On what are the ovaries attached after the removal of the uterus. What are the health consequences of removing the uterus and ovaries. What and how can be removed

It is a common practice. Another name for this surgery is a hysterectomy. It is carried out both on a planned and emergency basis. Women, regardless of age, react very painfully to such a doctor's decision. Let's try to figure out what are the consequences of the operation to remove the uterus.

Reasons for removal of the uterus

This method of treatment, if indicated, is mainly recommended for older women.

However, in some cases it is shown even younger. It is used in the absence of results from other types of therapy and under the following conditions:

• infection during childbirth;
• myoma;
• endometriosis;
• the presence of metastases;
• diagnosed oncology;
• polyps in large numbers;
• prolapse, prolapse, thickening of the walls of the uterus;
• frequent bleeding.

Types of Surgery

The choice of technique depends on the existing diseases, the size of the tumor, the degree of damage, and some other factors. What are the types of operations?

1. Laparotomy. This is an abdominal operation, which is indicated for severe pathologies. The consequences are manifested by complications in the form of bleeding, adhesions and divergence of sutures.
2. Laparoscopy. Compared to the previous type, it is less traumatic. Complications are minimal.
3. Transvaginal. Rehabilitation after such surgery is quite fast. Consequences and unpleasant complications are almost non-existent.

Uterus removal

In young women under the age of 40, such a surgical intervention is a rather rare occurrence and is dictated by serious indications. Older women are often prescribed surgery to remove the uterus. There are always consequences for the body, but they can have different severity:

• pain in the lower abdomen;
• hot flashes;
• weakening of the muscles of the anus;
• chest pain;
• urinary incontinence;
• swelling of the legs;
• pain in the lumbar region;
• dryness and prolapse of the vagina;
• disruption of the intestines.

Early physical activity (moving and walking) after surgery reduces the severity of negative consequences.

General Consequences

Any surgical intervention is characterized by some changes in the body. General consequences of hysterectomy:

• greater likelihood of adhesion formation. To prevent, an early exit from the postoperative period is recommended;
• pain at the site of surgery. This is an inevitable suture healing process;
• infection. To prevent it, a course of antibacterial agents is prescribed;
• vascular thrombosis. As a preventive measure, the lower limbs are bandaged immediately before the operation.

All of the above effects are temporary and do not affect the patient's life after discharge from the hospital.

Rehabilitation after surgery

Unpleasant consequences after removal of the uterus can be minimized if you follow the doctor's recommendations and follow certain rules for a long period:

1. To strengthen the pelvic floor and vaginal muscles, perform Kegel exercises, which are easy to perform and available at home.
2. Alternate homework and rest. Excessive physical activity, sports are not recommended. Give preference to daily walks.
3. Take water procedures in the shower. Refuse from baths, saunas, bathing.
4. A few months after the operation, it is mandatory to wear a bandage, which has a strengthening effect on the muscular skeleton. This is good prevention.
5. Follow the diet recommended by the doctor, as a sharp increase in body weight is possible due to hormonal failure. Limit fatty and sugary foods.

The duration of the rehabilitation phase depends on the type of operation.

Therapeutic diet

A woman who, after the removal of the genital organs, adheres to a healthy diet, prolongs her youth, and also reduces the risk of developing severe consequences of the removal of the uterus. Basic requirements of the diet:

• taking a sufficient amount of liquid;
• meals in small portions (150-200 grams) at least five times a day;
• exclusion of products that cause constipation and gas formation: chocolate, coffee, strong tea, flour products;
• give preference to products containing fiber, trace elements, vitamins and increasing hemoglobin;
• minimize heat treatment.

Removal of the uterus after 50 years

The reasons for such an operation are serious pathological conditions in the female genital area, which not only worsen the quality of life, but can also be life-threatening. Of course, unpleasant consequences of hysterectomy after 50 years are possible.

They are different and depend on the individual characteristics of the woman. Doctors with full confidence will not be able to say how the patient will feel after such a complex surgical intervention. For many of the fair sex, the removal of this reproductive organ causes stress, up to a depressive state. Others endure it quite calmly and find positive moments.

Complications after removal of the uterus

Depend on the state of health of the woman and the type of surgery. Early consequences of hysterectomy after 50:

• bleeding;
• thrombosis;
• scar infection;
• peritonitis;
• adhesions in the peritoneum;
• pain in the lumbar region and lower abdomen;
• slight divergence of seams;
• constipation;
• scar infection;
• outflow of urine with painful sensations.

Careless or incorrect actions of the surgeon during the operation lead to damage to the blood vessels, bladder and intestines. As a result, there is incontinence of feces or urine, bowel movements from the vagina, urinary incontinence.

Long-term complications of hysterectomy

The consequences of the removal of reproductive organs in old age may appear after a few years. The quality of life without these organs is reduced. Consider the most common complications:

Removal of the uterus with myoma

Consider the consequences of hysterectomy for fibroids:

• When removing only one uterus, no special changes occur. The necessary hormones continue to be synthesized in the ovaries. Sexual desire and the ability to experience orgasm are preserved.
• According to some sources, there is information that such an operation brings menopause closer by several years, but this has not been confirmed by anything.
• Bleeding in the postoperative period.
• Pain during scar healing.
• Adhesive disease.
• Psychological instability, which is manifested by tearfulness, mood swings. There is a feeling of uselessness due to inferiority. There is sweating, chills, hot flashes.
• Inability to have children. For women of childbearing age, this is one of the saddest consequences.

Common consequences that occur when removing the uterus after 50 years

With certain serious health problems at this age, doctors recommend removing the uterus and ovaries. The consequences after their removal are not large-scale when compared with a similar operation at a young age. After the loss of reproductive organs in half of the patients, a whole complex of symptoms develops, which is associated with impaired functioning of the cardiovascular, nervous and endocrine systems, i.e. posthysterectomy syndrome. This complication develops as a result of a significant decrease in the concentration of sex hormones.

When the uterus and ovaries are removed after 50 years, this syndrome rarely develops, since at this age the body is already accustomed to and works with a reduced level of hormonal substances. Sexual desire after removal of the uterus and ovaries at this age does not change significantly. However, there is little difficulty in obtaining sexual satisfaction and vaginal dryness occurs. Women in this age group are not afraid of the loss of reproductive function. Many patients experience emotional problems. They feel inferior, which is manifested by weakness, increased irritability, mood swings and other reactions.

Inevitable Change

After such an operation, a woman's life changes. Regardless of the age and extent of surgery, the following consequences occur after removal of the uterus:

• emotional problems. According to doctors, modern women cope with this situation on their own. There is a reassessment of values ​​​​and the acceptance of the prevailing fact;
• changes in sexual life. Almost all women note a significant improvement in this area;
• lack of menstruation;
• inability to have children;
• the pelvic organs are redistributed (displaced). If necessary, the doctor prescribes a correction.

Historically, in medicine, the opinion has been entrenched that the uterus is needed only for bearing a child. Therefore, if a woman does not plan to give birth, she can safely resort to surgery.

Is this really true or not? Why, for example, in March 2015, Angelina Jolie had both ovaries and fallopian tubes removed, but left behind an “unnecessary” uterus? Let's find out together whether the removal of the uterus is dangerous. And if dangerous, then with what.

From the surgeon's point of view, a radical operation solves the problem "at the root": there is no organ - there is no problem. But in fact, the recommendations of surgeons can not always be perceived as objective. They often do not follow up patients after discharge, do not conduct examinations six months, a year, 2 years after the removal of the uterus, do not record complaints. Surgeons only operate and rarely face the consequences of the operation, so they often have a false idea about the safety of this operation.

Meanwhile, scientists from different countries independently conducted a series of observations. They found that within five years of having their uterus removed, most women had:

1. (previously absent) pelvic pain of varying intensity,

2. problems with the intestines,

3. urinary incontinence,

4. prolapse and prolapse of the vagina,

5. depression and depression, up to serious mental disorders,

6. emotional and physiological problems in relations with a spouse,

7. Some women who underwent surgery for severe dysplasia or cancer in situ experienced a relapse of the disease - damage to the stump area and vaginal fornix.

8. fast fatigue,

9. persistent increase in blood pressure and other serious cardiovascular problems.

The problem is not invented, because according to the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences, various operations to remove the uterus range from 32 to 38.2% of all abdominal gynecological operations. In Russia, this is about 1,000,000 annually removed queens!

The problem has another side as well. Since all of these complications develop gradually, over a year or several years after surgery, women do not associate the deterioration in their quality of life with the previous operation.

I am writing this material for the purpose that you yourself can evaluateall the pros and cons of the operation, weigh all the pros and cons,and make an informed choice.

My practice shows that there are no superfluous organs. Even in older women, hysterectomy has negative health consequences, and I will elaborate on these in the second part of this article.

Diagnoses that have ceased to be indications for the removal of the uterus

Thanks to the introduction of high-tech methods, some of the indications for the removal of the genitals have ceased to be absolute indications. Here is a list of diagnoses in which the removal of the uterus in women can be replaced by other methods of treatment and save the organ.

1. Symptomatic, overgrown, fast-growing uterine fibroids today are treated with uterine artery embolization: the vessels that feed the fibroids overlap. In the future, the myoma gradually resolves.

2. Adenomyosis, or internal endometriosis, can be eliminated using a therapeutic method (PDT).

With endometriosis, cells of the inner lining of the uterus grow in atypical places. PDT specifically destroys these cells without affecting healthy tissues.

Photodynamic therapy is a organ-preserving method of treatment that is included in the federal standard of care (see).

3. Precancerous condition of the endometrium -, – are also amenable to PDT treatment. To date, I have successfully treated 2 patients with this pathology.

In cases where hyperplasia is predominantly viral in nature, PDT treatment can eliminate the cause of the disease. In the treatment of cervical pathologies, the complete destruction of the human papillomavirus after one PDT session is confirmed in 94% of patients, and in 100% of patients after the second PDT session.

4. Precancerous conditions and oncological formations in the cervix. , and even micro-invasive cancer can be completely cured with a photodynamic therapy procedure in 1 or 2 sessions.

The PDT method eliminates not only the disease itself, but also its cause - the human papillomavirus.

That's why correct and complete performed photodynamic therapy is the only method that provides lifelong recovery and minimal risk of relapse (reinfection is possible only in case of re-infection with HPV).

There is one more good news. Previously, a combination of age and several gynecological diagnoses was a good reason for removing an organ. For example, a combination of condylomas of the cervix and uterine fibroids, or cervical dysplasia with adenomyosis against the background of a performed generic function.

To justify the removal of an organ, the surgeon usually does not give rational arguments, but refers to his own experience or established opinion. But today (even if your doctor tells you otherwise), the combination of several diagnoses is no longer a direct indication for hysterectomy. Modern medicine considers each diagnosis as independent, and for each treatment tactics is determined individually.

For example, dysplasia and adenomyosis regress after photodynamic therapy. And the presence of multiple fibroids is not a reason for oncological alertness. Numerous observations of recent years show that fibroids are not associated with cancer in any way, do not degenerate into a cancerous tumor, and are not even a risk factor.

In surgery, there is a concept of risks of therapeutic exposure. The task of a good doctor is to minimize risks. When the doctor decides on the tactics of treatment, he is obliged to evaluate the indications, measure the possible negative consequences of different methods of treatment, and choose the most gentle and effective.

By law, doctors must be informed about all possible treatments, but in practice this does not happen. Therefore, against the background of the surgeon’s urgent recommendations for the removal of an organ, I strongly advise you to get advice from several specialists or write me to assess the possibility of performing a organ-preserving treatment that is right for you.

Unfortunately, not all diseases of the uterus are treated with minimally invasive and therapeutic methods, and in some cases it is still better to remove the uterus. Such indications for removal are called absolute - that is, not requiring discussion.

Absolute indications for hysterectomy

1. Uterine fibroids with necrotic changes in the node. The preservation of an organ with such a diagnosis is a threat to life.

2. Prolonged uterine bleeding that cannot be stopped by any other means. This condition is fraught with the loss of a large volume of blood and is a serious danger to life.

3. The combination of large uterine fibroids and cicatricial deformity of the cervix.

4. Prolapse of the uterus.

5. Cancer starting from stage I.

6. Giant sizes of tumors.

Depending on the indications, operations on the uterus are performed by different methods and in different volumes. First, we will get acquainted with the types of surgical intervention. Then I will dwell in detail on the consequences that every woman will experience to one degree or another after the removal of this organ.

Types of operations to remove the uterus

In medical practice, abdominal and endoscopic removal of the uterus is performed.

• Abdominal surgery (laparotomy) is performed through an incision in the anterior abdominal wall.
  The method is considered traumatic, but it provides great access and in some cases simply has no alternative. For example, if the uterus has reached a large size due to fibroids.
• The second method is endoscopic surgery (laparoscopy). In this case, the surgeon removes the uterus through punctures in the anterior abdominal wall. Laparoscopic removal of the uterus is much less traumatic and allows you to recover faster after surgery.
• Vaginal extirpation of the uterus - removal of the uterus through the vagina.

Consequences after abdominal surgery removal of the uterus

Abdominal surgery to remove the uterus through an extensive incision is one of the most traumatic procedures. In addition to the complications caused directly by the removal of the uterus, such an operation has other negative consequences.

1. After the operation, a noticeable scar remains.

2. High probability of hernia formation in the scar area.

3. Open surgery usually leads to the development of extensive adhesions in the pelvic area.

4. Rehabilitation and recovery (including working capacity) requires a lot of time, in some cases up to 45 days.

Removal of the uterus without a cervix. Consequences of supravaginal amputation of the uterus without appendages

Whether the cervix is ​​retained or removed when the uterus is removed depends on the condition of the cervix and the risks associated with preserving it.

If the neck is left, this is the most favorable situation possible.

On the one hand, due to the preserved ovaries, the hormonal system continues to function in a more or less normal mode. But why leave the cervix when removing the uterus? Preservation of the cervix allows you to maintain the length of the vagina, and after restoration, the woman will be able to lead a full sexual life.

Removal of the uterus without ovaries. Consequences of extirpation of the uterus without appendages

Removal of the uterus without appendages, but with a neck, is a more traumatic operation.

Leaving the ovaries, the surgeon allows the woman to maintain a normal hormonal background. If the operation is performed at a young age, the ovaries avoid menopause and all associated health effects.

But even after removal of the uterus without appendages, the anatomical ratio of the organs is disturbed. As a result, their function is impaired.

In addition, the complete removal of the uterus, even with the preservation of the ovaries, leads to a shortening of the vagina. In many cases, this is not critical for sexual activity. But the anatomy of the body is different for everyone, and not all women manage to adapt.

Removal of the uterus with appendages

This is the most traumatic operation that requires a lot of recovery time.

It needs serious hormonal correction and usually causes all the most serious consequences, especially if performed at the age of 40-50 years - that is, before the onset of natural menopause.

I will discuss the most common consequences of hysterectomy in more detail below. The most unpleasant thing is that all these consequences are irreversible and practically cannot be corrected.

Meanwhile, a series of recent scientific studies in this area suggests the opposite. Even with preservation of the ovaries, removal of the uterus is an operation with a high risk of endocrine disorders.

The reason is simple. The uterus is connected to the ovaries and tubes by a system of ligaments, nerve fibers and blood vessels. Any operation on the uterus leads to serious impaired blood supply to the ovaries, up to partial necrosis. Needless to say, in literally choking ovaries, the production of hormones is disrupted.

Hormonal disruptions are manifested by a whole string of unpleasant symptoms, the most harmless of which is a decrease in sexual desire.

In the vast majority of cases, the ovaries are not able to fully restore or compensate for normal blood supply. Accordingly, the hormonal balance of the female body is not restored.

Consequence 2. Ovarian cysts after removal of the uterus

This is a fairly common complication in cases where the ovaries are preserved after removal of the uterus. This shows the negative impact of the operation itself.

To understand the nature of a cyst, one must first understand how the ovaries work.

In fact, a cyst is a natural process that occurs every month in the ovary under the influence of hormones and is called a follicular cyst. If the egg is not fertilized, the cyst bursts and menstruation begins.

Now let's see what happens to the ovaries after the removal of the uterus.

The uterus itself does not produce hormones. And many surgeons assure that after its removal, the hormonal background will not change. But they forget to say how closely the uterus is connected with other organs. When separating the ovaries from the uterus, the surgeon inevitably disrupts the blood supply and injures them. As a result, the work of the ovaries is disturbed, their hormonal activity decreases.

Unlike the uterus, the ovaries produce hormones. Violations in the work of the ovaries leads to a violation of the hormonal background and the process of maturation of the follicles. The cyst does not dissolve, but continues to grow.

It takes about 6 months to restore the full functioning of the ovaries and even out the hormonal background. But not always everything ends well, and the enlarged cyst resolves. Often, a second operation is required to remove an overgrown cyst - with a large formation, there is a risk of rupture and bleeding.

If a few months after the removal of the uterus, pain appears in the lower abdomen, which increases over time, it is necessary to visit a gynecologist. The most likely reason why the ovary hurts is an overgrown cyst.

The probability of developing this complication is only 50% dependent on the skill of the surgeon. Every woman's anatomy is unique. It is not possible to predict the location of the ovaries and their behavior before surgery, so no one can predict the development of a cyst after removal of the uterus.

Consequence 3. Adhesions after hysterectomy

Extensive adhesions after removal of the uterus often leads to the development of chronic pelvic pain. The characteristic symptoms of these pains - they are aggravated by bloating, indigestion, peristalsis, sudden movements, long walking.

Adhesions after surgery to remove the uterus are formed gradually. Accordingly, the pain appears only after a while.

At the initial stage, postoperative adhesions in the small pelvis are treated conservatively; if ineffective, they resort to laparoscopic excision of adhesions.

Consequence 4. Weight after removal of the uterus

Body weight after surgery can behave differently: some women gain weight, sometimes even get fat, and someone manages to lose weight.

The most common variant of events after the removal of the reproductive organs is a rapid weight gain, or a woman's belly grows.

1. One of the reasons why women get better is due to the violation of metabolic processes and the fluid retention caused by it in the body. Therefore, strictly monitor how much water you drink and how much you excrete.

2. After the removal of the uterus with the ovaries, the hormonal background changes, which leads to a slowdown in the breakdown of fats, and the woman begins to gain weight.

In this case, a sparing diet will help to remove the stomach. Meals should be fractional, in small portions 6-7 times a day.

Should You Be Worried If You Have Lost Weight After Your Uterus Removal? If the cause of the operation was a giant tumor or fibroids, you should not worry, you have lost weight after the removal of the uterus.

If there was no volumetric education, but you are losing weight, most likely it is a hormonal imbalance. To return the weight to normal, hormone therapy is required.

Consequence 5. Sex after removal of the uterus

For women who have undergone vaginal hysterectomy, sexual rest should be observed for at least 2 months until the internal sutures heal. In all other cases, you can have sex 1-1.5 months after the operation.

Sexual life after removal of the uterus undergoes changes.

In general, women are concerned about vaginal dryness, burning sensation after intercourse, discomfort, pain. This is due to a drop in estrogen levels, due to which the genital mucosa becomes thinner, begins to produce less lubrication. Hormonal imbalance reduces sexual desire, interest in sexual life decreases.

• Removal of the uterus with appendages is most strongly reflected in the intimate side of life, since the absence of female hormones leads to frigidity.
• Removal of the body of the uterus has little effect on intimate life. There may be dryness of the vagina, decreased libido.
• Removal of the uterus with the cervix shortens the vagina, making it difficult to have sex after surgery.

Consequence 6. Orgasm after removal of the uterus

Does a woman experience an orgasm after a hysterectomy?

On the one hand, all sensitive points - the G-spot and the clitoris - are preserved, and theoretically a woman retains the ability to experience an orgasm even after the removal of the organ.

But in reality, not every woman gets an orgasm after surgery.

So, when the ovaries are removed, the content of sex hormones in the body drops sharply, and many develop sexual coldness. A decrease in the production of sex hormones occurs even with the preservation of the ovaries - for many reasons, after the operation, their activity is disturbed.

The best forecast for orgasms for those who have a neck remains.

The consequences after removal of the uterus and cervix are manifested in the shortening of the vagina by about a third. Full sexual intercourse often becomes impossible. Studies in this area have shown that the cervix is ​​of great importance in achieving vaginal orgasms, and when the cervix is ​​removed, it becomes extremely difficult to achieve.

Consequence 7. Pain after removal of the uterus

Pain is one of the main complaints after surgery.

1. In the postoperative period, pain in the lower abdomen may indicate a problem in the suture area or inflammation. In the first case, the stomach hurts at the seam. In the second case, a high temperature joins the main symptom.

2. If the lower abdomen hurts and swelling appears, a hernia can be suspected - a defect through which the peritoneum and intestinal loops go under the skin.

3. Severe pain after surgery to remove the uterus, high fever, feeling unwell signal pelvioperitonitis, hematoma or bleeding. Reoperation may be required to resolve the situation.

4. Pain in the heart indicates the possibility of developing cardiovascular diseases.

A large Swedish study of 180,000 women showed that hysterectomy significantly increases the risk of cardiovascular disease, coronary disease and stroke. Removal of the ovaries further exacerbates the situation.

5. If you are concerned about swelling of the legs, an increase in local skin temperature, thrombophlebitis of the veins of the small pelvis or lower extremities should be excluded.

6. Pain in the back, lower back, right side or left can be a symptom of adhesive disease, cysts on the ovary and much more - it is better to consult a doctor.

Consequence 8. Prolapse after removal of the uterus

After removal of the uterus, the anatomical location of the organs is disturbed, muscles, nerves and blood vessels are injured, and the blood supply to the pelvic area is disrupted. The frame that supports the organs in a certain position ceases to perform its functions.

All this leads to displacement and prolapse of the internal organs - primarily the intestines and bladder. Extensive adhesive process exacerbates the problem.

This is manifested by numerous growing problems from the intestines and urinary incontinence during physical exertion, coughing.

Consequence 9. Prolapse after removal of the uterus

The same mechanisms cause the so-called prolapse of the genitals - the omission of the walls of the vagina and even their prolapse.

If in the postoperative period a woman begins to lift weights without waiting for a full recovery, then the situation is aggravated. Increased intra-abdominal pressure, the walls of the vagina are "pushed" out. Lifting weights for this reason is contraindicated even for healthy women.

When lowered, a woman has a feeling of a foreign object in the perineum. Relieve pain. Sex life becomes painful.

To reduce the symptoms of prolapse of the walls of the vagina after removal of the uterus, special exercises are indicated. For example, Kegel exercises. Constipation also increases intra-abdominal pressure, so to prevent the process, you will have to learn how to monitor bowel function: defecation should be daily, and feces should be soft.

Unfortunately, vaginal prolapse after hysterectomy is not treatable.

Consequence 10. Intestine after hysterectomy

Problems with the intestines after surgery are affected not only by the changed anatomy of the pelvis, but also by a massive adhesive process.

The work of the intestines is disturbed, constipation, flatulence, various defecation disorders, pain in the lower abdomen occur. To avoid problems with the intestines, you must follow a diet.

You will have to learn to eat often, 6 to 8 times a day, in small portions.

What can you eat? Everything, with the exception of heavy foods, foods that cause bloating, stool retention.

Improves the condition of the pelvic organs and regular exercise.

Consequence 12. Urinary incontinence after hysterectomy

This syndrome develops in almost 100% of cases as a result of a violation of the integrity of the ligamentous and muscular frame during surgery. There is a prolapse of the bladder, the woman ceases to control urination.

To restore bladder function, doctors recommend performing Kegel exercises, but even with exercise, the condition usually progresses.

Consequence 13. Relapse after hysterectomy

Surgery on the uterus is performed for various indications.

Unfortunately, the operation does not protect against recurrence if the removal of the uterus was performed for one of the diseases that the human papillomavirus leads to, namely:

• leukoplakia of the cervix,
• cancer of the cervix or body of the uterus stage 1A
• microinvasive cervical cancer, etc.

Regardless of the execution technique, a surgical operation does not guarantee a 100% recovery, it only removes the focus. Traces of the human papillomavirus remain in the vaginal mucosa, which causes all these diseases. When activated, the virus causes a relapse.

Of course, if there is no organ, then a recurrence of the disease cannot occur either in the uterus or in its neck. The stump of the cervix and the mucosa of the vaginal fornix undergo relapses - dysplasia of the vaginal stump develops.

Unfortunately, relapses are very difficult to treat with classical methods. Medicine can offer such patients only traumatic methods. Removal of the vagina is an extremely complex and traumatic operation, and the risks of radiation therapy are comparable to the risks of the disease itself.

According to various sources, relapses after surgery occur in 30-70% of cases. That is why, for the purpose of prevention, the Herzen Institute recommends performing photodynamic therapy of the vagina and cervical stump even after surgical removal of the uterus. Only the elimination of the papilloma virus protects against the return of the disease.

This is the story of my patient Natalia, who faced a recurrence of cancer in situ of the vaginal stump after removal of the uterus.

“Well, I’ll start my sad story in order, with a happy ending. After giving birth at 38 and my daughter turning 1.5 years old, I had to go to work and I decided to go to a gynecologist. In September 2012, nothing foreshadowed sadness, but the tests were not consoling - cervical cancer of the first degree. It was certainly shock, panic, tears, sleepless nights. In oncology, she passed all the tests, where the human papillomavirus 16.18 genotype was found.

The only thing that our doctors offered me was the expiration of the cervix, uterus, but I asked to leave the ovaries.

The postoperative period was very difficult both physically and morally. In general, the stump of the vagina remained, no matter how sad it may sound. In 2014, after 2 years, the analyzes again show a not very good picture, then after six months, 2 degrees. Whatever she was not treated with - all kinds of suppositories, antivirals, ointments.

In short, a lot of money was spent, and in a year and a half of the treatment of this dysplasia, it passed into the third stage and again cancer. What did our doctors offer me this time: photodynamics.

After reading about it, I was delighted and gave myself into their hands. And what do you think, what was the result of their innovative technologies? And nothing has changed! Everything remained in its place. But I read so much about this method, studied various articles, I was especially attracted by the method of photodynamics of Dr. M.S. me at our clinic. Starting from the ratio of the drug per kilogram of my weight, the method itself, the questions they asked me. After photodynamics, I was forced to wear glasses for almost a month, to sit at home with closed curtains and not lean out into the street. I had no doubt that they simply do not know how to do this procedure! I contacted Dr. M.S. Afanasyev, bombarded him with questions, told my story, and he offered his help. I thought long and hard.

My doctor offered me radiation therapy, but knowing the consequences of it and the quality of life after this therapy, I still chose photodynamics again, but so that Maxim Stanislavovich would conduct it for me.

Gathering my strength, I flew to Moscow. The first impression of the clinic was of course pleasant, you feel like a person that everyone cares about, attentiveness and responsiveness are the main qualities of these employees.

About the PDT procedure and recovery

The procedure itself took place under anesthesia, went away quickly, in the evening I went to my sister where I stayed. I wore glasses for only three days. After 40 days, I went for an initial examination to my clinic, but I had an eroded spot, apparently healing was slow, but with all this, the tests were good! The doctor prescribed healing suppositories. And when I came 3 weeks later, the doctor spent me …….., everything healed, and was very surprised - how so! Indeed, for the entire practice of carrying out photodynamics using their technology, there was not a single positive result! Now in April I will go for another inspection. I am sure that everything will always be fine with me!

Here is my story. And I’m telling it to you so that you don’t give up, and during treatment choose the most gentle method of treatment, and not immediately remove everything, apparently it’s easier for our doctors. If I had known about Maxim Stanislavovich earlier, I would have avoided these tears, a terrible operation, the consequences of which will strain my whole life! So think about it! No amount of money is worth our health! And most importantly - if you have a human papillomavirus of this particular genotype, which provokes cervical cancer under certain circumstances, you need to remove this cause. Which is exactly what photodynamics does, but the technology and the doctor who does it must be masters of their craft. Who have extensive experience, scientific papers and positive results in this area. And I think the only doctor who observes all this is Maxim Stanislavovich. Thank you very much Maxim Stanislavovich!!!”

The consequences described above after removal of the uterus affect different women to varying degrees. The removal of the uterus is most difficult for young women of childbearing age.

Consequences of hysterectomy after 50 years

Surgery during menopause also does not greatly affect the health and well-being of women.

And if the operation was performed according to indications, then you made the right choice.

Consequences of removal of the uterus after 40 years

If a woman did not have a menopause before the operation, then it will be very difficult for her during the recovery period. The consequences of the operation in active childbearing age are much more acute than in the age of natural menopause.

If the operation was caused by a huge fibroid or bleeding, removal of the uterus brings significant relief. Unfortunately, over time, almost all the long-term consequences that we talked about above develop.

In medical language, this condition is called posthysterectomy and postovariectomy syndrome. It manifests itself as mood swings, hot flashes, arrhythmia, dizziness, weakness, headache. A woman does not tolerate stress, begins to get tired.

Within just a few months, sexual desire falls, pain develops in the pelvic area. The skeletal system suffers - the level of minerals falls, osteoporosis develops.

If the hormonal background is not corrected, aging will begin immediately after the operation: 55–69% of women operated on at the age of 39–46 years 5 years after hysterectomy have a hormonal profile consistent with postmenopausal.

Surgery to remove uterine cancer is not needed in its early stages

Uterine cancer is adenocarcinoma and carcinoma is a malignant process. The choice of treatment method and the scope of intervention depends on the stage of the disease.

Previously, the initial stages of cancer (, microinvasive cancer) and precancerous diseases (,) were an indication for removal of the uterus. Unfortunately, oncological surgery does not eliminate the cause of the disease - the human papillomavirus - and therefore has a high percentage of relapses.

The removal of the uterus and ovaries for every woman is a serious test, which means that the reproductive function will no longer be fulfilled. Just like that, no one will remove healthy organs, but if there are indications for removal, and a threat to the life of the patient, then operations are carried out without hesitation. But in most cases, the decision to remove the uterus or ovaries is made by the woman herself.

Location of the ovaries and uterus relative to other reproductive organs

Surgical intervention to remove the organs of the reproductive system. Consequences for the body

Women who are shown surgery to remove the uterus and ovaries are interested in the issue of further social adaptation. It should be understood that the removal of the main organs of the reproductive system significantly affects the level of sex hormones, which play an important role in the physiological processes of the body.

Most women will experience severe discomfort in the postoperative period, as they will enter a period of artificial menopause, but hormone replacement therapy can help avoid health troubles.

Procedure to remove the uterus. Indications and consequences

Surgery to remove the uterus (hysterectomy) may be indicated in the following cases:

• The degeneration of the tissues of the uterine cavity and its cervix into malignant. Cancer neoplasms.
• Growth of endometrial cells beyond the uterine cavity and disruption of neighboring organs. Prolonged bleeding caused by endometriosis.
• Benign neoplasms. Myomas are submucosal and subserous.
• Severe prolapse of the organs of the reproductive system. Prolapse of the uterus.
• Pain syndrome on the background of pathology.

Removal of the uterus for a woman is stressful, but the improvement in the condition of the body after surgery helps to cope with stress. If a woman was worried about bleeding and acute pain before surgery, then removal helps to solve these problems. Operations to remove the organs of the reproductive system mean that the woman will no longer be able to give birth, and the internal position of the pelvic organs will change.

Surgery to remove the uterus is common and safe, but complications are possible after it:

1. Urinary incontinence. Incontinence can be caused by weakening of the sphincters of the bladder, as a result of the onset of surgical menopause and a violation in the production of estrogen.
2. Vaginal prolapse.
3. The appearance of chronic pain.

Scars after surgery to remove the uterus: 1) traditional method; 2) laparoscopic histectomy

Removal of the ovaries and consequences

In addition to the partial removal of the organs of the reproductive system, a woman may be shown a complete hysterectomy with the removal of the ovaries and fallopian tubes, the uterine cavity, and the cervix.

Operations to remove the ovaries (oophorectomy) are not carried out so often, and have a negative impact on the woman's body. With oophorectomy, the level of production of sex hormones decreases, which leads to the onset of a surgical "artificial" menopause and general changes in the woman's body, the symptoms of which can develop into serious diseases. Sex hormones do not stop being produced at all, but are synthesized by the adrenal glands and other organs, but to a lesser extent.

The consequences may depend on the age of the patient, but the general symptom is the same - the inability to continue reproductive function and the risk of complications.

Scheme of laparoscopic surgery to remove the ovaries: laparoscopic, uterus, fallopian tube and ovary

The onset of menopause after removal of the uterus and ovaries. Early and late symptoms

Most women expect to get relief after surgery, but the onset of surgical menopause brings only negative symptoms, which can be complicated by the development of chronic diseases.

Artificial menopause is manifested by symptoms of the end of the menstrual cycle as a result of an oophorectomy or hysterectomy. Removal of the uterus leads to the complete end of the hormonal work of the ovaries, since during surgery, the doctor embolizes the uterine arteries that feed the appendages. Inhibition of ovarian function artificially leads to the onset of surgical menopause.

When menopause occurs in a woman's body, the level of sex hormones falls gradually, menopause syndromes in a woman's body increase slowly. And with surgical menopause, a drop in estrogen levels occurs the next day after surgery. A woman's body is not prepared for this, and begins to suffer from a deficiency of sex hormones - this is called postovariectomy syndrome.

These symptoms are similar to the onset of menopause in a natural way, but differ from them in significant severity.

The body suffers from neurovegetative and psychoemotional disorders, which are later joined by problems with metabolic and endocrine processes.

Surgical menopause brings severe psycho-emotional states

Early symptoms of artificial menopause

Early symptoms of artificial menopause are associated with psychovegetative disorders and lack of estrogen. Early symptoms of menopause manifest themselves on the second day after bilateral removal of the ovaries and uterus. Their severity depends on the state of the woman's body and previous diseases. But for most women, menopause after removal of the uterus is difficult to tolerate.

tides

The appearance of hot flashes in a woman's body is a clear sign of the onset of menopause. But hot flashes can accompany not only the natural onset of menopause, but also surgical menopause. Surgical menopause develops in the body immediately after the operation, which means that its symptoms appear faster and more intensely.

Hot flashes with artificial menopause appear already on the second or third day after the end of the operation, and manifest themselves:

• A sharp increase in temperature in the upper body, chills, heavy sweating.
• Increased blood pressure, redness of the skin of the face and neck.
• The frequency of occurrence is from 30 to 50 times a day.
• Night sweats.
• The duration of symptoms is from 3 to 5 years.

Hot flashes are the most specific of the symptoms of the onset of an artificial menopause, which significantly affects the psycho-emotional and general condition of a woman. Between hot flashes and during, a woman feels constant discomfort associated with increased sweating.

Hot flashes are accompanied by increased sweating

Autonomic disorders

Inadequate production of estrogen and androgen hormones is accompanied by disorders of the autonomic system. The patient after the operation within 1-2 weeks notices the appearance of:

• Headaches. An increase in pain can trigger a migraine.
• Vertigo.
• Palpitations and attacks of paresthesia.
• General weakness and decreased performance.
• Increased fatigue.

These symptoms appear in 60% of patients and continue until the end of the artificial menopause.

Psycho-emotional disorders

The loss of organs of the reproductive system and entry into an artificial menopause is the strongest stress for a woman, which manifests itself:

• Emotional lability. Tearfulness and irritability.
• The appearance of fears and an obsessive feeling of anxiety.
• The appearance of depression against the background of the inability to give birth and loss of organs.
• Sleep disturbance. Constant stress and hot flashes interfere with sleep, a woman develops persistent depression.
• Decreased libido.

For women of reproductive age, surgery is a severe stress, against which a woman begins to feel insecure about the future, and it is difficult to return to the usual course of life.

Against the background of surgical menopause, increased irritability develops

Mucosal changes

The lack of production of estrogen (the main sex hormone responsible for the youthfulness of the skin and the normal state of the mucous membranes of the internal organs of the reproductive system) leads to drying out and thinning of the mucous layer of the vagina. Against the background of these changes, a woman develops itching in the vagina. This leads to pain and dryness of the vaginal walls during intercourse. Such changes entail problems between sexual partners and subsequent depression.

Depression of cognitive function

The production of the sex hormone estrogen affects not only the part of the brain that is responsible for overheating the body, but also affects the part that is responsible for cognitive functions.

Against the background of the removal of the organs of the reproductive system, the patient may develop symptoms:

• Decreased ability to perceive information.
• Difficulty remembering new information.

All these symptoms worsen under the influence of psycho-emotional changes during artificial menopause.

Memory impairments accompany artificial menopause

Late symptoms of artificial menopause

Symptoms that appear a few months or a few years after the operation are called late symptoms of artificial menopause. Most often, these symptoms include endocrine disorders, cardiovascular complications and joint problems.

Symptoms of the late onset of artificial menopause are accompanied by disturbances in the metabolic process in the woman's body.

Signs of body aging

Menopause is the period of the onset of natural aging of the body and the introduction of an artificial menopause in the body of a woman is accompanied by these signs. Estrogen is responsible for the youthfulness of the skin, provoking the production of collagen and elastin in the proper amount. When the uterus and ovaries are removed, estrogen production is significantly reduced, which cannot but affect the skin and hair of a woman. After the operation, the patient observes the appearance of wrinkles, a decrease in skin elasticity, the appearance of dryness and thinning of hair and brittle nails, a decrease in tissue turgor, and the appearance of itching in the vagina.

Skin aging is due to estrogen deficiency.

Problems of a urological nature

Insufficient production of estrogen leads not only to a deterioration in skin elasticity and dryness of the mucous membranes, but also to disorders in the urinary tract. The epithelium of the bladder walls becomes thin, and the sphincter leading from the bladder to the canal loses its strength. These changes lead to painful urination, incontinence and frequent urination. All this negatively affects the psycho-emotional state of a woman, leading to depression and a decrease in the level of libido.

Complications of the cardiovascular system

Removal of the ovaries leads to the fact that the production of estrogen, which is responsible for the cardioprotective properties of the body, decreases in the body. The risk of developing atherosclerosis and thrombosis, the appearance of arterial hypertension, the appearance of a sudden stroke, or heart attack increases.

Osteoporosis

Menopausal changes in the body lead to the development of osteoporosis. Changes in bone tissue lead to a decrease in the density of the structure, which can cause bone fragility. Women who have undergone such surgery are advised to regularly check for signs of bone loss to avoid complex fractures.

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 the possible risks associated with it, but the consequences of depriving the organ.

At the same time, taking into account the functional purpose of the uterus, there is a very big difference in the attitude towards 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 a planned manner. There is an opportunity to prepare both the patient, physically and mentally, and the attending physicians, and relatives. But, sometimes situations arise that threaten the life of a woman 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, at the physical and psychological level, depend 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 of the 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 medical care, the development of methods for diagnosing almost all diseases of the uterine cervix at the earliest 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 the neck should be constantly under the supervision of a 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 of reproductive age. The reason for this is the preservation of its own physiological cycle of hormonal regulation in order to prevent endocrine disorders.

early menopause

Panhysterectomy and radical removal leave the 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 who has had her appendages removed, the more the signs of menopause bother her. 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 closer the age of the natural cessation of childbearing function approaches, the lower the estrogen level becomes. 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, hormone replacement therapy is prescribed. 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 cancer. In this situation, herbal remedies will be the only aid.

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 for the periodicity of the hormonal background is not met - there is no 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 errors in lipid metabolism. 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 the female way of thinking is prone to exaggeration and the adoption of their 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.

In this period, it is important to understand that internal changes will have very little effect on the usual 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 in 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, metabolic disorders and a number of others. The resumption of activity after the healing period after the operation, control of the 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 reason for the absence of sexual relations. But, permission to them must be obtained from the attending gynecologist. Only after making sure that the posterior wall of the vagina is completely healed can penetration be allowed.

Most operated women experience psychological discomfort during the restoration of sexual life, even with a 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

The resumption of 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 is likely due to emotional and / or hormonal reasons. In case of severe psychological stress, lengthening the foreplay and additional stimulation of erogenous zones will help. 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. Sexual 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 the early recovery period. 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 not thinking about a 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 is the only way to stay alive and in relative health. For greater confidence in the correctness of the medical appointment, you can undergo an examination and get a conclusion in another clinic.

For the fastest and most complete recovery after the operation, it is necessary to prepare for it not only clinically (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 a psychologically positive attitude is to fully trust the attending physician. 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!

For all women who have to remove the uterus, the consequences of the operation are an urgent issue. There is a misconception that along with the uterus, a woman is deprived of a normal life in principle. She no longer receives sexual pleasures, the body ages faster and so on.

This is nothing more than just a myth.

The uterus and its functions

The uterus is an organ of the female body that performs certain functions. It is designed for the development of the embryo and the bearing of the fetus. In the process of childbirth, the uterus also takes a direct and very active part - it contracts, thereby contributing to the expulsion of the fetus.

Inside the uterus, as it were, is “lined” with a mucous membrane, the endometrium. The endometrium is saturated with blood vessels, and the blood supply increases markedly by the middle of the menstrual cycle and in the second phase (medics say: "the endometrium thickens"). The body needs this so that the fertilized egg is safely fixed in the uterus and begins to develop. If fertilization does not occur, then the vessels do not receive nutrition, the upper layer of the endometrium is separated and rejected by the body. Menstruation begins.

When the uterus is removed, there can be no menstruation, because there is no endometrium, the body simply has nothing to expel. However, such a state has a completely different nature than menopause. It's called "surgical menopause."

What is a climax

Climax

is the loss of ovarian function. They produce less and less sex hormones (estrogen, testosterone, progesterone), the egg does not mature in them.

Estrogens (female sex hormones) are very important for the state of bone tissue and blood vessels, so their absence very often leads to problems with the musculoskeletal system and blood circulation.

A decrease in the production of testosterone (male sex hormone) leads to a lack of sexual desire (libido). An active hormonal restructuring takes place in the body - it is this that can lead to such external changes as excess weight, skin aging, hair loss. Removal of the uterus cannot cause hormonal changes, because the ovaries will continue to function and produce sex hormones.

Clinical studies prove that when the uterus is removed, the ovaries work in the same mode and during the same period that is planned, "programmed" by the body genetically.

Estrogens are produced regardless of whether the uterus is removed or left, they continue to have a positive effect on bone tissue and the cardiovascular system. Testosterone is also produced, so libido does not decrease, and the quality of sexual life does not change in any way.

Moreover, if you are familiar with such a condition as premenstrual syndrome (PMS), then it will continue. Because PMS is caused by the cyclic work of the ovaries.

The uterus is an unpaired muscular organ of the female reproductive system, without which it is impossible to endure and give birth to a child. Securely hidden behind a wall of abdominal muscles, protected from external shocks - nevertheless, the uterus is prone to diseases, the result of which can be the saddest - the uterus has to be removed.

Should the uterus be removed?

The decision on whether to remove the uterus or not should be made by specialists after a thorough examination of the woman. The operation to remove the uterus - hysterectomy - is one of the most common gynecological operations. The main indication for its implementation is the presence of malignant neoplasms. Hysterectomy can be complete or partial, and according to the method of carrying out - abdominal (cavitary), vaginal or laparoscopic. When choosing a method, the general condition of the woman, the form and stage of development of the disease are taken into account.

If both the cervix and the uterus with appendages are removed, this is a complete (total) hysterectomy. If during the operation the uterus (its upper part) was removed, and the cervix was not removed, this is a partial (supravaginal) hysterectomy. Whether it is necessary to remove the uterus completely, or whether the cervix can be saved depends on the degree of damage to the organ.

Previously, it was considered necessary to remove even healthy ovaries when removing the uterus - to prevent the development of cancer in them. However, at present, oncologists have established that the ovaries can be left when the uterus is removed, because the incidence of ovarian pathology does not depend on whether the operation was performed or not.

Such operations began to be carried out about a hundred years ago, so a lot of experience has been accumulated in this field of gynecology. A large number of clinical studies have also been conducted, which allow drawing certain conclusions regarding the consequences of the operation and the quality of life of the operated patients. The modern level of gynecology and medical equipment make it possible to perform hysterectomy using laparoscopy (in the case when the size of the uterus makes it possible), which guarantees high accuracy during the operation and a quick recovery after it.

However, almost every woman for whom doctors recommend hysterectomy is much more concerned about the consequences of the operation. Although, quite often, you need to worry more about the pathology that is an indication for surgery.

Sex life after extirpation or hysterectomy of the uterus is one of the first most popular questions. There is a widespread opinion that after this operation, sexual life is not possible, and if it is possible, then the woman will definitely not receive pleasure.

During the first two months after the operation, the woman should completely abstain from sexual intercourse. In the future, there are absolutely no obstacles to this. After a hysterectomy, women retain all the sensitive nerve endings located both on the external genital organs and in the vagina. Therefore, they can, as before, experience an orgasm and enjoy sexual pleasure. Problems in sexual life after removal of the uterus mainly occur only in women with a labile psyche. They are so afraid of the consequences of hysterectomy due to fibroids or some other disease that they are unable to think of anything else. And as a result of this, they cannot achieve the sexual arousal necessary to obtain an orgasm. So their problems are more psychological than physical. In this case, it helps to seek help from a competent psychologist. But you yourself must understand that the operation did not fundamentally change anything in your life, except for one thing - the ability to have children. British scientists conducted a survey of women who underwent hysterectomy. According to their reviews, many of them simply did not feel the consequences of removing the uterus. Their lives continued as usual. 94% of the operated women stressed that they had no reason to be afraid of the upcoming operation and the possible negative consequences associated with it.

Consequences of hysterectomy: early postoperative period

The rehabilitation period after a hysterectomy lasts about a month and a half, of course, provided that the operation was completed without any complications. According to reviews, the consequences of removing the uterus in the first few days after the operation are:

Pain in the area of ​​the postoperative wound. Usually they last for 1-2 days and are well stopped by injections of conventional painkillers (baralgin, analgin, ketanal).

Bleeding. Normally, the postoperative wound should not bleed. But spotting from the vagina in a small amount can continue for a month after surgery. But if you have heavy bleeding or its intensity increases over time, you should immediately consult a doctor.

You should also immediately consult a surgeon if any of the following symptoms appear:

Increase in body temperature;

Swelling and redness of the skin in the lower extremities;

Sudden sharp decline in strength or an attack of severe general weakness;

Acute urinary retention.

After hysterectomy, the postoperative period is much easier for those women who went to the operation with the right psychological attitude, and also followed all the instructions of the attending physician.

The right mental attitude is the key to your well-being, quick recovery after surgery and return to your usual way of life. For a favorable psychological state, first of all, you need trust in the doctor and confidence that your body will function in the same way as it did before the operation (which is really true). A positive attitude and support from loved ones is very important.

Many women give the uterus a certain symbolism, endow it with super-significance. In their minds, the uterus is, as it were, identified with the female essence. You can read above that the actual situation is different. If you attach great importance to the opinions of others and want to protect yourself from their negative psychological impact, then you do not have to dedicate them (including all close relatives, except for your husband) to the details of the operation. This is the case when "a lie is for salvation." Remember that the most important thing in this case is your health. Both physical and psychological.

Removal of the uterus with fibroids: consequences

Many women are so frightened by myths about the dangers of hysterectomy that they prefer to continue living with fibroids, refusing surgical treatment. Yes, indeed, in some cases, with myoma, conservative therapy can be successful. But this happens, unfortunately not always. By refusing an operation, a woman risks not only her health, but also her life. As we wrote above, the removal of the uterus in case of fibroids does not have negative consequences. But the operation saves the woman from frequent and heavy uterine bleeding, to stop which sometimes it is necessary to resort to an operation to scrape the uterine cavity. Iron deficiency anemia, which develops as a result of blood loss, requires serious and long-term treatment, and sometimes blood transfusion (blood transfusion). In addition, there is always a fairly high risk of malignant degeneration of fibroids with the development of cancer of the uterine body. So the consequences of the removal of the uterus with fibroids for the life of a woman are only positive.

How long is the recovery period?

Recovery (rehabilitation) after hysterectomy or hysterectomy, as a rule, takes a month and a half, provided that the operation was successful and there are no complications.

It is not known in advance what consequences after removal of the uterus will appear for you, but try to do everything so that they are the least noticeable.

If you have survived a hysterectomy, rehabilitation may not always be a quick and easy process. But subject to a positive psychological attitude, compliance with all the prescriptions of the doctor, diet and careful monitoring of your body, everything will be successful.

After the removal of the uterus in a woman's life, of course, changes come. In the first days and weeks, it is necessary to experience the purely physical consequences of surgery; the duration of the rehabilitation period depends on the method of hysterectomy. And in the future, psychological factors come into force ...

Every woman experiences hysterectomy differently; it all depends on the individual characteristics of the organism. For some, life after removal of the uterus becomes easier: the disease is defeated, and at the same time there is no need to worry about contraception in the presence of an active sex life.

However, it also happens that the removal of the uterus (and even more so, its congenital absence) forever closes the woman's ability to endure and give birth to a child herself. In case of removal of the uterus, assisted reproductive technologies such as IVF will not help either.

But, as a rule, even with a total hysterectomy, doctors try to maintain healthy ovaries, and this makes it possible for women without a uterus to have their own child.

The only way to become a mother for a woman without a uterus is surrogacy.

Forecast

Hysterectomy not only does not affect life expectancy, but even improves its quality. Having got rid of the problems associated with the disease of the uterus and / or appendages, forever forgetting about contraception, many women literally flourish. More than half of the patients note emancipation and increased libido.

Disability after removal of the uterus is not granted, since the operation does not reduce the woman's ability to work. A disability group is assigned only in the case of severe pathology of the uterus, when the hysterectomy entailed radiation or chemotherapy, which significantly affected not only the ability to work, but also the patient's health.

Thus, you just need to weigh the pros and cons. The consequences of removing the uterus will not bring you discomfort. The choice between the state of health after the removal of a diseased organ, and your imaginary fears about changing your appearance and lifestyle, always remains with you.