The consequences after removal of the uterus and ovaries may not be the most pleasant and you need to know about them even before surgery. Hysterectomy not only disrupts the functioning of the reproductive sphere, but also negatively affects other functions of the female body: urinary, endocrine, cardiovascular and neuropsychic.
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After surgery on the uterus and ovaries, the patient may experience early menopause, urinary incontinence, metabolic disorders, and emotional distress. However, removing reproductive organs is often the only way to protect a woman from cancer.
Rehabilitation after surgical removal of the uterus and ovaries takes 2–2.5 months. In the first days, the woman is in the hospital, where she receives the necessary treatment. This period lasts 14–20 days and depends on the complexity of the manipulations.
The first two days after a hysterectomy are the hardest. A woman should not get out of bed and eat. Only the simplest and lightest foods are allowed - vegetable or chicken broth without salt, tea, water. Pain inside the abdomen and in the suture area is relieved with analgesic injections.
On the third day after amputation of the uterus, you are allowed to walk. This causes a lot of unpleasant sensations, but it is absolutely necessary for speedy healing and the prevention of blood clots and adhesions. Before getting out of bed, you need to put on a support belt and compression garments.
While in the hospital, you should take leisurely walks around the department. This activity improves intestinal motility and helps relieve constipation and gas formation. During rehabilitation, you should adhere to a diet that includes the consumption of easily digestible foods and strive for daily bowel movements.
The procedure is very traumatic, causes many unpleasant consequences and requires long-term rehabilitation. It is performed only as a last resort when other methods of therapy have failed.
After this operation to remove the ovaries and uterus, the patient is faced with hormonal imbalance, premature aging, early menopause, and the inability to conceive. Metabolic disorders lead to exacerbation of chronic diseases, the development of osteoporosis, and weight gain.
Possible consequences of radical intervention:
- injury to the bladder or rectum;
- damage to the pelvic tissue;
- formation of adhesions and fistulas.
Despite the negative consequences, many patients feel much better after removal of the uterus and ovaries. Pain, bleeding and drowsiness caused by anemia disappear.
How to avoid complications?
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Removal of organs of the reproductive system makes significant adjustments to the patient’s lifestyle. Therefore, it is necessary to prepare in advance for the occurrence of undesirable consequences and not make a tragedy out of the operation.
How to live after removal of the uterus and ovaries? The same as before, but with some reservations that will help you recover faster and cope with the consequences.
So, what is required from the patient during the recovery period:
- Wearing a bandage during the entire rehabilitation period. The product reduces pain, helps keep internal organs in place, and prevents seams from coming apart.
- Avoiding activities that strain the abdominal muscles (heavy lifting, bending).
- Limit sun exposure. It is best to visit the beach before 11 a.m. and after 4 p.m.
- Prevent constipation with proper nutrition or medication.
Until the discharge ends, it is necessary to use gauze hygiene products. Tampons and menstrual cups can lead to serious consequences, including blood poisoning.
In the first time after removal of the uterus, you should avoid colds - with fresh stitches, it is not advisable to sneeze, cough or blow your nose. For 1.5 months, you cannot take baths, visit the steam room, or swim in open water or swimming pools.
How long do they live after removal of the ovaries and uterus? It has been proven that resection of reproductive organs does not in any way affect the number of years to come. It’s another matter if the intervention is prescribed for a malignant tumor. In this case, life expectancy depends on the development of oncology.
Diet
To avoid gaining excess weight after removal of the uterus and ovaries , It is necessary to follow the rules of healthy eating. A properly selected diet will improve intestinal motility, restore normal bowel movements, relieve gases and eliminate other consequences of the intervention.
Drinking regime is no less important. It is very useful to consume freshly squeezed juices with pulp, rosehip infusion, and green tea.
The diet after removal of the ovaries and uterus should contain more boiled or stewed vegetables, white meat, dairy products, whole grains, and fresh fruits.
The following will help prevent bone thinning and other consequences of phosphorus-calcium metabolism disorders:
- cheeses (Adygei, Russian);
- nuts (pistachios, almonds, hazelnuts);
- olive oil;
- eggs;
- liver;
- fish (sardine, tuna).
The most useful berries after uterine surgery are cherries and cherries, and dried fruits - raisins and prunes.
It is advisable to exclude sugar and confectionery products, margarine, lard, canned food, sausages, chips, and fast foods from the menu. Marinades, pickles, and smoked foods cause thirst and frequent urination, which removes vitamins and minerals from the body.
Intimate life after hysterectomy
Despite the serious consequences, hysterectomy is not a reason to end your personal life. Women even after the operation receive satisfaction, sometimes even to a greater extent, because they no longer worry about an unwanted pregnancy.
Restoration of the reproductive system after removal of the uterus and ovaries lasts from 1.5 to 2 months, sometimes longer. In any case, you should abstain from sexual intercourse until the bleeding stops and the tissues heal.
The likely consequences may be associated with the early onset of menopause - if the patient has her ovaries and uterus removed, menopause begins regardless of age.
The resulting dryness and thinning of the vaginal mucosa makes intimate life uncomfortable, thereby reducing sexual desire. Various gels and lubricants will help cope with such consequences: Vagilak, Ginoffit, Estrogel, Ginocomfort, Divigel.
Exercising after surgery
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One of the components of rapid rehabilitation after hysterectomy is a decrease in physical activity for at least three months. This is how long it takes for the incisions that were made during the intervention to heal. Therefore, during the recovery period, you should not lift weights, walk or stand for long periods of time, or engage in cleaning the apartment or gardening. But you shouldn’t behave too passively either.
If the uterus is removed and the ovaries are left, then health consequences cannot be avoided. Nevertheless, the possible complications of such an operation are significantly less than with the complete removal of the female genital organs. To maintain the normal functioning of body systems during the rehabilitation period, the patient is prescribed a course of medications.
Functions of the uterus
The uterus is a reproductive organ designed to bear an unborn child. It is a muscle tissue lined on the inside with a mucous membrane - the endometrium. It is necessary for reliable attachment of the fertilized egg. In the absence of conception, the endometrium is shed and leaves the body along with menstrual blood.
If the uterus is removed and its cervix and ovaries are left, then menstruation can subsequently continue; in the absence of a cervix, the symptoms of the approaching menstruation may continue regularly without subsequent bleeding.
Indications for intervention
Removal of the uterus while preserving the ovaries is carried out if there are relative or absolute indications. In the second case, such an operation is necessary and is performed when the woman’s life and health are threatened.
Relative readings:
- endometriosis;
- uterine fibroids;
- inflammatory diseases of the organ;
- frequent intermenstrual bleeding that does not lead to a sharp deterioration in health;
- precancerous condition of the endometrium;
- chronic pain in the pelvic area.
Absolute readings:
- cancer of the uterus or cervix;
- uterine prolapse;
- abnormal uterine bleeding.
Removal of the uterus with preservation of the appendages, if there are relative indications, is most often prescribed to women over 40 years of age or to patients who do not plan to conceive a child.
In case of relative indications, surgical treatment can be abandoned. Most of these pathologies can be eliminated with the help of medications or physical therapy. If such treatment fails for a long time, the patient is recommended to have the organ removed.
Why are the ovaries left behind when the uterus is removed?
When the uterus is removed, a woman can no longer have children. Preserving the ovaries even in the absence of reproductive function is important for the patient’s health. The appendages synthesize hormones that support the normal course of all processes in the body.
The hormonal balance is determined by the functionality of all endocrine organs - the ovaries, adrenal glands, pituitary gland, hypothalamus, thyroid and pancreas. In the absence of one of them or its malfunction, the flow of many processes in the body is disrupted. This can lead to the following consequences:
- weight change – exhaustion or obesity;
- loss of appetite or increase in appetite;
- excessive body hair or hair loss;
- deterioration of the condition of the skin, nails, appearance of stretch marks, acne on the face;
- sleep disturbance;
- mood swings;
- hand tremors;
- increase in body temperature up to 37 degrees;
- loss of libido;
- changes in blood pressure;
- heart rhythm disturbance;
- joint diseases;
- headaches, migraines;
- development of diabetes mellitus;
- increased fatigue;
- muscle cramps;
- diseases of the digestive system.
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If the uterus is removed but the ovaries remain, these symptoms rarely occur. Signs of changes in hormonal levels are possible in the first time after surgery. After 3-6 months, the ovaries function normally after removal of the uterus.
Preserving the appendages allows a woman to avoid lifelong use of hormonal drugs and diseases of the endocrine organs.
Possible types of operations
Removal of the uterus while preserving the appendages, or hysterectomy, is performed using various surgical methods.
Types of surgery differ in the speed of rehabilitation and morbidity:
- Cavity. It is performed by making an incision on the front wall of the abdomen. Prescribed in emergency cases or in case of large pathological formations in the uterus.
- Laparoscopy. Minimally invasive intervention with several punctures on the abdominal wall. The condition of the organs during the operation is monitored using a laparoscope - a device with a small camera that is inserted into the peritoneum.
- Through the vagina. Making an incision around the cervix. It is carried out in women who have given birth. The main advantage of this intervention is the absence of scars.
Types of hysterectomy with preservation of the ovaries - subtotal and total. The first is characterized by the removal of only the organ itself, the second - the uterus and its cervix.
Rehabilitation period
The duration of recovery depends on the type of surgery performed. The longest rehabilitation is needed after abdominal surgery. When the uterus is removed by laparoscopy or through the vagina, the recovery period is reduced.
The early postoperative period proceeds as follows:
- compliance with bed rest – 2-7 days;
- taking antibiotics and painkillers – 5-14 days;
- removal of sutures - after 2-3 weeks;
- adherence to the diet - from 1-2 weeks to 1.5-2 months;
- taking anticoagulants, immunostimulants and other prescribed medications – up to 1.5 months from the date of intervention.
During the rehabilitation period, a woman needs medications that support hormonal levels. These may be products containing synthetic hormones or vitamins that regulate the functioning of the appendages. In these cases, experts prescribe Mastodinon, Cyclodinone, Femoston. Starting them early can prevent hormonal imbalance.
The woman is discharged from the hospital after 5-10 days. After this, rehabilitation continues at home. Rules for rapid recovery after removal of the uterus with preservation of the ovaries:
- taking prescribed medications regularly;
- performing light gymnastics;
- refusal of excessive physical activity, heavy lifting;
- prohibition on sexual activity;
- regular walking;
- wearing a postoperative bandage;
- following a diet is necessary if there are disturbances in the intestines, stomach diseases or swelling;
- giving up alcohol.
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Lifting the ban is possible only after the patient is re-examined by the attending physician. Rehabilitation ends after complete healing of the internal and external sutures. On average, its duration is 1-3 months.
Consequences of the operation
Possible consequences that befall a woman after the intervention are divided into several groups. In most cases, such an operation does not affect the patient’s quality of life.
Health effects
If the intervention is carried out correctly and there are no concomitant diseases that complicate recovery, the consequences of removing the uterus without the ovaries are minimal. Most often they appear in the first months after surgery and go away on their own. Their further course is a consequence of incorrect treatment or non-compliance with the doctor’s instructions.
During the intervention, the ovaries are left together with the fallopian tubes, only the uterus is removed - this reduces the likelihood of such a negative consequence as disruption of the blood supply to the appendages.
Health consequences of hysterectomy:
- hormonal imbalance - occurs when the blood supply to the appendages is disrupted, which is usually a consequence of errors during surgery;
- ovarian cysts are a consequence of a failure of their functionality in the absence of normal blood supply;
- adhesions - to prevent them, a woman is prescribed anticoagulants and other drugs that improve blood flow;
- weight change is the result of hormonal changes and non-compliance with a special diet;
- pain – localized in areas of scars and the pelvic area, their prolonged presence may indicate the course of adhesive or inflammatory processes, the formation of blood clots and ovarian cysts;
- organ prolapse is a natural process that appears as a result of the space freed up after removal of the uterus; its symptoms usually go away on their own;
- prolapse and drooping of the vaginal walls is a consequence of physical exertion and constipation in the postoperative period;
- failure of the intestines - in the first months, patients often complain of constipation, diarrhea, bloating, which appears when organs are displaced or the diet is not followed;
- relapse of the disease - possible when the uterus is removed in a precancerous state or during the course of oncology;
- Urinary incontinence is a common complication that occurs when the integrity of ligaments and muscles is damaged during surgery; to prevent it, you need to perform Kegel exercises.
When the first symptoms of negative consequences appear, you should consult a doctor - this will prevent serious complications of removing the uterus while preserving the ovaries.
Sex life
Intimacy is prohibited in the first months after the intervention. This is necessary for complete healing of the sutures and to prevent many negative consequences regarding the functioning of the pelvic organs. After recovery, sexual intercourse is allowed.
Surgical removal of the uterus is called a hysterectomy. In another way, this gynecological operation is called extirpation or amputation of the uterus. Rehabilitation after such surgery takes place using several techniques.
Indications for surgery and types of interventions
This treatment method is used for the following conditions:
- malignant tumors in the ovaries, cervix or uterine body;
- uterine fibroids that are large or actively growing, as well as multiple fibroids;
- endometriosis;
- bleeding;
- uterine prolapse;
- chronic pelvic pain;
- surgical gender reassignment (in combination with operations to change the breasts and genital organs).
The operation is performed in three ways: laparoscopic, laparotomy and transvaginal.
There are several types of hysterectomy:
- Supravaginal amputation. With this manipulation, the cervix and appendages are preserved.
- Hysterectomy is the removal of the uterus and cervix, which may be accompanied by amputation of the appendages.
Advantages of supravaginal amputation of the uterus with preservation of its cervix:
- Urological disorders develop less frequently after surgery;
- There is almost no sexual dysfunction observed after surgery;
- preservation of the ligamentous apparatus of the uterus.
The choice of a specific access and extent of surgical intervention depends on several parameters:
- underlying disease (reason for surgery);
- patient's age;
- results of examination for the presence of malignant cells.
Complications of the operation
During surgery and in the postoperative period, the following complications may develop:
- psychological discomfort and development of depression;
- violation of sexual and urinary functions;
- bleeding;
- hematomas in the area of manipulation;
- infection in the suture area, peritonitis;
- allergic reactions to anesthetic drugs;
- sudden cardiac arrest (complication of anesthesia);
- intraoperative injury to surrounding organs, tissues, vessels and nerves;
- infertility;
- when removing the ovaries - surgical menopause;
- phlebitis and thrombophlebitis.
After surgical treatment (total hysterectomy), in 50-80% of cases, the so-called post-castration syndrome occurs, which includes a combination of the following disorders:
- neuropsychic: weakness, tearfulness, nervousness, irritability, memory impairment, sleep disorders;
- vegetative-vascular: feeling of heat, sweating, pain in the head and heart, redness of the face, dizziness, manifestations of fear and lack of air;
- metabolic-endocrine.
Rehabilitation
As a rule, after a hysterectomy, patients are discharged from the hospital after 48 hours; with extended surgery, a few days later.
After laparotomy surgery with open access through the anterior abdominal wall, women resume their normal lives after 6-8 weeks.
After the laparoscopic approach, patients return to normal activities within a few weeks.
For 6 weeks after surgery you cannot:
- lift more than 4.5 kg;
- take baths and swim in ponds;
- engage in sexual relations;
- supercool.
Rehabilitation measures include a diet rich in fruits and vegetables, physiotherapy, physical therapy, and acupuncture. The listed recovery methods can be supplemented.
Indications for physiotherapy
Indications for treatment with physical factors are:
- post-castration syndrome;
- swelling of the lower extremities;
- tissue fibrosis;
- hypotension and atony of the bladder.
To facilitate the course of post-castration syndrome and adapt to a new lifestyle, electrosleep is used. The conducted studies prove that this type of treatment can significantly reduce the severity of neuropsychic and vegetative-vascular disorders.
Contraindications to electrosleep therapy:
- focal symptoms;
- neoplasms in the head area;
- high degree of myopia;
- psychical deviations;
- violation of the circulation of spinal fluid.
If urination is impaired due to the development of bladder atony, neuromuscular stimulation with sinusoidal modulated currents of certain parameters is used.
To improve blood flow and tissue regeneration, low-frequency magnetic therapy is used, which also helps accelerate the resorption of edema and inflammatory infiltrates.
With the development of swelling of the lower extremities, it is used, in addition to which compression hosiery of a certain density is selected for patients.
Hardware physiotherapeutic treatment is complemented by massage of swollen limbs.
Contraindications to physiotherapy
Physiotherapeutic procedures are contraindicated if the patient has the following disorders:
- bleeding and tendency to it;
- blood diseases;
- presence of neoplasms;
- general serious condition of the patients;
- severe cachexia;
- mental disorders;
- acute inflammatory diseases;
- decompensation of chronic pathologies;
- for lymphatic drainage and massage: severe damage to the vascular bed;
- phlebitis and thrombophlebitis up to 6 months.
Physiotherapy
Physical therapy exercises help strengthen muscles and return to normal life after surgery. After removal of the uterus, problems with urination and bowel movements often occur due to the displacement of internal organs. Kegel exercises must be performed to restore normal function.
To prevent the appearance of adhesions in the pelvis, special complexes of physical therapy are prescribed.
Change in quality of life
After the operation, a woman’s life changes for the better. Depending on the underlying disease, it:
- gets rid of chronic pain syndrome, malignant or benign neoplasm;
- can lead a normal sex life;
- feels a surge of strength and improved well-being.
Many women of reproductive age report liberation in their sexual life after surgery, which is associated with the disappearance of the fear of an unwanted pregnancy, as well as the absence of pain that bothered patients before surgery.
6-8 weeks after surgery, after receiving permission from the gynecologist, you can continue your sexual life. At first, a woman may be bothered by vaginal dryness and pain during sexual intercourse. In this case, the attention and tenderness of the sexual partner is necessary. It is worth spending more time on foreplay for arousal, then the vaginal mucosa will secrete more lubricant. If this is not enough, you can use special intimate lubricants or oils (an allergic reaction is possible).
As a rule, these symptoms disappear after some time, but it must be remembered that severe discomfort is a reason to be examined by a gynecologist.
When the ovaries are removed during surgery, a woman experiences surgical menopause, which may be accompanied by acute symptoms: hot flashes, mood swings, pressure surges and pulse instability. With such symptoms, hormone replacement therapy is prescribed to improve the patient’s well-being.
Modern methods of diagnosis, treatment and rehabilitation help to recognize the disease in time, treat it with the most effective and minimally invasive means and restore lost functions, allowing you to quickly return to the usual rhythm of life.
Hysterectomy is a common operation that involves removing the uterus and is performed for certain indications. This is usually experienced by women after 45 years of age. Especially those who have lived with fibroids for many years.
Hysterectomy and panhysterectomy
Before the intervention, enteroscopy and hysteroscopy are performed, during which the uterine cavity is examined and then all manipulations are performed to eliminate it.
Hysterescomy is performed through laparoscopic openings and by open surgery. In the first case, the uterus is removed through the vagina with 1 cm long incisions, and a blind sac is formed. General anesthesia is given. The stitches are not removed, the woman is on sick leave for 14 days.
Extirpation of the uterus without appendages on the operating table (open surgery) extends sick leave to 1.5 months. Excision is carried out horizontally, in the future the scar is noticeable.
The second option involves removing the uterus through the abdominal wall (laparoscopy). General anesthesia is also given. The woman stays in the clinic for 2-3 days, with sick leave for a month. The stitches are removed after a certain time.
Pfannenstiel laparotomy is also considered a common way to approach the uterus. The laparotomy procedure is considered an open method, involving an incision in the peritoneum.
Panhysterectomy, what is it and how is it done, you can learn about it from your doctor. During the operation, not only the uterus is removed, but also the ovaries and appendages. Such radical manipulation changes a woman’s life.
Complete rehabilitation is 2 weeks. Extirpation of appendages can significantly change your lifestyle for the worse in sexual terms. During Wertheim's operation, the greater omentum, or part of it, is removed.
Supravaginal amputation of the uterus is also performed, which involves removing the organ while preserving the cervix. In the process, lymph is disrupted. The basic tactics of the procedure are no different from the above. According to Wertheim, they are excised in almost all open operations.
Often one ovary is amputated in the pelvic area without touching the fallopian tubes. This is due to the presence of such a growth as a borderline tumor. Removing one ovary does not lead to significant changes. Fertility is preserved; you can get pregnant both naturally and with the help of IVF. The main thing is to prevent polycystic disease. The reasons for such an operation are extensive. Among them are cysts and cancer. Every woman needs a correct diagnosis.
It is also noted that it is possible to remove the uterine cavity during menstruation, but taking into account the current condition of the woman and the general results of the tests.
During a caesarean section, the uterine cavity can also be removed if during such a birth there is a partial rupture or ruptures on its own. The fetus is extracted using a vacuum.
If there are no emergency prohibitions on the procedure, then a subtotal hysterectomy will take place. Contraindications – inflammatory processes, acute respiratory infections, infections of the cervix and vagina.
Removal of the uterus for fibroids
The hysterectomy procedure for fibroids 100% prevents the development of relapse, but here the inability to give birth to a child is at stake. For this reason, surgery is prescribed for those women who have already reached menopause.
- A medical procedure for extirpation is prescribed in such cases as:
- Large fibroids (comparable to 3 months of pregnancy).
- Pronounced tumor clinic.
- Myoma together with uterine prolapse.
- Sumbucous fibroid with bleeding.
- Presence of a tumor on the pedicle.
- Traces of degeneration of fibroids into cancer.
- Pressure from the growth on nearby organs.
Such an operation, when the fibroid is removed along with the uterus, is the worst development of the disease. They resort to surgery if other treatments have not produced any results.
After the procedure, you need to adjust your diet, lifestyle, and review the amount of physical activity.
If hysterectomy does happen after 40 years, despair is the last thing. After the operation, it is necessary to change your lifestyle and be more attentive to your health, to prevent the development of a cyst. In old age, after fibroids are eliminated, granulation takes longer.
Consequences after hysterectomy
After a hysterectomy is performed, a woman forgets about bleeding, pain, “movements” of organs, and a serious condition before menstruation.
When the organ is removed, a uterine stump remains, which means that some endometrium is still present. In this case, there will be cleaning, after which the tissue will be sent for analysis (histology). This means that there will be discharge and this is the norm.
The histology result will show the presence of malignant cells.
If endometriosis occurs during the recovery period, recovery will be delayed. Ablation may be used due to a disease such as adenomyosis.
A woman does not always discuss issues concerning her life and health with a doctor. The fair sex cares about their appearance, sexual relationships and quality of life in general. Not surprisingly, menstruation occurs after surgery. This is due to incomplete removal of the organ. It’s all due to hormonal imbalance and cavity remnants.
The consequences of the operation are quite obvious - the woman will no longer be able to give birth.
In addition, the organs in the pelvis will move slightly. If the procedure is done in a timely manner, the woman quickly comes to her senses and lives a normal life. In any case, it is important to monitor your health and be attentive to every little detail.
If you experience painful spasms in the peritoneal area or bleeding, you should consult a doctor as an emergency. No matter how many months have passed since surgery, you need to understand that this is a big risk.
Symptoms that may occur after hysterectomy surgery include:
- Painful cramps (back, lower abdomen). This is due to slow scarring of the incision or the formation of adhesions. It hurts to go to the toilet, the lower abdomen hurts both constantly and in surges.
- Hematoma. May occur on the abdomen after an open removal procedure.
- Discharge. The ichor comes out. A sign that the ovaries continue to work, and the cervix is under pressure from sex hormones. Developed thrush indicates an infection; a doctor’s help is needed.
- Breast. It may swell and ache. The mammary glands are also subject to diagnosis.
- Temperature. It may increase slightly. Usually on the first day. At this time you need to be under the supervision of doctors.
- Bleeding. In some cases it can last for several weeks. If blood loss is already significant, there is a reason to consult a specialist.
- Cystitis. A burning sensation in the perineum when urinating is not uncommon. It cannot be called a disease, since the condition passes quickly.
If a woman is diagnosed with cervical cancer (oncology), they resort to radiation therapy, after which hair falls out.
Radio irradiation cannot be the only treatment, so the course of medication must be completed. Having completed therapy, the woman needs peace and competent care. There are many contraindications, but there are also many advantages. Irradiation is one of the most unpleasant disadvantages of therapy; hair loss is often observed.
Nutrition for oncology should be selected by a doctor. If metastases are started, chemotherapy begins.
Total hysterectomy is rarely performed and requires serious reasons (cancer, large tumor).
Pericultitis may also occur, especially after 60 years of age, which can be successfully treated with Trichopolum and similar drugs. In any case, you need to consult a doctor and undergo tests.
Complications after removal
There are some complications, if they develop, you need to immediately go to the doctor or call an ambulance.
We are talking about conditions such as:
- Heavy bleeding.
- Festering stitches.
- Inflammation in the perineum (lymph nodes).
- Intense pain.
- Disturbed urination.
- Redness in the lower leg area (development of blood clots).
All complications after removal of the uterus are caused by physiological processes, since the functioning of the bladder and intestines is disrupted. Typically, the pelvic floor muscles become weak and cannot support the vagina as before. For this reason, Kegel strengthening exercises or vaginal tightening procedures are recommended after a hysterectomy procedure.
Resection of the uterus is a generally safe and fairly common operation, but after the procedure, urinary incontinence, vaginal prolapse and hemorrhoids, bladder prolapse, fistula formation, and regular pain may occur.
Late complications are cultitis and mastopathy. Usually appears 30 days after the procedure to remove the organ. Accompanied by pain (joints) and discharge.
Lymphocyst is a terrible complication. It is diagnosed at stage 3, so treatment is long, sometimes without results.
Only the attending physician can give a prognosis after examination and consultation.
Most patients are frightened by such a procedure, so they deliberately delay the removal process. It is important to understand that ignoring the problem will not solve the problem, but will only worsen the consequences after surgery.
Intimate life and sex
If the uterus was amputated without removing the ovaries, then the hormonal system does not fail. Consequently, libido remains as before, and sensations during sex are similar to previous ones. Intimate life will be normal.
When the uterus and ovaries are removed, the desire may fade a little or disappear. Everything will be restored later, when the course of drugs is completed.
Sexual life after removal of the uterus usually does not change, the only difference is the ability to feel arousal. With any gynecological pathology, the arousal function is impaired. As a rule, this is temporary.
An examination by a gynecologist should take place one month after extirpation. The doctor will evaluate the internal condition of the vagina and make recommendations.
It is possible that the first time you have sex will be uncomfortable. There is no need to be afraid of this, because over time it will return to normal.
The organ inside is removed, the clitoris remains. Therefore, a man should carefully and slowly relax his partner so that she does not feel pain.
Menopause after hysterectomy
Menopause in women that occurs after a hysterectomy is considered a long-term consequence. It must be remembered that if the uterus is removed without appendages, then menopause will occur as it should be genetically.
According to statistics, it turns out that menopause after surgery will occur 5 years earlier than expected.
There is no specific justification for this phenomenon, but it is believed that the blood supply to the ovaries after the removal of the organ begins to malfunction, and this affects the hormonal system.
To understand the problems of menopause, it is important to know the terms that doctors use.
- Natural menopause(cessation of menstrual cycles due to fading of the functioning of the gonads).
- Artificial menopause(cessation of menstruation due to removal of the uterus or suppression of ovarian function with the help of hormonal drugs Remens).
- Surgical menopause(Removal of ovaries and uterus).
The onset of surgical menopause is difficult to bear. This is caused by the inability of the ovaries to produce hormones. As a rule, the process of reducing hormones lasts several years.
When the uterus and appendages are removed, the body undergoes global changes. The consequences will be more serious if the woman could still give birth.
Symptoms of this menopause are noticeable a couple of weeks after surgery. First of all, hot flashes and sweating are of concern. They are followed by emotional lability and changes in appearance (withering skin, brittle nails). There is urinary incontinence and vaginal dryness. Bladder problems are a complaint of many.
If the uterus and ovaries are removed, then hormone therapy takes place. This is especially true for young women under 50 years of age. Estrogens (Divigel) and gestogens are usually prescribed.
It happens that the cavity is removed due to the development of large fibroids, then the woman must take not only pills, but suppositories with pills.
Hysterectomy with appendages performed against the background of endometriosis requires treatment with estrogen. As a rule, taking medications begins 30-60 days after the procedure. Hormone therapy reduces the risk of heart pathologies and osteoporosis.
But it is worth taking into account individual characteristics; such treatment is not prescribed for everyone. You should not start taking medications if you have:
- Breast cancer.
- Surgery (uterine or cervical cancer).
- Thrombophlebitis.
- Pathology of the kidneys and liver.
- Meningioma.
Treatment with HRT lasts for a long time - from two to five years. For example, with the drugs Femiton Feminorm, Femoston.
You should not expect rapid improvement during postmenopause and the disappearance of climatic manifestations.
Adhesions after surgery
Any operation on the abdominal cavity and within it is accompanied by the development of adhesions. Adhesions after surgery to remove the uterus are cords that connect the peritoneum and internal organs. They are also located between the organs inside.
After a hysterectomy, about 90% of the female population experiences a similar condition, the cause is unknown.
The process of development of adhesions after removal of the uterus depends on several factors:
- Duration of the procedure.
- Volume of operation.
- Loss of blood (leakage, bleeding).
- Development of infection after surgery.
- Genetics.
- Asthenic physique.
If after the operation you feel pain, aching in the lower back, difficulty urinating and constipation, then it is likely that this is a signal of adhesions.
To prevent their occurrence, antibiotics, anticoagulants, and physiotherapy are prescribed. Rehabilitation must be arranged competently; this is the only way to avoid unpleasant consequences.
Treatment after surgery
Antibacterial therapy is prescribed mainly for prevention, since the organs have had contact with air. This means that infectious agents could get inside. The course of treatment is a week.
Anticoagulants are allowed in the first days after surgery. They are able to thin the blood, protect against the formation of blood clots and the development of thrombophlebitis. Intravenous medication is given on the first day after surgery. This replenishes blood loss.
HRT with the uterus and ovaries removed is important for a woman. The drugs will help normalize imbalances and support the body. Hormone replacement therapy is important, otherwise the system will fail extensively, after which all body functions will fail.
If after removal of the uterus the condition does not worsen and no symptoms appear, then the postoperative period is considered easy. You can judge further consequences by the first week. Without an ovary in the first 3 days after the procedure it will be more difficult than with the removal of one uterus.
After amputation of the uterus, you need to take painkillers.
Recovery period
Postoperative replacement therapy is aimed at restoring water balance and preventing inflammation.
The support of the patient is important, so you need to pay attention to the psychological aspect. Any operation brings stress to the body, and intervention in gynecology is a serious shock.
A woman must adhere to a diet - do not eat foods that irritate the mucous membranes.
It is necessary to remove from the menu such drinks and food as:
- Chocolate.
- Cottage cheese.
- White bread.
To get your intestines back on track, you should eat often, but in small portions. Water consumption – up to 4 liters per day.
It is allowed and approved to eat porridge and drink meat broths. The main thing is to stick to the diet that the doctor prescribed for the first days after discharge.
During the rehabilitation period after surgery to remove the uterus and ovaries, you should not put stress on the body. You cannot lift more than 5 kg. Physical exercises and gymnastics are allowed to be performed only after the stitches have completely healed.
Most doctors advise after surgery (on the 3rd day) to get up and slowly walk if your legs don’t hurt. Such a load will speed up the blood, and recovery will go faster. In addition, 30 days after abdominal surgery it is allowed to pump up the press.
A hysterectomy often changes a woman's lifestyle.
For a quick and successful recovery, experts recommend:
- If the course of the postoperative period is smooth, you need to continue to engage in prevention aimed at the occurrence of long-term consequences, then changes in the body will be minimal.
- Bandage. Is a good help. Women whose abdominal muscles are weakened even without surgery should wear a bandage. There is more than one type of corsets of this type. You need to choose the one with less discomfort. The main thing is that the width of the “accessory” should be 1 cm above and below the scar.
- Sex after hysterectomy. It is better to refrain from intimacy. Your doctor will tell you when you can have sex. Each woman is individual, and sexual life begins when the patient herself feels it. If you left the ovaries, then you don’t have to worry about libido. Sexual rest is necessary for a long time. When intimacy begins, you need to protect yourself so as not to introduce a new infection.
- gravity. Until the seam is healed, you should not lift weights exceeding 5 kg. This is fraught with suture divergence and repeated visits to doctors. The doctor's testimony must be taken into account from beginning to end.
- Discharge. After removal of the uterus, they will last 1-1.5 months. During this period, it is advisable not to lift anything heavier than a plate, otherwise there is a high risk of bleeding inside the peritoneum. Hygiene must be maintained.
- Gymnastics and exercises. To strengthen the vaginal muscles, you should perform exercises using a special exercise machine (perineal gauge). It is this that provides the effect of intimate gymnastics. It is also recommended to perform Kegel movements, which are also aimed at strengthening the vaginal muscles.
- Sport. This means yoga, Pilates, shaping, swimming, fitness. You can think about classes only after 90 days from surgery. And then provided that there were no complications. You can play sports, but only light physical activity. If you want to spin a hoop, you definitely need to talk to a doctor.
- After a hysterectomy, for 60 days you cannot take baths, use tampons, douche, go to a sauna or bathhouse, or swim. If there is any discharge, it is necessary to use only pads.
- Nutrition. A proper diet is important after surgery. To prevent constipation and bloating, you need fluid and fiber. These are vegetables and fruits in any form. You cannot drink strong tea or coffee drinks. Alcohol is strictly prohibited; it also has the ability to provoke bleeding. A woman should receive the bulk of her calories before lunch. You should also remove fatty, smoked and fried foods from the menu. Vitamins and regimen are required.
- Sick leave. The average period of incapacity for work is 40-45 days. This is relevant if not, and there were no complications. If they are available, the sick leave is extended. During this period, at least 2 ultrasounds should be done. Doctor's supervision is required.
- A tan. You shouldn't hide from the sun, but it's not recommended to sunbathe on purpose. You can go to the sea, but you shouldn’t swim, it’s better to walk along the shore. A trip to a sanatorium, where the woman will be provided with a therapeutic massage, will be told what prevention against complications is, and, if necessary, will be given compression stockings, will not hurt.
Forecast
Many people do not know that a hysterectomy is a cause of disability. This depends on the extent of the procedure, the reason for removal and any complications encountered.
It happens that a disability group is assigned, but only for 1 year. If you want to extend it, most likely there will be a refusal. There are no options for lifelong disability for this operation.
Hysterectomy is a surgical procedure aimed at removing the uterus with or without appendages. As a rule, this surgical procedure is prescribed only in extreme cases when there is a strong threat to the woman’s health or life. However, before making a responsible decision, the patient should think carefully about everything and find out what the consequences of removing the uterus may be.
According to statistics, such an operation is not uncommon among women over 40 years of age. But there are also alternative measures when, if surgical intervention is refused, the patient needs to undergo drastic lifestyle changes. True, this is only possible in situations where there is no threat to the woman’s life.
Consequences that occur as a result of surgical intervention to remove the uterus and ovaries
Often, health workers claim that amputation of the uterus will not cause any problems for a woman, but in fact this is not the case at all. What are the consequences of removing this organ:
- Loss of fertility. Unfortunately, any patient who has had her uterus removed is forever deprived of the opportunity to bear and give birth to a child, since the fetus grows and develops only in this organ.
- Problems of a psychological nature. Often, women who have undergone this operation experience such abnormalities as emotional breakdowns, expressed by increased anxiety, irritability and depression.
- In addition, they experience fatigue and frequent mood swings. Often, women who have had their uterus removed are very worried about what happened, and may also experience a feeling of loss and uselessness. These torments are fertile ground for the emergence of complexes.
- Decreased libido or complete loss of libido. This doesn't happen to all women, but it still happens quite often. Such changes are due to changes in hormonal balance that resulted from the operation.
- The likelihood of health problems. Often, due to the operation, the possibility of the following difficulties increases: pain during intimacy, osteoporosis and prolapse of the vaginal walls. Menopause during removal of the uterus and appendages. This is due to the fact that as a result of the absence of ovaries, the production of estrogen stops. After surgery, normal hormonal levels in the body are completely disrupted. As a result, all its systems begin to adapt to functioning without estrogen. An abrupt onset of menopause is quite difficult to bear.
- Unpleasant symptoms occur just a few days after the operation. Women who have not yet reached the age of forty suffer especially from such manifestations. To combat such unpleasant consequences, health workers prescribe estrogen replacement agents.
- The appearance of adhesions, which is almost inevitable during any operation, and can cause constant pain.
- Urinary incontinence after hysterectomy. As a result of the operation, the muscles that are responsible for supporting the bladder are weakened. Accordingly, some women may develop enuresis.
Aesthetic defect. Of course, after a hysterectomy, a rather unsightly scar remains in the area of the surgical suture. True, modern cosmetic procedures can make it as invisible as possible.
As a result of such surgery, there will be no significant hormonal changes, since the appendages continue to work. Therefore, after the operation, the ovaries will also produce estrogen as before. Since there are no hormonal disruptions, libido remains at the same level.
However, even if the uterus was removed without appendages, there is a high probability that premature menopause will occur. This occurs because blood flow to the pelvic area decreases.
Possible postoperative complications
No one is immune from the occurrence of various complications after surgery performed to remove the uterus. The most common problems in the early postoperative period are as follows:
- Inflammation of the surgical suture, which results in redness, swelling, suppuration of the wound, and possible suture separation.
- Infection of a postoperative scar. The first sign is an increase in body temperature, usually no higher than 38 °C. Basically, the procedures that are carried out to process the seam are enough to stop this process.
- Difficulty urinating. If the uterus is removed and the mucous membrane located in the urethra is damaged, this becomes the cause of traumatic urethritis. As a result, when emptying the bladder, painful and unpleasant sensations, as well as cramps, occur.
- Bleeding, which is a consequence of a poorly performed operation.
- Pulmonary embolism. A very dangerous complication that can lead to blockage of the artery, and this can cause pulmonary hypertension, pneumonia, and in the worst case, death.
- Peritonitis. An inflammatory process in the peritoneum that spreads to nearby organs. If measures are not taken in time, sepsis may develop. This process is characterized by a sharp deterioration in the patient’s general condition, the temperature increases and reaches 39-40 °C. The woman is in severe pain. Treatment is carried out with antibiotics, and if there is no result, the stump that remains from the uterus is removed and other medical procedures are performed.
- Hematomas in the area of surgical sutures.
Women who have had their uterus removed need to carefully monitor the condition of the body so as not to accidentally miss a complication that appears. For some time after the operation, the woman must be under the supervision of doctors, but problems may arise even after discharge.
Adhesive processes
When removing the uterus, the consequences are varied, since this is a rather complicated surgical procedure. One of the inevitable postoperative problems is the appearance of adhesions. After the procedure, they are observed in most women. Adhesions are connective tissue that joins the membranes of various organs together. The occurrence of adhesions is caused by many factors:
- Duration of the operation.
- The extent of the surgical intervention (the larger the damaged area, the greater the likelihood of adhesions).
- Blood loss.
- The presence of internal bleeding and even a slight leak of blood, which, when reabsorbed, becomes an impetus for the formation of adhesions.
- Suture infection.
- Genetic predisposition.
- Thinness and thin bones in a woman.
The main manifestations of adhesions are expressed in the form of pain in the lower abdomen, disorders in the processes of urination and defecation, as well as disruptions in the gastrointestinal tract.
To minimize the risk of adhesions, antibiotics and anticoagulants are prescribed. Physical activity and physical therapy are also indicated.
Correctly carried out rehabilitation in women who have had their uterus removed will significantly reduce the likelihood of adhesions and other possible complications.
Menopause after hysterectomy
- In a situation where only the uterus must be removed, but the ovaries are preserved, menopause does not occur. The appendages continue to function normally and produce the necessary hormones. However, according to statistics, menopause in such women occurs on average five years earlier. In general, menopause can be classified into several types:
- Natural, in which menstruation stops as a result of the slow decline of the function of producing hormones by the sex glands.
- Artificial menopause, characterized by the cessation of menstruation as a result of medication or surgery.
Surgical menopause, which occurs when both the uterus and ovaries are removed.
It is the latter type that is most difficult for women, especially those who have not reached 50 years of age. This is due to a sudden, rather than gradual, cessation of hormone production. Menopause after removal of the uterus and appendages is inevitable. At this moment, complex processes of hormonal changes will occur in the woman’s body.
- Just a few days after surgery to remove the uterus, a woman may experience the first manifestations of surgical menopause, expressed as:
- Increased sweating.
- Frequent mood swings.
- Quite often, blues and depression appear.
- The skin begins to fade faster and becomes noticeably dry.
- Nails become more brittle and hair falls out.
- Possible urinary incontinence when coughing or laughing too much.
- Deficiency of natural vaginal lubrication, causing difficulties in the sexual sphere.
- Decreased sexual desire.
If the uterus is removed together with the ovaries, then proper hormone replacement therapy is necessary. For women over 50, it is no longer so relevant, but younger patients definitely need it.
Surgical menopause after surgery is regulated by hormonal drugs for more than one year. Don't expect improvement to happen instantly. The unpleasant symptoms that bother the woman will disappear gradually.
What after the operation?
Often, patients who have undergone such surgery experience severe psychological stress, which leads to emotional problems. Often a woman simply does not understand: how to live after removal of the uterus?
Patients are tormented by many doubts and questions. And the most dangerous problem is that they often cease to feel like women due to amputation of the uterus. Of course, this is completely wrong, since it is not only the presence of this organ that determines human essence. At this moment, the understanding and support of your spouse is very important.
Women's far-fetched fears. Fears that do not have any sufficient basis include fear of facial hair, weight gain and a change in voice timbre. The woman certainly does not face such consequences.
As for decreased libido, this can occur as a result of hormonal imbalance during removal of the uterus and ovaries.
In addition, women often wonder: how long do they live after hysterectomy? Fortunately, this operation does not in any way affect life expectancy. This means that a woman, having recovered from surgery, can return to normal existence.
Long-term consequences
We have already looked at what the consequences are after removal of the uterus, but there are also long-term problems. These include the possibility of developing osteoporosis in the future, to which women are more often susceptible, and vaginal prolapse.
The first problem arises as a result of decreased estrogen production caused by hysterectomy or age-related reasons. This disease is dangerous because calcium is washed out of the bones. Accordingly, the bones become thinner and more fragile, which is fraught with frequent fractures. In addition, osteoparosis is insidious and often occurs secretly, so it is diagnosed already at an advanced stage. Preventive steps against this disease in case of removal of the uterine cavity and appendages is the prescription of hormonal drugs. In addition, moderate physical activity and introducing more foods high in calcium into a woman’s diet would be helpful.
The second long-term complication after surgery to remove the uterus may be vaginal prolapse. To minimize the possibility of such a problem, you need to avoid excessive loads, do Kegel exercises and try not to lift heavy objects, which can also cause a hernia.
Pros and cons of hysterectomy
This surgical intervention has both disadvantages and advantages. If the uterus was removed, the positive consequences are expressed as follows:
- Stopping menstruation.
- The possibility of intimacy without contraceptives and the constant fear of unwanted pregnancy.
- Problems caused by female diseases disappear.
- You are not at risk of cancer associated with the organ being removed.
And the negative aspects of hysterectomy include:
- Physical discomfort and emotional instability after surgery.
- A scar on the abdomen.
- Painful sensations in the pelvic area during the rehabilitation period.
- Lack of intimacy while the body recovers.
- Inability to get pregnant after removal of the uterus.
- The occurrence of early menopause.
- Possibility of vaginal prolapse and osteoporosis.
Who is a hysterectomy indicated for? The main objective of uterine amputation is to eliminate its diseases. Such an operation is a last resort if all previously tried methods did not bring the expected result.
How to get ready for surgery
Often, a woman who has serious indications for a hysterectomy is afraid to make a responsible decision, not imagining life after removal of the uterus. The most important thing in this situation is not to panic and try to maintain positive psychological attitudes. A woman should have complete confidence in her attending physician and in the fact that her body, after surgery to remove the uterus, will function as smoothly as before.
In addition, during this period, support from family and friends, especially from your beloved man, is more important than ever. In addition, before making a final decision about surgery to remove this organ, you need to find out what life is like without a uterus by reading the stories of women who have already gone through this. It is also important to evaluate all the pros and cons, familiarize yourself with all the consequences, so that later they do not become a complete surprise.
In general, hysterectomy surgery has more disadvantages than advantages. But in situations where this is the only possible solution, surgical intervention is still better, rather than risking life. And after a short period of time after the operation, with the sensitive guidance of health workers, the woman’s life will return to normal.
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