and there is a serious threat to life; uterine fibroids of complex shape ( big sizes more than 12 weeks, many nodes, intensive growth);
• prolapse of the uterus, which is accompanied by profuse bleeding;
• severe adenomyosis;
• malignant formations;
• hyperplasia of the endometrium of an atypical form.

After hysterectomy

The recovery period for a woman, after she has had an extirpation of the reproductive organ, with or without appendages, is divided into two stages: early and late. When a woman has undergone supravaginal amputation of the uterus and / or ovaries or an operation to remove an organ by another method, she will spend the early period after the operation in a hospital, since constant medical supervision is required. So, if laparoscopy was performed, you will have to spend 3 to 5 days in the hospital. If the operation to remove the uterus with appendages was performed vaginal access, the length of stay in the hospital will be 8-10 days, then the stitches are removed.

The first day after the operation will be the most difficult. Of course, if laparoscopy was performed, it will be much easier.

• The abdomen can hurt inside and in the area of ​​​​the sutures, sometimes very strongly. The fact that the stomach hurts is considered normal, because the wound is both outside and inside. If the stomach hurts a lot, they are prescribed various medicines for pain relief (drugs, non-narcotics).
• To prevent thrombophlebitis, the legs after surgery should be compression stockings or they should be bandaged with an elastic bandage.
• You can get out of bed after the permission of the doctor. After laparoscopic surgery - in a few hours, after laparotomy - in a day. It is very important not to lie too long in bed, because the movement will help stimulate the bowels. Physical activity is important because the body recovers faster, the risk of complications is much lower.
• On the 1st day after surgery after removal of the uterus and / or ovaries, the diet should be sparing: pureed food, broths. You can drink fruit drinks, still water, weak tea without sugar. Water with gases can cause the stomach to swell. Such a diet is aimed at stimulating intestinal motility, which helps it empty itself without the use of laxatives or enemas 1-2 days after surgery. What indicators indicate the normalization of bowel function? Of course, normal stool after which you can eat normal food.
• Within 3-10 days after the operation, the stomach hurts, but this is not at all necessary.
• If your stomach hurts a lot, your doctor will prescribe pain medication. Body temperature may rise.

After a hysterectomy, treatment includes:

• Antibiotics. Prescribed for prevention different kind infections, regardless of whether there is a temperature or not. The course of admission is 7 days.
• Anticoagulants. Prevention of thrombosis and development of thrombophlebitis. The course is 2-3 days.
• infusion therapy. Infusion of solutions intravenously to replenish the circulation of blood lost during the operation.

What complications after removal of the uterus can occur in the first days?

More common after removal serious complications does not appear, especially if laparoscopy was performed. But, it’s better to immediately indicate what to expect in order to quickly take all measures:

• Bloody discharge from the genitals different nature. A second operation may be required.
• Inflamed seam.
• Pain during the exit of urine, most often this is due to the fact that during the procedure the urination channel was damaged.
• Inflammatory process in the peritoneum, which in the end can provoke sepsis.
• Hematomas in the area of ​​postoperative scar.
• Blockage of an artery in the lungs or its branches (thrombosis), which is very dangerous and can even be fatal.

How to recover correctly?

The operation to remove the uterus, and especially the ovaries, changes the already familiar rhythm of life, especially for those patients who are over 40 years old. In order for the recovery period to pass faster and without complications, you should follow the recommendations of the doctor. With a smooth course of the early postoperative stage, after discharge from the hospital, prevention of the consequences of the operation is important. Health needs to be given due attention so that the body can get stronger, and what measures need to be taken, the doctor will tell.

• Diet. If a hysterectomy is performed, diet is very important for quick recovery organism. Fiber in the form of vegetables, fruits, wholemeal bread must be present in the diet. The stomach should not swell. It is equally important that the body receives enough liquids: non-carbonated mineral water, morses. Limit tea, coffee, alcoholic drinks. Fatty and fried foods, as well as smoked meats, are also now forbidden. Food should be as healthy and balanced as possible.
• Charger. It is very important after the operation is performed, to direct all efforts to strengthen the weakened muscles of the vagina, as well as pelvic floor. Exists whole complex Kegel exercises that will help with this. Do exercises daily, and for effectiveness intimate gymnastics recommended to use special simulator. You need to do at least 300 exercises a day, then you can prevent such unpleasant phenomena, as well as urinary incontinence, as well as the prolapse of the walls of the vagina, which many women experience when menopause occurs. What should these exercises be? AT rehabilitation period gymnastics should include simple exercises that will not wear down. The operation was completed successfully, and there are no complications? You can start exercising after 3 months. But to lift weights and perform heavy physical work(do not strongly strain the abdomen) for two months after the operation is not recommended. This will protect against bleeding and divergence of seams.
• Sex life. Sex is also recommended to be avoided for 1.5-2 months after surgery.
• Wearing a bandage. It is especially recommended for women over 50 years old, with a history of more than two births, with a weakened abdominals. You need to choose a corset so that it does not create any discomfort, but at the same time provides reliable support. The width of the bandage must necessarily be at least a centimeter larger than the postoperative scar.

For a month and a half after the operation, it is also forbidden to swim in the bathroom and open water, visit the sauna and bath. It is not recommended to use tampons until the discharge has passed.

What changes in life will be after a hysterectomy?

Removal of the uterus consequences can also be psychological. Many believe that since they have lost their reproductive organ, it means that they can no longer be full-fledged women. So that the fair sex does not fall into depression, it is very important that her husband or loved one supports her.

Pregnancy becomes impossible

After the operation, the woman will not be able to conceive a child. The fair sex will no longer be able to get pregnant and give birth to a child. Of course, if a woman is over 50 years old, she can consider this a positive thing, which cannot be said about a young girl for whom the removal of the uterus and ovaries was an emergency measure. Doctors, before recommending the removal of the genital organ, especially in cases where it is necessary to remove the appendages, try to save the uterus.

Sexual life will remain the same

As before the operation, sex will be the same and the woman will enjoy it. If it was possible to save the ovaries, then they will work, as before, releasing hormones, so the woman will feel sex drive. Sometimes women can even experience increased sexual desire.

If we talk about orgasm, then after the removal of the uterus and ovaries, it will also be, in some women it can be much more pronounced.

When a woman undergoes a hysterectomy or a radical hysterectomy, when the ovaries are removed, discomfort and sometimes severe pain may occur during sexual intercourse. It is possible to solve this problem with a partner.

The advantage of removing the uterus is that there will be no more menstruation and unpleasant symptoms associated with these days. However, if a woman has retained her ovaries, on the days of menstruation there may be scanty spotting from the vagina, which is considered the norm.

The onset of menopause

Climax is one of long-term effects removal of the reproductive organ. Of course, the process is inevitable sooner or later for any woman, but many wanted it to come as late as possible.

In the case when, during the operation, the doctor removed the genital organ, but the appendages remained in place (removal of the ovaries was not required), menopause will come with age (at 45 or 50 years), which is genetically inherent in nature itself.

The menopause that occurs after removal is much more difficult for women to tolerate. The explanation for this is this: with a natural menopause, the ovaries gradually stop producing hormones, and not instantly.

When laparoscopy or laparotomy of the uterus and appendages (ovaries and tubes) is performed, the body undergoes a restructuring in the hormonal background, sex hormones cease to be produced, this is especially true for those who are not yet 50 years old.

The first signs of menopause after a hysterectomy are similar to the signs of natural menopause and may appear as early as a couple of weeks after the operation:

• a sharp change in mood;
• hot flashes;
• excessive sweating;
• hair and nails become brittle;
• dryness and gradual withering of the skin;
• frequent depressive states;
• spontaneous urination (during laughter or coughing);
• decreased libido;
• discomfort and pain during sex and all due to the fact that the vagina is too dry.

Patients who are not yet 50 years old after the removal procedure are recommended to take hormonal drugs. It is very important to start taking such drugs a couple of months after the intervention of the surgeon, which will significantly reduce the risk of many diseases, in particular, osteoporosis, Alzheimer's, heart and blood vessels. But, ZGD also has contraindications: thrombophlebitis, thromboembolism, surgical intervention for the treatment of cancer of the genital organ, pathology of the liver and kidneys in severe form. The course of HDD lasts more than two years.

spikes

The appearance of adhesions is characteristic of any procedure for removing an organ from abdominal cavity. Almost all women who have undergone a hysterectomy have adhesions (connective cords that appear between the organs of the peritoneum).

Adhesive disease is manifested by flatulence, defecation and urination disorders, pain in the lower abdomen of a periodic or permanent nature.

To prevent the formation of adhesions, antibiotics and anticoagulants are prescribed in the early postoperative period. No less important physical activity starting from the first day after surgery, as well as physiotherapy. At proper rehabilitation, you can avoid not only adhesive disease, but also other consequences.

Hysterectomy improves the quality of a woman's life, especially after 50 years, without affecting its duration in any way. Having recovered after the intervention of a surgeon, many women can bloom just before their eyes, because nothing bothers them anymore, no contraception, their stomach does not hurt so often. And some of the fair sex say that their sexual attraction rose greatly. The removal of the uterus also does not affect the performance of the fair sex.

If, after the removal procedure was carried out, discomfort appeared: the temperature rises, the stomach hurts a lot, incomprehensible discharge appears, you should immediately seek qualified help.

There was a period in the history of gynecology when doctors believed that after childbirth, the uterus ceases to be necessary for the body and even increase the risk gynecological diseases. Therefore, for any problems "below the belt", the organ, which in many ways makes a woman a woman, was removed without any doubt: no uterus - no problems.

THE TRUTH ABOUT THE WOMB

But the problems were not slow to appear: in the operated women, menopause came on average 5 years earlier, which means that heart diseases and
Therefore, now the "preventive" removal of the uterus (hysterectomy) has been abandoned, and doctors are fighting for the diseased organ to the end. But it happens that all means are exhausted and removal of the uterus is the only way out?

WHEN THE UTERUS IS REMOVED

Many women believe that to destroy the muscular organ, perfectly protected and hidden in the depths of the small pelvis, which during childbirth creates an effort comparable to traction passenger car in first gear, maybe just some absolutely terrible disease. Actually it is not. Here they are, the mortal enemies of the uterus.

* Large myoma. With this disease, the size of the organ increases, as during pregnancy. And when it grows more than "12 weeks", the uterus must be removed.

* - growth of the inner layer of the uterine mucosa. Possible at any age; provoke his abortions and others gynecological operations. Main danger that endometriosis can spread to other organs: the vagina, ovaries, bladder, rectum.

Treatment with long courses of expensive drugs does not always help.

* Cervical cancer occurs in women of all ages, including even virgins. Scientists are increasingly inclined to believe that this form of cancer is associated with a sexually transmitted disease. The disease can be easily detected during a medical examination and successfully treated in the initial stages, but in advanced cases hysterectomy is the only way out.

* Cancer of the body of the uterus develops mainly between 40 and 50 years. Symptoms are varied: weight loss, weakness, pain, bleeding. The most radical method of treatment is the removal of the uterus.

HOW THE OPERATION IS CARRIED OUT

Women undergoing surgery have many concerns. Where to apply? How will the intervention take place? What to expect after it?

Hysterectomy operations can be divided into open and, but they are all performed under general anesthesia. Judge for yourself the advantages and disadvantages of each. Just remember that in some cases endoscopic surgery impossible.

The operation is over, life is slowly returning to its usual track ... But this process is hindered by heavy thoughts: should I tell my husband about such a delicate operation? What will happen to the body, forcibly deprived of the uterus, in 2-3 years? And most importantly - has a woman remained a woman, can she hope for love and happiness?

The same questions were once asked by the specialists of the clinic of obstetrics and gynecology named after V.F. Snegirev of the MMA named after I.M. Sechenov. They conducted psychological testing of women who underwent hysterectomy, and here are the results.
It turns out that before the operation, 80% of women seriously thought about the consequences. 39% were not afraid of her; of the remaining 61%, a quarter were afraid of death, 18% of complications, 9% of violations of relations with their husband, 6% of lack of results, 3% of early aging and just as many thought about the "cosmetic" side of the issue.

The vast majority - 94% of women - after the operation felt that their fears were not justified. A third of women experienced self-doubt, depression. But 38% felt that their quality of life improved significantly after the operation, and 16% even harmonized family relationships! Moreover, these were mostly patients who did not hide the fact of the operation from their husbands.

Relationships with their husbands remained smooth for the majority of those operated on, and only one in ten reported a deterioration in family relations.

FINAL CHOICE

So, you have to make a choice, and the choice is not easy. Psychologists in such cases are advised to take a sheet of paper, draw it in half and write the pros and cons in two columns. possible solution. We will help you with this. Here are the pros and cons of hysterectomy most often mentioned by women who have undergone this operation.

Minuses
– Psychological discomfort
- Seam in the lower abdomen
– Pelvic pain for several months after surgery
– Restriction of sexual life for several months after surgery
– Inability to have children
– Menopause occurs on average 5 years earlier
– Risk of osteoporosis and heart disease at an earlier age

pros
+ No periods (savings on pads)
+ Impossible to get pregnant, you can not think about protection during sex
+ No pain and bleeding, which were symptoms of the disease and tormented before surgery
+ You no longer need to be treated for diseases of the uterus, you can not be afraid of its oncological diseases
+ Reduction of the abdomen and weight (for example, a uterus with several fibroids can weigh several kilograms)

Of course, the cons of hysterectomy are much more serious than the pros. However, it would be strange if it were otherwise. But if the operation is inevitable, it is very important to understand: the tragedy did not happen. With the help of doctors, you will overcome the disease and find the joy of life again.

Hysterectomy or is a fairly common operation. Most often, it is performed in the presence of tumors in this organ or in the event of metastases after cancer treatment in other tissues of the body.

In exclusively rare cases such an operation is carried out at the request of a woman for contraceptive purposes. Also, the uterus can be removed in some pathologies of pregnancy, when the operation is the only way to save the life of the mother and child.

Most common causes hysterectomy:

• Fibrosis or;
• birth infection;
• Severe bleeding during or outside of pregnancy;
• Prolapse of the uterus.

Removal of the uterus is usually performed only in cases where less traumatic treatments do not exist. However, women are afraid of the consequences of this operation and wonder if they will be able to live a full life after a hysterectomy.

Removal of the uterus (hysterectomy): what happens after the operation?

This is a fairly serious operation, after which a woman is waiting for a long recovery period. If it is performed under general anesthesia, then the first hours after waking up, a woman may be disturbed by nausea. After about 1-2 hours, it should become easier and the patient will be able to drink water, and after 3-4 hours to eat. But in some cases, the discomfort is delayed.

At first, it is normal to have severe pain and subfebrile temperature. Also, for 1-2 days, doctors can leave a catheter in the bladder to remove urine.

When can you get out of bed?

Movement is one of the conditions for a quick recovery after surgery. It allows you to avoid stagnation of blood in the pelvic area, as well as disorders in the intestines. After laparoscopy, you can get up after a few hours, and if a full-scale abdominal operation- on the second day.

Pain after surgery

You need to be prepared for the fact that after the end of the anesthesia, it will be really painful, both in the area of ​​\u200b\u200bthe sutures and in the abdomen. There may also be pain during urination due to damage to the mucous membrane of the urethra. Therefore, women in postoperative period, for about 5 days, strong analgesics are necessarily prescribed.

It has been proven that severe pain significantly slows down the healing process, so taking painkillers is mandatory.

Gradually, the wounds will heal and discomfort will decrease. But slight tingling and pulling sensations can persist for several more months. This is due to damage to the nerve endings and will gradually also pass.

When will they be released from the hospital?

Length of stay in the hospital depends on several factors:

• How big was the surgery?
• Reasons for the operation.
• The patient's well-being.
• Absence or presence of complications.

In each individual case, based on the available data, the doctor decides when to drink the patient. But even after discharge, a woman must continue treatment, the sick leave lasts an average of 30-45 days.

How long does recovery take after hysterectomy?

Duration recovery period usually depends on the characteristics of the operation and the presence of complications. Quite quickly, in just 2-4 weeks, the state of health improves if the removal of the uterus is carried out by the laparoscopic method - through small incisions on the abdomen. If the organ removal is performed through the vagina, the recovery period may take 3-4 weeks. After an abdominal hysterectomy, rehabilitation takes at least 4-6 weeks.

Until the end of the recovery period, it is necessary to limit activity, travel and air travel are also prohibited. You can travel no earlier than 4 weeks after laparoscopy and 6 weeks after major surgery.

How long can not lift weights after removal of the uterus

The first time after the operation it is strictly forbidden to load the muscles abdominal wall, as well as the pelvic floor, so exercise and weight lifting are prohibited. For about 4-6 weeks, it is necessary to completely abandon lifting objects heavier than 1-2 kg. If after this period the woman feels well, you can slightly increase the weight. But if any discomfort arises, you should immediately lower the object.

Many women cannot lift more than 2 kg for a whole year after surgery and more than 5 kg for the rest of their lives.

In no case should you test yourself for strength, trying to lift weights, this can lead to abdominal pain, spotting, and even the formation of a hernia, which will later have to be removed surgically.

How long can you not have sex after removing the uterus?

Sex life after hysterectomy is allowed after 4-6 weeks, depending on the complexity of the operation and the speed of recovery of the patient's body. sometimes limit sexual life take six months or even a year.

It should also be borne in mind that with the simultaneous removal of the ovaries, the hormonal background of a woman is disturbed, so sexual desire may decrease. It is normalized after the appointment of the appropriate hormonal drugs.

How long can you swim after removing the uterus?

For the first time after the operation, it is forbidden to swim in the pool and especially in open water because of the questionable quality of the water in them. You can return to your favorite activity no earlier than 6-8 weeks after the hysterectomy.

Diet after surgery to remove the uterus and appendages

Immediately after the operation, it is very important to avoid dehydration, so it is necessary to observe the correct drinking regimen, i.e. drink at least one and a half liters of water per day. As for nutrition, it is necessary to start eating with small quantities liquid and semi-liquid dishes, gradually expanding the diet. All food should contain a minimum of salt to prevent fluid retention and swelling.

It is necessary to take food in small portions 6-7 times a day. Food should contain fiber for recovery normal functioning bowel and avoid constipation. The calorie content of food is increased gradually, with caution introducing new products. In this case, the food should not be too fatty and not spicy.

In the early postoperative period, the use of products that promote development, such as chocolate, pastries, strong coffee and tea. Abdominal distention can cause suture separation.

After a hysterectomy, patients are often diagnosed with a decrease in the level of hemoglobin in the blood. To prevent it will help the use of dried apricots, buckwheat, pomegranate juice and lean meats.

It is important to follow a sparing diet for the first 2-4 months after the operation, then you can return to your usual diet. But we must remember that after the removal of the uterus, many women gain excess weight Therefore, it is important to control the calorie intake and the level of physical activity.

Suture after hysterectomy

The postoperative suture can be either very small after laparoscopy or quite large after abdominal hysterectomy. In any case, it needs careful care until it heals completely.

If the suture is made with absorbable material, then after about 6 weeks it will disappear on its own. In other cases, the surgeon warns when to return to the hospital to remove stitches.

The first time after the operation, the seam must be processed by special means to avoid infection. You can take a shower without fear, but a bath is prohibited. The seam is gently washed with liquid soap and washed off with water.

Gradually, a scar will form at the site of the incision. Sometimes the skin itches a little, it can be lubricated with an emollient cream or lotion. Feelings of slight burning or numbness in the area of ​​the scar are normal and usually disappear after a couple of months.

Brown vaginal discharge after hysterectomy

After hysterectomy bloody issues from the vagina are normal. Their hue can be brown, reddish or pink, but the intensity is always reduced. After about 4-6 weeks, the discharge stops. Usually a woman notes that their number increases with active movement.

When bleeding after removal of the uterus, it is forbidden to use tampons, only sanitary pads, preferably from breathable material.

The nature of the secretions different patients can vary greatly, but there are clear limits to the norm. The reason for the immediate appeal to the doctor is:

• Increase in the amount of discharge over time;
• The appearance of abundant bright red discharge (if the pads have to be changed more often than once every hour and a half);
• Availability too large clots, it may indicate a scale internal bleeding;
• The appearance of pus in the discharge and an unpleasant odor.

Temperature after hysterectomy

A slight increase in temperature in the first days after surgery is normal. If necessary, the doctor may prescribe antibiotics. After discharge, the temperature may also remain elevated, but not more than 37.5 ° C. If it exceeds this mark, you should consult a doctor.

Removal of the uterus and menopause

Many women are afraid of a hysterectomy, believing that menopause will come immediately after it. But if only the uterus was removed during the operation, and the tubes with the ovaries were preserved, then practically no changes in the hormonal background of the woman will occur, the state of health will not change, only menstruation will disappear.

Menopause in this case occurs naturally, when the supply of eggs in the body runs out.

There is an opinion that the removal of the uterus can slightly speed up the onset of menopause, by about 5 years. This is due to a violation of the blood supply to the ovaries, which for the most part occurs due to the uterine arteries.

If, during a hysterectomy, appendages were also removed, a surgical menopause begins. Usually it is tolerated a little harder than natural, since during normal menopause, the production of sex hormones stops gradually and the body has time to adapt to this, and after the operation it happens suddenly. It is most difficult for women of childbearing age.

Approximately 2-3 weeks after the operation, symptoms of menopause appear, which differ little from the signs of natural menopause - hot flashes, sweating, emotional instability, dry skin and hair, urinary incontinence when coughing and laughing, and vaginal dryness. Timely appointment of hormone replacement therapy helps to avoid these problems.

Properly selected drugs not only relieve unpleasant symptoms, but also help to avoid osteoporosis, reduce the risk cardiovascular diseases and Alzheimer's disease.

Hormone replacement therapy may not be carried out in all cases. Contraindications to it are:

• oncological diseases;
• Diseases of the kidneys and liver;
• meningioma;
• Leg vein pathologies (thromboembolism, thrombophlebitis).

It should also be remembered that there is no immediate improvement after the start of treatment, and medications will have to be taken for years until the time of natural menopause comes.

What complications are possible after removal of the uterus?

Although a hysterectomy is a complex abdominal operation, complications after it are quite rare. But you need to know them in order to notice and consult a doctor in time. Complications can occur both immediately after surgery and for several years after it.

In the first weeks or months after a hysterectomy, the patient faces:

1. Wound inflammation. It manifests itself in the form of edema, redness, severe soreness and pulsation of the skin in the wound area. The temperature can rise to 38 °C or more. Also, deterioration of well-being, headaches and nausea are often recorded.
2. Bleeding. The opening of some vessels after surgery can lead to profuse bleeding from the vagina. The blood is usually red, and clots may occur.
3. Inflammation of the bladder and/or urethra. It occurs due to mechanical damage to the mucous membranes during the introduction of the catheter. After its extraction, pain remains, which usually disappear after 4-5 days. If the pain does not go away or gets worse, you should consult a doctor.
4. Blockage of arteries by blood clots or thromboembolism. More often this complication occurs in patients who move little, so doctors recommend trying to get up and walk as early as possible.

There are a number of complications that occur some time after surgery, possibly even years later:

• Postvariectomy symptoms or premature menopause occur after hysterectomy with removal of the ovaries. They are characterized by all the symptoms of menopause. For treatment, physiotherapy, physical education and the use of hormonal drugs are recommended.
• The prolapse of the vaginal walls is one of the most frequent complications. Wearing a vaginal ring and Kegel exercises help to partially prevent it. In the most difficult situations surgery is required.
• Urinary incontinence has two main causes - weakening ligamentous apparatus and a decrease in blood estrogen levels in case of spaying. Eliminate it with special exercises and hormonal drugs. Reoperation not required.
• Pain due to development adhesive process require tricks enzyme preparations. A thorough diagnosis is also necessary, since pain can occur due to the failure of the sutures.
• The formation of a fistulous tract sometimes occurs when the sutures fail and infection joins. You can solve the problem with the help of an additional operation for sanitation and suturing the course.

Very often, women experience depression, after surgery they begin to consider themselves inferior. Therefore, doctors try to leave at least one ovary and part of the uterus to maintain a normal menstrual cycle. This allows you to avoid depressive moods and maintain normal hormonal levels.

To avoid many problems, it is very important to talk to the patient even before the operation, to explain to her that the uterus is an organ designed exclusively for bearing offspring and there is no great need for it the rest of the time. After a hysterectomy, her body will not change, the disease, the risk to life and the need for contraception will simply disappear.

An operative benefit for the removal of the uterus (hysterectomy) is a necessary measure when there are no other ways to save the health, and, sometimes, the life of the patient. Despite this, the majority of the fair sex perceives this surgical benefit as deprivation of something important. One might say, even disability. And they are not afraid of the operation itself and associated with it, possible risks, and the consequences of organ deprivation.

At the same time, given the functional purpose of the uterus, there is a very big difference in relation to hysterectomy of women who already have children and no more pregnancies were planned and those who were still going to become a mother. With regard to the latter, the need for removal in an emergency is especially difficult for them to perceive.

There is no doubt that any surgical intervention, especially one aimed at removing an organ and involving significant changes in the body and in the life of the patient, is more comfortable to perform in planned. There is an opportunity to prepare both the patient, physically and mentally, and the attending physicians, and relatives. But sometimes there are situations life threatening women and there is no other way out.

For whatever reasons, in whatever situation you have to remove the uterus (one of the reasons for removing the uterus is). For each woman, a number of questions arise regarding her postoperative condition, and these questions relate only to a small state of health in the postoperative ward. Basically, they are connected with the future life, which for many is divided by the boundary “before” and “after”.

In some cases, this judgment is quite correct. Changes in the state in the body, on the physical and psychological level, on how radically and in what way the uterus was removed. Based on the clinical situation, the course of the disease and a number of other factors, the following is performed:

• subtotal hysterectomy (only the body of the uterus is removed, without its cervix and other internal organs female reproductive system)
• supravaginal extirpation (the entire uterus and its cervix are removed, the rest of the organs are preserved);
• panhysterectomy (remove the entire uterus and its neck, along with the ovaries and tubes);
• radical hysterectomy (the entire uterus and its cervix are removed, along with a third of the vagina, appendages, adjacent lymph nodes and the pelvic tissue surrounding these organs).

Operational assistance can be performed by transvaginal access, laparoscopically, their combination, and direct - through an incision on the anterior wall of the abdomen.

Any operational benefit, even if the word “radical” is in its name, is carried out with the maximum possible preservation of organs and tissues. This is done, first of all, to maximize the preservation of the anatomical position (topography) of the internal organs and the functions assigned to them.

Not so long ago, in the practice of surgical gynecology, the removal of only the body of the uterus, without its cervix, was practically not used. It was believed that the risks of various diseases, including tumor growth on the left neck, outweigh the benefits of organ-preserving surgery. Improving the quality of delivery medical care, the development of methods for diagnosing almost all diseases of the uterine cervix at the most early stages, the introduction of cutting-edge methods of preventing them, made it possible to resort to this method of hysterectomy much more often.

Leaving the neck allows you not to affect the supporting ligaments of the vagina. This contributes to the preservation of the topography of the internal organs of the female pelvis and prevents prolapse and prolapse of the vagina, the development of urinary disorders (incontinence and other urodynamic disorders). Women who have preserved their cervix should be constantly on dispensary observation gynecologist.

Subtotal removal and supravaginal extirpation provide for the preservation of the uterine appendages. To a greater extent, attention is paid to the ovaries in women in reproductive age. The reason for this is the preservation of physiological cycle hormonal regulation to prevent endocrine disorders.

early menopause

Panhysterectomy and radical removal leave a woman without the production of her own sex hormones. At the same time, if such operations are performed in patients before the onset of age-related menopause, then a sharp cessation of hormonal regulation leads to pronounced manifestations. All of them come quickly and with high intensity.

There is some pattern that the younger the patient, whose appendages were removed, the stronger signs menopause give her anxiety. This pattern is quite easy to explain. Over the years, there is a gradual inhibition of the production of one's own sex hormones and, the more approaching the age of natural cessation reproductive function the lower the estrogen level. But slowly, and the body gets used to such a change. Moreover, so much so that in some women menopause has little or no effect on well-being or comes without symptoms at all.

For those who are at the age of active fertility, when the production of their own hormones is at a maximum level and with a clear cycle, artificial menopause will manifest itself most strongly.

In order to prevent these unpleasant consequences, in the case of ovarian resection, it is prescribed substitution treatment hormones. It is calculated based on the indicators of the natural content of estrogens, according to the age of the patient and her other physiological parameters.

Sex hormone preparations are strictly prohibited for women who have undergone a hysterectomy due to oncological disease. In this situation, the only auxiliary means there will be herbal medicines.

It should be noted that during organ-preserving operations, when even both ovaries are left, the onset of menopause occurs within a very short time. This period depends on the age of the patient, her physiological and functional parameters. This period can be up to five years at most.

The reason is that there is no backlash in the body to the cycling of estrogen. The entire regulation of processes (both nervous and humoral) depends on the response of the tissues and organs to which it is directed. If one of the main conditions of periodicity is not met hormonal background- the absence of data on the change of mucosal cells in the uterine cavity, the body perceives this as a cessation of function and ceases to act on it.

Loss of pregnancy

A hysterectomy deprives a woman of further biological motherhood. After the operation, there is no organ intended for bearing the fetus. Even if the ovaries are preserved, such a patient does not have the opportunity to become a mother in a surrogate way. They do not grow eggs for collection. Partly alleviating the situation is that the removed uterus is an extremely rare fate for young and childless women.

Changes in bones, joints and blood vessels

Violations of the absorption of calcium and phosphorus in the bones, which leads to the development of osteoporotic manifestations, are prevented by the same replacement therapy. It also prevents changes in cartilage tissues (ligaments, joint capsules), and lipid metabolism errors. The deposition of plaques in the lumen of the arteries (atherosclerosis) does not develop as a result of this action.

False and real fears

Fears about the operation itself, and its consequences, excite the minds of almost all patients referred for removal of the organ / s. Moreover, the intervention itself and the risks associated with it do not bother them as much as the constantly arising question: “What will happen to me then?”.

There are two real facts that a hysterectomy leads to:

1 Loss of the possibility of biological motherhood.

2 The inevitability of artificial menopause. But since female image thinking tends to exaggerate and accept its own conclusions, based, as a rule, on indirect assumptions, both of these facts are transformed into the development of a female inferiority complex.

The vast majority of patients, in the early post-hysterectomy period, define their condition as "devoid of femininity." Undoubtedly, internally they suffered irreparable losses, and this is reflected in self-consciousness. Moreover, one should not neglect the fact of the termination of the regulation of the emotional state by sex hormones in the case of radical operations.

This judgment is supported by the physical components of the early postoperative period: weakness, pain, bleeding, fever, disorders of the digestive tract and urinary tract. Adding to this the inability to fully take care of their own appearance leads a woman to a feeling of depression, bordering on the development of depression.

During this period, it is important to understand that internal changes very little impact on the habitual way of life in the future. After the end of the recovery, which is directly related to surgical intervention, it is possible and necessary to lead an absolutely full-fledged, in all respects, lifestyle.

Possible appearance changes

All female changes associated with insufficiency or lack of sexual hormones in them, sooner or later, will begin to occur. And no one can stop this process. As for the situations that arise after a hysterectomy, an important aspect here is the preservation of one's own hormonal activity or a properly selected replacement therapy.

The fair sex, due to the necessity of having lost only the uterus, should regularly keep their hormone levels under control. For those who have no appendages left, there should be no exceptions to this rule at all. In this case, all the external signs associated with menopause will not precede the individual biological rhythm.

Moreover, the vast majority of women who have adequate hormone replacement, on the contrary, note an improvement appearance. And this is expressed not only in the preservation of the structure of the skin, hair, nails, etc.

For probable weight gain, even with replacement therapy, there are still the same predispositions that "healthy" people have. Hereditary factor, nutritional errors, reduced physical activity, violations metabolic processes and a number of others. Resumption of activity after the healing period after surgery, control diet and refraining from gastronomic struggle with stress, will create favorable conditions for the desired kilograms.

And do not forget about the expression of emotions. The haggard silhouette, the lack of a smile and the "extinguished" look do not look attractive at all.

Possibilities for restoring sexual life

The completed postoperative recovery period, which takes about one and a half to two months (depending on the volume of intervention), ceases to be the only physical cause for not having sex. But, permission to them must be obtained from the attending gynecologist. Just making sure you're fully healed rear wall vagina can be penetrated.

Most operated women experience psychological discomfort during the restoration of sexual activity, even with permanent partner. This is due to thoughts about changes inside the vagina, which he can feel. A man may suspect any changes if part of the vagina was removed during the intervention. All benefits with the preservation of the neck on male sensations are not reflected.

Almost like the first time

Resumption sexual relations should take place in conditions of maximum psychological and physical comfort. In part, this can be compared with the first experience, except that the existing own knowledge will help to minimize possible difficulties.

Insufficient hydration of the vaginal mucosa, probably due to emotional and / or hormonal reasons. In the case of a pronounced psychological stress lengthening of foreplay and additional stimulation will help erogenous zones. The estrogenic cause of dryness is eliminated by correcting replacement therapy (or herbal remedies). In both cases, additional lubrication is acceptable.

Unpleasant or painful sensations from penetration are easier to prevent if the woman herself controls the depth of insertion. This is achieved by using the position of the "rider", when the woman is on top. In the same way, you can control not only the depth, but also the frequency of frictions.

Over time, the psychological barrier to sexual intercourse will disappear. As a rule, the production of vaginal mucus also normalizes. sex life is restored completely. At the same time, one should not forget that although pregnancy is now impossible, those diseases that are transmitted during sex are as likely as before. Therefore, barrier protection (use of a condom) should not be neglected, especially if there is no permanent partner.

Sexual attraction and satisfaction

Sexual desire in women, as well as in men, is due to the action of androgens. Testosterone in the female body is produced mainly in the ovaries. And only a part in the adrenal glands. With the removal of appendages, there may be some decrease in attraction and excitability in early period recovery. However, rather quickly, testosterone deficiency is compensated. If this does not happen, it is permissible to prescribe this hormone in addition to estrogen.

It should be noted that, in some cases, when estrogen is prohibited, this prohibition does not apply to testosterone. But, any introduction of hormones should take place exclusively with the appointment of the attending gynecologist and under constant monitoring of their level.

It was statistically revealed that hysterectomy in 75% of women did not change sexual desire, it increased (against the background of taking hormones) in 20%, and only 5% noted a steady decrease.

Satisfaction with sexual intercourse was distributed statistically about the same. Although, many operated patients noted that the sensations became richer. This is largely due to the fact that they are no longer bothered by pain, bleeding and other signs of an existing disease or preceding menstruation. Most shared the observation that the lack of thought about possible unwanted pregnancy allowed them to be more liberated.

Those women who had no orgasms at all or had difficulty achieving them said that they could achieve pleasure only with maximum penetration of the penis. In other words, as a result of cervical stimulation.

What to think, whom to listen to, whom to speak

The removal of the patient's organs of her internal female belonging, few of them are perceived as a due necessity. Therefore, when receiving a referral for a hysterectomy, it should be borne in mind that the doctor has already found other options. And this - the only way stay alive and in relative health. For greater confidence in the correctness medical prescription you can be examined and get a conclusion in another clinic.

For the fastest and most full recovery after the operation, it is necessary to prepare for it not only clinically (to undergo examinations and tests) and physically, but also psychologically. You should tune in to the exclusivity of the situation, which is different - nothing. And that after the operation, life will continue in the same way as before it. And your health will be much better.

The main thing in psychological positive attitude- Completely trust your doctor. After all, he is, in fact, the only one who knows everything about this disease and the operation. And that the precise implementation of all appointments and recommendations in the postoperative period will help to recover quickly and as much as possible.

The support of family and friends is important. But, psychologists recommend sharing about what exactly happened in the hospital only with those who have the highest degree of trust.

Read all about diseases and treatment of the uterus.

WHO SAID THAT INFERTILITY IS HARD TO CURE?

• Have you been wanting to have a baby for a long time?
• I've tried many ways but nothing helps...
• Diagnosed with thin endometrium...
• In addition, the recommended medicines for some reason are not effective in your case ...
• And now you are ready to take advantage of any opportunity that will give you a long-awaited baby!

Removal of the uterus is a very serious operation, which should be done only in special occasions. For women's health, surgical intervention can lead to enough backfire, but avoiding the removal of the uterus is not always possible. In some cases, this is the only way to save the life and health of the patient.

Complications depending on the type of operation

Hysterectomy (removal of the uterus) complicated operation, which is prescribed in the following cases:

Most often, such an operation is performed on women after 40-50 years, however, it can also be prescribed to patients under 40, but only in cases where other methods of treatment are powerless and health, and sometimes the patient's life is in danger.

What methods are used to remove the uterus:

Complications after removal of the uterus most often depend on which organs are removed along with the uterus:

Removal of the uterus after 40-50 years: features of the consequences

Hysterectomy is very a rare event for young people aged 20 to 30 years, but after 40-50 years, such surgical intervention occurs quite often.

But there are cases when the operation is necessary for childless young girls whose health is in danger. In this case, as in women after forty, the operation can affect the menstrual cycle, that is, menopause will come much earlier.

Removal of the uterus almost always causes consequences, negative changes can occur in all body systems:

An operation under general anesthesia can cause nausea and vomiting in the first hours after the process, and a little later - frequent hot flashes. Stay for a long time in bed after surgery is not recommended.

The sooner the patient starts walking, the less negative postoperative consequences for health, in particular, it will be possible to minimize swelling of the legs and avoid the occurrence of adhesions.

After amputation of the uterus, the patient may experience severe pain, this is normal, as the healing process takes place. The pain is felt both outside, in the area of ​​​​the seam, and inside, covering the bottom of the abdominal cavity.

Doctors during this period prescribe painkillers (Ketonal, Ibuprofen).

Rehabilitation after surgery depends on its type and can last:

• supravaginal hysterectomy - up to 1.5 months;
• vaginal hysterectomy - up to a month;
• laparoscopic hysterectomy - up to a month.

It is also worth noting that when supravaginal surgery occurs, the healing process takes much longer. What may arise unpleasant complications with this type of surgery:

General health effects

With the total removal of the uterus, the location of many pelvic organs changes, this is due to the removal of the ligaments. Such rearrangements adversely affect the health of the bladder and intestines.

What effects can the intestines feel:

• the appearance of hemorrhoids;
• constipation;
• difficulty going to the toilet;
• pain in the lower abdomen.

Hemorrhoids appear due to the fact that the intestines are displaced under pressure on the lower abdomen of other organs, and part of it begins to fall out. Hemorrhoids bring a lot of discomfort and cause great discomfort.

The displacement of the bladder may be accompanied by such deviations as:

• problems with the release of urine as a result of squeezing the bladder;
• urinary incontinence;
• frequent urges that do not lead to sufficient urine output.

Also, urine that is constantly excreted as a result of incontinence may be contaminated with blood, and a precipitate in the form of flakes may be observed in it.

After amputation of the organ, the patient may develop atherosclerosis of the vessels. To avoid this pathology, immediately a few months after the operation, it is recommended to take special prophylactic drugs.

In order to avoid weight gain, you should eat right and not neglect physical activity, though the first time after surgery, all loads are prohibited. But after rehabilitation, physical education is shown as much as possible.

Also, against the background of the operation, lymphostasis of the limb, that is, swelling of the leg (or both legs), may develop. This happens because when the uterus with ovaries and appendages is removed during surgery, the lymph nodes are eliminated. Swelling of the leg in this case occurs due to the fact that the lymph cannot circulate normally.

Lymphostasis manifests itself as follows:

If a woman, after removing the uterus with appendages and ovaries, notices all these symptoms in herself, an urgent need to consult a doctor.

After removal of the uterus, many women begin to periodically complain about constant pain in the chest area. This happens because of the ovaries, which are often left when the uterus is removed. The ovaries are in the dark that there will be no periods, and therefore fully work and secrete female hormones.

Hormones are sent to the area of ​​the mammary glands, which leads to swelling of the breast and pain in its area. Most often, the chest hurts precisely on the days when menstruation should be. At this point, the woman may feel:

As soon as the cycle should end, the chest pain disappears along with all unpleasant symptoms. In this case, specialists prescribe Mastodinone and a constant visit to the doctor in order to avoid the development of breast cancer and restore the patient's health.

Menopause and emotional state after removal of the uterus with ovaries

Amputation of the ovaries and uterus ends with menopause. This process occurs due to a lack of estrogens, which stop being produced. In this regard, a hormonal failure begins in the body of a woman 40-50 years old.

The body begins to rebuild, as irreversible changes occur due to the lack of estrogen. Hot flashes are very common.

In some cases, there is a decrease in libido, especially if the operation is performed before the age of 50, the woman often loses her sensuality.

Menopause brings the patient very strong discomfort, she feels unwell, suffers from:

She often gets urinary incontinence, so you have to be very careful about your body hygiene in order not only to avoid spreading the smell of urine, but also inflammatory processes in the vaginal area and its dryness. The younger the woman, the more difficult it is for her to endure this condition. Urinary incontinence often provokes a woman's isolation, avoidance of society.

To ease menopause, get rid of hot flashes and avoid complications, experts prescribe hormone therapy. Medications are started immediately after the operation. Get rid of hot flashes will help, for example, drugs Klimaktoplan and Klimadinon, but they should be prescribed by a doctor in order to avoid negative reactions organism.

For those women after 40-50 years who were already in a state of menopause that occurred naturally, loss of appendages, ovaries and uterus, as a rule, does not bring strong physical torment. However, at this age, more often develop vascular pathologies such as leg swelling.

It is worth saying that a total operation is rarely performed, more often it is done in such a way as to maximize the preservation of female reproductive organs especially the ovaries and cervix. If the ovaries were left after the amputation of the uterus, then there are no big changes in the level of hormones.

Studies have shown that if appendages are left, they do not stop working fully after the loss of the uterus, observing the regime laid down by nature. This suggests that after the operation, the appendages give a full amount of estrogen.

If the surgeons left one of the appendages, then the ovary that remained also works further fully, compensating for the work of the lost organ.

It creates a very big problem psychological condition women, especially young age who loses the ability to have a child. However, it is possible that psychological problems and in women and after 40 and 50 years.

A woman is very worried and feels constant anxiety, depression, suspiciousness, irritability. Hot flashes create discomfort when communicating. Also, the patient begins to constantly get tired, and loses interest in life, considering herself flawed.

In this case, visits to a psychologist, support and love of loved ones will help. If a woman reacts psychologically correctly to the current situation, then the risk of getting complications will be much less.

Amputee women should complete their entire free time. Find a new hobby, visit gym, go to the theater, devote more time to the family. All this will help to forget about the operation and improve the psychological background. It is worth saying that women after 50 still tolerate the loss of female organs more easily, however psychological help they may need it too.

Risks and recovery after surgery

After removal of the uterus, metastases can remain in the body of a woman, since the lymphatic system becomes the way of their spread. Metastases are formed in the lymph nodes of the small pelvis, which were left during the operation. Metastases can also spread to:

In some cases, metastases reach the bones, lungs and liver.

In the early stages, metastases make themselves felt with the help of vaginal discharge, in the form of leucorrhoea and bloody fluid, which may also appear in the urine.

If specialists diagnose metastases in the ovaries that they left, then not only the uterus is removed, but also the ovaries themselves, and big omentum. If metastases grow into the vagina and other pelvic organs, chemotherapy is performed.

In this case, the removal of the uterus may continue, and doctors prescribe a new treatment for the patient. So, if there are distant metastases, i.e. not only in those female organs, which are left, but also throughout the body, then chemotherapy or radiation exposure is prescribed.

Amputation has its risks, which include:

In some cases, after amputation, endometriosis of the vaginal stump that was left may occur.

This can lead to pain and unpleasant discharge from the vagina, in which case the stump is also removed.

It is worth saying that the removal of the uterus may have its own positive sides, this is:

• there is no need to protect yourself;
• there is no risk of oncology of the uterus;
• lack of a menstrual cycle if the operation was performed on a woman under 40 years old.

To reduce the negative consequences after amputation of the uterus, it is necessary:

Do not forget after the operation about proper nutrition, this will help to avoid constipation and increased flatulence. It is advisable to use urological pads, this will help get rid of the smell of urine during incontinence and feel more comfortable.

The operation to remove the uterus is a rather traumatic method of surgical intervention, however, despite all Negative consequences, it is he who is able to save the life of a woman and return her to normal life.