Therapeutic exercises after removal of the uterus and ovaries. Kegel exercises after hysterectomy

Hysterectomy is one of the most common gynecological operations, which involves the complete removal of the uterus. Chronic severe pain, diagnosis of a malignant tumor, severe bleeding - all this can be the reason for such an operation.

If it is possible to stop uterine bleeding by other methods, they try not to perform a hysterectomy. In addition to the uterus, the ovaries, part of the vagina, fallopian tubes, and cervix can be removed. Much depends on the indications for surgery and the severity of the disease.

The main indications include:

Malignant tumors. Tumors arising in the female genital organs.
Myomas. These growths are not cancerous, but can cause pain, bleeding and general discomfort.
Endometriosis. This is a disease in which tissue from the uterus spreads beyond the uterus, causing cramps, infertility, and periodic bleeding.
Chronic pain. Women often suffer from constant pain in the lumbopelvic region. If they cannot be diagnosed and other treatment prescribed, surgery becomes the only option.
Hemorrhage. In rare cases, it becomes a consequence of cesarean section. Heavy bleeding can only be stopped with a hysterectomy.
Uterine prolapse. and its loss occurs due to the fact that the muscles that hold the uterus lose their elasticity.
Chronic bleeding. Bleeding due to anemia or a general decrease in quality of life.

Consequences of hysterectomy

After removal of the uterus and ovaries, the female body stops producing hormones. Therefore, they have to be taken in tablet form. Long-term use of tablets supports the functioning of the body and gives vitality.

About a week after surgery, women develop post-castration syndrome, which can last up to 25 days. This difficult period in the life of patients is characterized by:

Heart rhythm disturbances.
Violation of the vegetative-vascular system.
Strengthening the work of the sweat glands.
Mental disorders accompanied by nervousness and insomnia.

Three years after a hysterectomy, osteoporosis may develop (due to a lack of estrogen, calcium is quickly washed out of the body) and cystitis.

In some women, such consequences appear only 5-6 years after surgery. Sometimes periodontal disease can develop if the tissues are poorly restored. When performing an operation before the onset of menopause, one should expect the maximum manifestation of negative consequences, since the natural functioning of the body is disrupted. Menopause may occur prematurely. One of the main consequences of a hysterectomy is the inability to become pregnant.

Despite all the negative consequences of removing the uterus and ovaries, many women note an improvement in their quality of life. Former patients are not bothered by pain and bleeding, nor are they concerned about pregnancy. Patients who have already reached menopause and have children can achieve a positive attitude.

Some women, after some time, have their ovaries removed after the uterus due to the risk of developing cancer. But easier operations are also performed to remove one uterus or excise it. Such an operation can lead to prolonged depression. Women are constantly depressed, feeling their own inferiority.

After a partial hysterectomy, one should expect premature menopause, the formation of adhesions, urination problems, and the development of venous thrombosis. After removal of the uterus, disruptions in the blood supply to the ovaries are observed. Therefore, they cannot function stably.

Carrying out an operation abroad

Modern Russian medicine does not reach the level of foreign medicine. Therefore, many doctors refer patients to have a hysterectomy abroad - in Israel or Germany.

Depending on the indications, the following types of operations are performed abroad:

Radical hysterectomy is the removal of the uterus, cervix and all appendages.
Amputation of the uterus with preservation of the cervix and appendages.
Extirpation is the removal of the uterus with the cervix without appendages.
Hysterosalpingo-oophorectomy involves cutting out the uterus and fallopian tubes.

In Israel, Germany and other foreign countries, operations are performed through the abdominal wall or vagina. Laparoscopy is possible.

The latest surgical equipment is used for hysterectomy. The presence of robotics allows for more accurate and safe operations.

Many patients prefer to be treated abroad also because they can undergo special training before surgery. The best psychologists work with patients and make them feel positive. A positive attitude plays an important role in the successful completion of the operation. In Russia, a similar method of preparation for surgery is not used.

After the operation, the woman must spend at least two weeks in the hospital. 6-8 days after the hysterectomy, the staples are removed from the stitches. The healing process directly depends on the physiological characteristics of the body.

In the postoperative period, special attention should be paid to rehabilitation aimed at restoring normal water and blood balance. The duration of rehabilitation may vary depending on the surgical methods and indications.

Hormone replacement therapy

It is of particular importance for patients who are in the premenopausal period. Taking hormonal medications can delay the onset of menopause and help improve overall well-being.

Within two days after removal of the uterus and ovaries, testosterone levels decrease several times. But this hormone is very important for the female body, as it helps regulate the ratio of muscle and fat mass in the body. It is because of its lack that women often gain weight after a hysterectomy. Testosterone is also responsible for sexual attraction to a partner. Doctors recommend replenishing hormone levels by taking specially formulated supplements that contain testosterone and estradiol.

Hormone replacement therapy is usually prescribed for a period of 5 years after surgery.

Medications

The deficiency of estrogen in the female body can be compensated for by a drug such as Estrimaks in tablet form. It contains estradiol, identical to that produced by the ovaries. Estrofem tablets have a similar effect.

Feminal is considered no less effective. It helps to delay early menopause and alleviate the general condition of the body after removal of the uterus and appendages. Divigel is suitable for external use. It refers to progestin drugs that stimulate estrogen cellular receptors. It is recommended to use Divigel for osteoporosis and thrombophlebitis (after hysterectomy).

Kegel exercises

Exercises are prescribed to strengthen the muscles and ligaments of the pelvic floor. Therapeutic exercises help solve problems associated with urination and defecation. Before performing Kegel exercises, be sure to empty your bladder. They are performed in a sitting, standing or lying position.

The essence of Kegel gymnastics is to periodically tense the muscles of the pelvic area. But the abdominal and buttock muscles should be in a relaxed state. At first, the duration of the period of muscle tension should not exceed 3-4 seconds. Then comes the relaxation phase, which lasts 5 seconds. As your muscles strengthen, you can maintain tension for up to 7-10 seconds at a time. Breathing should be calm - no deep inhalations or exhalations during exercise.

Diet

To lose weight after hysterectomy, it is recommended to follow the following nutritional rules:

Drink a large amount of clean drinking water up to 3.5-4 liters.
It is necessary to eat small portions 5-6 times a day at regular intervals.
The calorie content of dishes should be increased gradually.

The following foods should be included in your diet:

Boiled meat and broth (lean beef and chicken).
Low-fat fermented milk products.
Puree vegetable puree.
Fresh fruits, except pomegranate and grapes.
Green tea and crumbly cereals, which have a beneficial effect on intestinal motility.

Prohibited products include:

Liquid porridge and jelly.
Cocoa and chocolate, strong coffee.
Smoked, fatty and salty products.
Alcohol.
Bean products.
White bread, rich pastries.
Cottage cheese with high fat content.

It is necessary to consult a doctor to prescribe a special diet. Deviation from proper nutrition can lead to postoperative complications.

Despite popular belief, removal of the uterus and ovaries does not have a significant impact on sex life. Women are very worried that they are losing their sexual attractiveness and may even become depressed. But that's not true. Patients can fully expect to have a fulfilling sex life and enjoy sexual intercourse. This type of surgery does not change the ability to have orgasms.

Doctors recommend abstaining from sex for 7-8 weeks after surgery. After this time, sexual intercourse will no longer cause unpleasant and painful sensations. But at first it is better to use lubricant, since the operation leads to increased vaginal dryness.

The postoperative period, as a rule, can take from three months to a year. Such an operation is no longer uncommon today, but still scares many. But, unfortunately, sometimes this is the only correct way to preserve the health and life of a woman.

For what indications is hysterectomy required?

What could be an indication for this operation? There are several main reasons, and all of them are quite serious and can be fatal to a woman. This is primarily ovarian and uterine cancer. Very often, this female organ is surgically excised for fibroids, fibrosis (benign tumor), and less often for endometritis. In rare cases, the uterus is removed after childbirth, for example, if there is severe bleeding caused by injury or infection.

Removal of the uterus: postoperative period

After the operation, the woman will spend two weeks in the hospital. About 5 to 8 days after your hysterectomy, your doctor will remove the staples from the incision. The healing process and its speed depend on the physiology of each patient. After the uterus has been removed, the postoperative period requires therapy aimed at restoring blood, water balance in the body and preventing inflammatory diseases. They also be sure to pay attention to the woman’s psychological mood, because any operation is stressful, not to mention gynecological surgery. A sick leave certificate is required for recovery after hysterectomy for up to 45 days.

Rehabilitation after hysterectomy

The attending physician will definitely tell the patient and her relatives what she needs to eat and what foods will contribute to a quick recovery. The diet of a woman who has undergone hysterectomy is strictly outlined during the postoperative period. Strong tea, chocolate, coffee, cottage cheese, and white bread should be excluded from it. In order for the intestines to work again after surgery, a woman needs to eat fractionally, up to 7 times a day. Water consumption should be increased to 4 liters per day. It is also necessary to include in the menu dishes that help weaken the intestines (meat broth, porridge, fermented milk products). The main rule: follow the diet prescribed by your doctor.

Recovery after hysterectomy should eliminate or minimize stress - you should not lift objects weighing more than 5 kg. You can return to your normal lifestyle only after the stitches have completely healed. By the way, most experienced doctors advise women to get up the very next day after a hysterectomy. Such physical activity will not allow the blood to stagnate, and therefore the healing process will occur faster.

Complications that may result from hysterectomy

The postoperative period, which takes different lengths for women, may be accompanied by some complications. Pain of varying intensity may occur due to bleeding or adhesions. Such symptoms are characteristic, as a rule, only for the first days after surgery. More serious consequences of the procedure can be thrombosis of the deep veins of the legs, suppuration of the suture, disturbances in urination and bowel movements, and hematomas. Often after such operations, a woman may experience all the symptoms of menopause: decreased libido, vaginal dryness, sudden changes in mood. But such complications are quite rare, they are not the rule. Patients may also develop atherosclerosis and osteoporosis.

In what cases should you urgently visit a gynecologist?

After a hysterectomy, there may be some slight bloody discharge. If the following factors are present, you should urgently visit an antenatal clinic:

Vaginal discharge has an unpleasant odor.
They have the color of rot mixed with blood.
Nausea.
Urinary incontinence.
Large clots of blood are discharged from the vagina.
There is a need to change gaskets many times within an hour.
Bright red vaginal discharge.

Collapse

Removal of the uterus and appendages is perhaps one of the most serious and difficult operations in gynecology. It can cause quite a lot of complications, and in addition, it is characterized by a long and difficult recovery period, during which various restrictions apply to many areas of life. But it is precisely careful adherence to the doctor’s recommendations at this stage that can significantly speed up recovery from the disease, recovery after the procedure and improve the quality of life. This material describes how the postoperative period goes after removal of the uterus, what features it has, and what recommendations should be followed at this stage of treatment.

Duration

How long does the patient’s rehabilitation actually take after such an intervention? To some extent, this is influenced by its method and volume. For example, if the uterus and appendages were removed, then the recovery period can be up to two months, and if only the organ cavity itself, then up to six weeks or one and a half months.

It is customary to distinguish between early and late rehabilitation periods. By early we mean the first three days after surgery, with the first 24 hours having the maximum value. By late we mean the entire remaining period - up to one and a half to two months.

Fast recovery

How to quickly recover after hysterectomy? There are no express methods of recovery after this intervention. This intervention is quite serious and extensive, accompanied by hormonal changes in the reproductive system. And also, the symptoms of the disease that required amputation of the organ have their own effects. Therefore, the recovery period after removal is normally long and is accompanied, to the greatest extent in the first weeks, by a deterioration in well-being.

Taking into account the individual characteristics of the body, recovery after removal of the uterus can go a little faster or a little slower, but there will still not be a significant difference. And even if your health improves after 2-3 weeks, this does not mean that you should stop following the doctor’s recommendations.

Within 24 hours after the laparotomy was performed, it is necessary to maintain bed rest. It takes a lot of time just to come out of anesthesia. You shouldn't sit down or get up, even to go to the toilet. Although by the end of the first day, carefully, with the help of your hands, it is already acceptable to turn over on your side. Only liquid food is allowed.

First 72 hours

Over time, it is necessary to increase physical activity. At this stage, the patient should already be half-sitting in bed, getting up to go to the toilet, and turning over on her side. You should still eat liquid and semi-liquid food, and by the third day, begin to include easily digestible regular food. It is important to control your bowel movements to avoid constipation and gas formation.

These days, treatment is already being carried out after removal of the uterus - broad-spectrum antibiotics are taken to avoid infection.

It is necessary to pay attention to your general condition - a high temperature after the procedure at this stage may be a sign of an inflammatory process.

One and a half to two months

About a week after the abdominal surgery was performed, antibiotic treatment ends. Often, at this stage, hormone treatment may be prescribed to facilitate menopause (if the ovaries are removed). At the same stage, consultations with a psychologist are prescribed, if necessary.

The patient can eat regular food, but it is important that it is healthy and natural and does not cause constipation or gas. Bed rest is moderate during the first two weeks. Then it can be canceled, but physical exertion should be avoided.

Rehabilitation after hysterectomy excludes saunas, steam baths, and any overheating. You cannot swim in natural bodies of water; you can maintain hygiene using a shower.

What should you do at this stage? It also depends on the type of intervention. Depending on it, the patient may be given additional instructions for rehabilitation.

Subtotal hysterectomy

Perhaps the simplest procedure is hysterectomy, with a short postoperative period. With such an intervention, only the body of the organ is removed, the neck and appendages remain unaffected. The duration of the rehabilitation period is about one and a half months, the scar is small, hormonal treatment is not required.

Total hysterectomy

The uterus and cervix are removed, without appendages. The duration of the recovery period is approximately the same; you can return to sexual activity no earlier than after two months. Hormonal treatment is also not required.

Hysterosalpingo-oophorectomy

Not only the body of the organ is removed, but also the appendages - the ovaries and fallopian tubes. Extirpation of the uterus and appendages is a fairly difficult operation, requiring a long, up to two months, rehabilitation period. Scheme of the procedure in the photo in the material.

Radical hysterectomy

The entire organ is removed. Rehabilitation has the same features as for total hysterectomy.

Intimate life

During the entire recovery period after hysterectomy, it is advisable to abstain from intimate life. Although in many ways this can only be determined based on the method by which the intervention was carried out. For example, if only the uterine cavity is removed and the vagina and cervix are completely preserved, doctors allow you to resume sexual activity after a month or a month and a half. If the cervix and upper third of the vagina were removed, the period of abstinence may be longer, since the suture may be injured after the intervention.

Thus, during the first five weeks, sex is prohibited. After this period, you should consult with a specialist on this issue. This is true for any time that has passed after abdominal surgery to remove the uterus - consult your doctor before resuming sexual activity.

Sport

When can you exercise after a hysterectomy? This question can only be answered taking into account the type and intensity of loads. During the initial stages of recovery after the procedure, any physical activity should be kept to a minimum. After the first week of rehabilitation, therapeutic exercises can be added, which prevents the formation of adhesions, etc. After completing the full rehabilitation period, you can again engage in gymnastics and aerobics in moderation and without excessive loads and strength exercises.

You can also start doing fitness no earlier than 2 months after the intervention, and only with the permission of the attending physician. As for professional sports and bodybuilding, the time to start such exercises must be discussed with the doctor separately, since the nature of the load, the nature of the intervention, the speed and characteristics of healing play an important role.

Example of a daily routine

Rehabilitation after surgery is faster with the correct daily routine. You need to sleep more - in the first 7 days after the procedure you need to sleep as much as you want. Then it is recommended to sleep for at least 8 hours, but you can’t sleep for more than 10 hours either, since at this stage you shouldn’t lie down too much. Physical activity is needed to avoid blood stagnation and the formation of adhesions. That is, bed rest should still be observed, but not excessively - taking into account sleep, you should spend 13-15 hours a day in bed, the rest of the time it is better to sit, walk, and do simple, non-stressful household chores.

Starting from the second week, walks are shown. At first, short ones - 15-20 minutes each. Over time, their duration can be increased to one hour in good weather. Every day you need to do therapeutic exercises for 10-15 minutes.

Diet example

As already mentioned, for the first three days it is better to eat fairly light food - natural vegetable broths and purees. Then you can gradually introduce food of normal consistency, and by the end of 5-6 days the patient should switch to a general diet. Although food should meet the requirements of a healthy diet, it is necessary to avoid fried, fatty, canned, smoked, and also sweets, preservatives and dyes. For example, the diet could be like this:

Breakfast – rolled oats porridge, egg, black tea;
Late breakfast – fruit, cottage cheese;
Lunch – soup with vegetable or chicken/meat broth, lean beef with rice, rosehip broth;
Afternoon snack – vegetable/fruit salad or yogurt;
Dinner – white fish with fresh or stewed vegetables, tea.

In general, after surgery to remove the uterus, you must adhere to the rules of a healthy diet, eat small meals, and do not overeat. The calorie content of the diet should remain at the same level.

Consequences

Consequences after removal of the uterus in the recovery period are possible if the rules for its passage are violated, as well as with certain characteristics of the body. For example, complications may arise such as:

Depression, nervous breakdowns, other complications of an emotional and psychological nature;
Bleeding due to poor healing of sutures or stress on them;
Suture endometriosis is a condition in which the endometrium begins to form on the peritoneum (extremely rare);
Infection of the blood or peritoneum, neighboring organs during the operation manifests itself precisely during this period;
Long-term and persistent pain syndrome that develops when nerve trunks are damaged;
An inflammatory process, temperature after removal of the uterus is a sign of it;
Attachment of viruses and infections, fungi, as a result of reduced local immunity;
Some deterioration in the quality of sexual life, which usually disappears after hormonal therapy;
Decreased libido, which is also regulated by hormones;
Possible problems with the intestines, constipation;
Symptoms of early menopause when not only the cavity is removed, but also the ovaries.

Moreover, after abdominal surgery, which was performed under general anesthesia, complications after anesthesia can always arise. But they appear already in the first 24 hours after the procedure.

Conclusion

Regardless of the method used to remove the organ, a properly conducted recovery period is no less important than careful preparation for the intervention and its high-quality implementation. It is now that healing occurs, and it depends on it whether the patient will be bothered by the consequences of this intervention in the future. For example, if the postoperative period after removal of the uterus is carried out correctly, then adhesions will not form, which can subsequently cause pain, the scar will smooth out more or less aesthetically, etc.

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Treatment of gynecological diseases is aimed at maximizing the health and reproductive functions of women. But in some cases, only complete removal of an organ can help: ovaries, fallopian tubes, uterus. After such a surgical intervention, the patient’s life changes dramatically. To avoid complications and restore the body faster, it is important to pay attention to the quality of the rehabilitation period.

Specifics of hysterectomy

Tumor in the uterus

Surgery to remove the uterus is called a hysterectomy. Such intervention is carried out as a last resort when other treatment methods have been ineffective or emergency assistance is necessary. Sometimes the uterine (fallopian) tubes and ovaries are cut out along with the organ (oophorectomy). Radical surgery is performed for the following diseases:

prolonged uterine bleeding in the presence of benign tumors, for example, fibroleiomyoma (combines the properties of muscle and connective tissue), endometriosis.
benign tumor during menopause;
prolapse, prolapse of an organ (with this pathology, the patient needs to wear tight-fitting panties to support the muscle tissue).

The operation is performed using different technologies, depending on the complexity of the lesion, the experience of doctors, and available equipment.

Types of hysterectomy

Vaginal (the organ is removed through the vagina without damaging the muscle layer of the abdominal cavity; it can be performed only if certain conditions are met: small size of the organ, elastic vaginal walls).
Abdominal wall or abdominal (intervention occurs through an incision in the anterior abdominal wall).
Laparoscopic (the doctor makes several small incisions from 5 to 10 mm and, using special laparoscopic instruments, an optical system, and endoscopic equipment, separates the uterus and removes it through the vagina; thanks to this method, it is also possible to take a biopsy of the uterus - a tissue sample for laboratory testing).
Supravaginal extirpation (removal of the organ while preserving the cervix).
Robotic (the intervention is carried out using laparoscopy technology, but with a three-dimensional image; the operating technique is difficult to learn, so this is not done in all countries and is rare).

Laparoscopic surgery

Surgical laparoscopy is one of the most progressive treatment methods. With its help, you can not only find out the cause of the disease, but also perform the necessary amount of interventions. The current level of development of medicine allows us to perform about 95% of gynecological operations using this technology, including removal of cervical and ovarian cysts. In this case, the recovery period is much shorter compared to open interventions.

If an adhesive process or severe endometriosis is diagnosed in the small pelvis, laparoscopy of the fallopian tubes is prescribed to cut the adhesions and restore their patency. In case of ectopic pregnancy, this is a necessary intervention to save life. Surgeries on the fallopian tubes are divided into several types:

salpingo-ovariolysis (removal of adhesions to restore patency);
fimbryolysis (the surgeon separates the fimbriae - the villi at the ends of the tube that propel the fertilized egg into the uterus);
salpingoneostomy (creation of a new lumen of the fallopian tube);
salpingotomy (removal of an ectopic pregnancy while preserving the organ);
tubectomy (complete removal).

In many cases, such interventions save the patient’s life. They also require a recovery period and regular consultations with specialists.

After laparoscopy of the fallopian tubes and ovaries, postoperative antibiotic therapy, physiotherapy, and therapeutic exercises are required. Within a few hours after the intervention, the woman can get up.

Recovery after hysterectomy: principles of rehabilitation therapy

After removal of the uterus, a woman will not be able to bear and give birth to her child. If the fallopian tubes and ovaries were cut out, even assisted reproductive technologies will not help her. In addition, menstruation will disappear, the body will stop producing female hormones, and menopause will occur.

Before laparoscopic surgery, the patient feels fear of pain and consequences, but the next period does not always bring relief. In order for a woman not to consider herself inferior or devastated, in addition to the medical component, consultations with a psychologist must be included in the rehabilitation schedule.

Depending on the woman’s age, pathology, and condition of the ovaries, the operation is performed with their preservation or excised along with the uterus. Such intervention is carried out strictly according to indications. To correct hormonal levels, an endocrinologist will prescribe special treatment.

Almost all women in the postoperative period exhibit clinical symptoms of posthysterectomy syndrome. It occurs in approximately 32-79% of patients. Depending on the stage, its signs can be early (starting on the 1st day) and late - a period from 1 month to a year after the intervention. The main symptoms are headache, insomnia, irritability, hot flashes, depression, weakness. Restorative therapy is aimed at eliminating them and restoring the body.

After the operation, daily hygiene is required; at the end of the day you need to wash yourself with weak herbal decoctions

During the first time after surgery, the woman will be given painkillers and electrophoresis to relieve pain. It is also necessary to follow a diet; the diet is expanded gradually. Its basis should be protein, easily digestible food. Stable intestinal function without constipation and flatulence contributes to better tissue healing. As in the case of removal of the fallopian tubes, the patient is given antibiotics and vitamins. Postoperative underwear (pants) will make you feel more comfortable and support your muscles. After discharge home, the second stage of recovery begins.

Advice: spotting may appear in the first week after the intervention. To avoid discomfort, you should use pads and regularly wash with boiled water, chamomile, and sage decoction.

Rehabilitation after hysterectomy includes:

therapeutic exercises (to avoid problems with urination and defecation, you need to do Kegel exercises, which strengthen the walls of the vagina, the pelvic floor muscles, and prevent the formation of adhesions in the tubes, but you cannot do fitness and running);
physiotherapy (electric sleep, low-frequency magnetic therapy, massage of limbs for swelling);
drug support (to avoid the development of specific diseases - atherosclerosis, diabetes mellitus; after removal of the uterus, the patient must take preventive medications, hormones, if the ovaries are removed);
acupuncture (impact on active points on the human body contributes to the rapid recovery of the body).

If the operation was performed in the traditional way through an incision in the abdominal cavity, you can return to your previous life after 6-8 weeks, with laparoscopy - after 2-3. You cannot take a bath, lift heavy things, or have sex. When the stitches heal, they gradually return to their usual hobbies: fitness, going to the pool, running.

Advice: removal of uterine fibroids most often leads to loss of organ function. To maximize her chances of recovery, a woman should never ignore any changes in women’s health, and especially the appearance of tumors. Even tiny myomatous nodes identified during ultrasound should immediately become a therapeutic target. Waiting tactics will only worsen the situation and can lead to radical methods of surgical treatment - removal of the uterus and fallopian tubes.

During this period of life, it is important to pay attention to a woman’s mental health. The psychologist examines her condition using psychometric scales and special questionnaires. This will help avoid depression, increase self-esteem, and optimize your emotional state. If necessary, the specialist will prescribe sedatives. Medical and psychological measures and support from loved ones stabilize the mental state of a woman after radical surgery on the genital organs.

Extirpation of the uterus and fallopian tubes - surgical removal of an organ, is today in second place in the frequency of all surgical interventions performed in gynecology. Often it is the only way out of the current situation. The five-year survival rate for all stages of uterine cancer is 94% (for stage 1) and 79% (for stage 2). With the help of early diagnosis of gynecological pathologies and a high-quality rehabilitation period, it is possible not only to preserve the health and life of the patient, but also to restore her fullness to the maximum extent possible.

Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for independent treatment. Be sure to consult your doctor!

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Postoperative period after hysterectomy

The postoperative period after removal of the uterus is an important stage in a woman’s treatment, which is fraught with a number of complications and therefore requires a careful and professional approach.

Naturally, when a hysterectomy is performed, the consequences depend on the type of operation and many factors. You can watch videos about how hysterectomy is performed on the official websites of specialized clinics. In general, when a high-quality hysterectomy is performed, the consequences and reviews give no reason to doubt the positive result. Even if a good clinic performs the most complex removal of the uterus for fibroids, the consequences and reviews allow us to make a very optimistic prognosis.

The essence of the emerging problem

Surgery to remove the uterus or hysterectomy is considered a fairly well-developed and widespread method of surgical treatment for some serious pathologies that threaten serious problems for women's health. World medicine statistics claim that almost 1/3 of all women after 40 years of age are forced to undergo such a procedure.

Any surgical intervention causes injuries of varying severity associated with damage to various vessels and tissues. After surgery to remove the uterus, characteristic damage also remains, and complete tissue restoration requires some time. The duration and scheme of rehabilitation measures depends on the individual characteristics of the female body, the severity of the disease, the type of operation and the degree of surgical intervention, aggravating circumstances and postoperative complications.

In order for the uterus to be removed, what indications are necessary? The following reasons are highlighted:

heavy and prolonged uterine bleeding;
myomatous nodes;
metroendometritis that cannot be treated;
oncological diseases;
endometriosis;
uterine prolapse.

Depending on the severity of the pathology, the following types of operations can be performed:

Types of operations

removal of the uterine body only (subtotal amputation);
removal of the uterus and cervix (total estirpation);
removal of the uterus with appendages and nearby lymph nodes (radical panhysterectomy).

The degree of traumatization depends not only on the type of operation, but also on the method of its implementation. The most radical is considered to be the abdominal technology associated with opening access by cutting the peritoneal wall. Another option is the vaginal method, where an incision is made in the vagina. The least dangerous method is to remove the uterus using the laparoscopic method, which uses a special laparoscope that allows you to make a minimal incision. When a laparoscopic hysterectomy is performed, the consequences are less dangerous.

General principles of postoperative rehabilitation

The postoperative recovery period includes the entire time period from surgical intervention to full restoration of performance, including sex after hysterectomy. As with any surgical treatment, complete postoperative rehabilitation is divided into 2 stages: early and late stage.

The early stage of recovery is carried out in a hospital setting under the supervision of a doctor. The duration of this stage depends on what consequences after removal of the uterus occurred after surgery.

On average, with a successful abdominal operation, the early period is about 9-12 days, after which the sutures are removed and the patient is discharged from the hospital. Laparoscopic intervention reduces the time of early rehabilitation to 3.5-4 days. The main tasks of the early stage: eliminating bleeding, pain and other symptoms, eliminating infection of the affected area and dysfunction of internal organs, ensuring primary tissue scarring.

The early stage of recovery is carried out in a hospital setting under the supervision of a doctor.

The late stage of rehabilitation is carried out at home as prescribed and in consultation with a doctor. In the case of surgical intervention without complications, this stage lasts on average 28-32 days, and in case of a complex operation it is extended to 42-46 days. At this stage, complete restoration of tissues, improvement of general condition and strengthening of the immune system, normalization of the psychological state, and complete restoration of performance are ensured.

What measures are taken immediately after surgery?

During the first 24 hours after removal of the uterus, all measures must be taken to exclude the occurrence of complications, blood loss from internal bleeding, the occurrence of inflammatory processes, the penetration of infections and the elimination of painful symptoms. This period is the most important in the early stages of rehabilitation.

The main activities include the following impacts:

Anesthesia. After the operation, the woman feels natural pain in the lower abdomen, inside. Strong drugs are used for pain relief.
Activation of organ functions. Measures are being taken to normalize blood circulation and stimulate the intestines. If necessary, Proserpine is administered by injection to activate intestinal functions.
Providing diet. It is important to restore normal intestinal motility. The menu is dominated by broths, pureed foods, and drinks. If independent defecation occurs at the end of the first day, then the measures were carried out correctly.

Drug therapy immediately after surgery includes the following:

antibiotics to exclude infection (course – 5-8 days);
anticoagulants to prevent blood clots in blood vessels (administered over 2-3 days);
infusion influence through intravenous drips to normalize blood circulation and restore blood volume.

Infusion influence through intravenous drips to normalize blood circulation

Main problems during early rehabilitation

At the first stage of rehabilitation after removal of the uterus, the following complications may occur:

Inflammation of the site of tissue dissection. This phenomenon, when it occurs, is characterized by such signs as redness, swelling, and purulent exudate. Possible seam divergence.
Disruption of the urinary process. Main manifestations: pain and pain when urinating. A complication usually occurs when the mucous membrane of the urinary canal is damaged during surgery.
Internal and external bleeding. Their intensity depends on the correct performance of hemostasis during surgery. External blood discharge may have a scarlet or dark red, brown tint, and blood clots may be released.
Pulmonary embolism. One of the very dangerous complications that can cause a blood clot in an artery or its branches. The development of pathology can lead to pneumonia and pulmonary hypertension.
Peritonitis. If there are violations during the surgical procedure, damage is possible that can cause an inflammatory reaction in the peritoneum. The danger of peritonitis is the rapid spread to other internal organs and the development of sepsis.
Hematomas. In the area of scarring of damaged tissue, hematomas often occur due to damage to small blood vessels.
Pain syndrome. Often becomes the result of an adhesive process. For such pain, enzyme agents are administered: Trypsin, Chymotrypsin, Longidaza, Lidaza, Ronidaza.
Fistula formation. This problem occurs when the sutures are of poor quality and infection occurs. Often it is necessary to perform additional surgery to remove the fistula.

An important early postoperative measure is to exclude infection during the first 1-3 days. The penetration of infection is indicated by an increase in temperature to 38.5 0C. To eliminate the risk of infection, antibiotics are administered and the suture area is treated with antiseptic. The first change of dressing and treatment of the wound is carried out the next day after exposure. Curiosin provides an antibacterial effect and accelerates the formation of scar tissue, so it is often used to treat sutures.

A support bandage helps weakened abdominal muscles in the postoperative period

Fighting peritonitis

When performing total and radical operations, especially in emergency situations, there is a high probability of developing peritonitis. This pathology is expressed by the following obvious symptoms:

a sharp deterioration in general health;
temperature rise to 40.5 0C;
intense pain;
peritoneal irritation.

Treatment includes the active administration of several types of antibiotics. Saline solutions are introduced. If the effectiveness of therapy is low, a repeat operation is performed to remove the uterine stump, and the abdominal cavity is washed with antiseptic drugs and a drainage system is installed.

What should be done during late rehabilitation

After discharge from the clinic, a woman should not stop restorative procedures. Late-stage rehabilitation helps the body fully recover after surgery. The following activities are recommended:

Wearing a bandage. A supportive corset helps weakened abdominal muscles during the postoperative period. When choosing a bandage, you should adhere to the condition that its width exceeds the length of the wound scar by 12-15 mm from below and from above.
Avoid lifting loads over 2.5 kg and limiting physical activity. Sexual contact should be avoided for 1.5-2 months after surgery.
Gymnastic exercises and exercise therapy. Kegel exercises are recommended to strengthen the muscles of the vagina and pelvic floor using a special exercise machine called the perineal trainer. Serious sports activities are possible only after 2.5 months after surgery.
Saunas, steam baths and hot baths are prohibited for the entire period of late rehabilitation. Swimming in open waters should be significantly limited.
Organization of proper nutrition. A gentle diet is an important element of the recovery phase. Dietary measures should be taken to prevent constipation and flatulence. It is recommended to include fiber and liquids (vegetables, fruits, coarse bread) in the menu. Alcoholic drinks and strong coffee should be excluded. It is necessary to increase the intake of vitamins.

Dietary measures should be taken to prevent constipation and flatulence

What you should be prepared for

Removal of the uterus leads to a number of inevitable consequences, for which you should be psychologically prepared. As a rule, after such an operation, premature menopause occurs. Since most often when the uterus is removed, the appendages also suffer, incl. ovaries, then menopause occurs immediately after surgical treatment. This artificial menopause stops the functioning of the menstrual cycle. However, you should not worry about your sexual performance. After removal of the uterus, sexual intercourse is allowed 2-3 months after the operation. Naturally, when the uterus is lost, reproductive abilities are also lost. Due to the removal of the cavity for fetal development, pregnancy is impossible.

Removal of the uterus is performed only when absolutely necessary, especially in women of reproductive age. The modern technology of such surgical treatment has been sufficiently developed, and numerous reviews indicate a positive prognosis for the complete recovery of the body after surgery. To do this, it is important to follow all the necessary measures of early and late rehabilitation.

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Life after removal of the uterus and ovaries: consequences and rehabilitation

Uterus and appendages

Carrying out such a serious gynecological operation as a hysterectomy has a significant impact on the health and hormonal levels of a woman, and in order to avoid the negative consequences associated with this, proper rehabilitation after removal of the uterus and ovaries is simply necessary. Hysterectomy is more often used to treat women over 40 years of age, since it leads to the loss of the opportunity to have children and is more difficult for younger patients to tolerate, both physically and psychologically.

Each woman makes her own decision whether to have surgery or not. But even in cases where life-saving is involved and surgical intervention is inevitable, its impact on the body can be minimized. Being aware of the possible consequences, being attentive to your health and following your doctor’s recommendations allows you to avoid many complications and continue to lead your previous lifestyle.

Postoperative period

Removal of the uterus and ovaries

The time from the operation to the restoration of normal well-being and ability to work is called the postoperative period. After a hysterectomy, during this period of time it is recommended:

wear a compression bandage for at least two weeks after surgery;
Avoid lifting weights weighing more than 3 kg;
refrain from taking a bath (replace with a shower), sexual intercourse and intense physical activity for 6 weeks.

For a speedy recovery after surgery, you should begin physical activity as soon as possible. These can be simple gymnastic exercises, agreed with your doctor. It is also necessary to follow a diet: exclusion from the diet of sweets, smoked foods, flour products, alcoholic beverages and other foods that irritate the mucous membranes.

The impact of hysterectomy on later life

Life after removal of the uterus and ovaries inevitably undergoes a number of changes. They affect both physiological and psycho-emotional states.

The operation cannot but affect the psycho-emotional state of a woman

Consequences of the operation

Most often the operation is well tolerated

In most cases, after removal of the uterus and ovaries, patients do not experience any special health problems. But they are at increased risk of developing cardiovascular disease and osteoporosis. It is also possible that you may experience discomfort during sexual intercourse and a decrease in desire.

In addition, women who have had a total hysterectomy often experience anxiety, irritability, fatigue, and signs of depression. Due to the loss of reproductive function, a feeling of personal inferiority and loss of attractiveness may develop. In such a situation, a woman needs the help of a psychologist and, of course, the support of loved ones, because successful rehabilitation after removal of the uterus and ovaries largely depends on the emotional mood.

The main cause of the above conditions is a lack of hormones, and hormone replacement therapy (HRT) helps to successfully cope with the problems.

Possible complications

Adhesions are also a complication of hysterectomy.

Most complications of this operation are related to its physiological consequences. In the postoperative period, the following may occur:

pain caused by poor scar healing or the formation of adhesions;
severe bleeding;
vein thrombosis;
inflammation of the postoperative suture.

In order not to miss the onset of the development of undesirable consequences of hysterectomy, you should carefully monitor your condition. Although in the first time after surgery (up to 2 months) spotting after removal of the uterus and ovaries is normal, a change in their color to a scarlet color and the appearance of severe abdominal pain are a very alarming symptom. This indicates bleeding and requires urgent medical attention. You should also be wary if the discharge has a strong, unpleasant odor: this may be a sign of inflammation.

Another possible complication arises from the fact that during a total hysterectomy, the ligaments that support the organ are excised. This leads to displacement of the intestines and bladder, which may result in difficulties with bowel movements and urination. To solve and prevent this problem, women who have had the uterus and appendages removed are recommended to perform Kegel exercises to maintain the tone of the pelvic floor muscles.

It is necessary to keep yourself in good physical shape, within reason.

Restoring and maintaining health

Rehabilitation after hysterectomy should be comprehensive. To prevent unwanted consequences and improve a woman’s well-being, the following medication support is provided:

mandatory HRT after removal of the uterus and ovaries, which helps prevent premature menopause;
hypocholesterolemic drugs that reduce the risk of atherosclerosis;
prescribing antihypertensive drugs if necessary.

The support of loved ones plays a huge role

The patient herself should also follow a number of recommendations:

Begin sexual activity only after the period prescribed by the doctor has expired. Usually it is 6-8 weeks.
Strengthen your pelvic muscles by doing Kegel exercises.
Monitor blood pressure readings and take blood biochemistry tests.
Be regularly examined by a gynecologist, especially if the operation was caused by cancer, since the risk of relapse in this case remains.
Follow a diet to prevent excess weight gain. It is recommended to exclude fried and spicy foods, as well as flour products, from the diet, giving preference to fermented milk products, fruits and vegetables.
Move more, maintain good physical shape by leading an active lifestyle and engaging in non-traumatic sports.

Operation option

Although a hysterectomy is a major surgical procedure with consequences, sometimes it is a life-saving necessity. If you are scheduled for such an operation, do not despair and panic. Timely therapy, competent rehabilitation after removal of the uterus and ovaries and compliance with the doctor’s instructions can minimize possible complications, and the quality of life only improves after the problem is eliminated.

Here's how this operation can be performed (video):

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Recovery after hysterectomy

Hysterectomy, or removal of the uterus, is one of the most common gynecological procedures. Despite the fact that most specialists try to resort to this method of treatment only in extreme cases, the operation is quite common, especially among women 40-50 years old.

The main indications for hysterectomy surgery are:

malignant tumors;
prolapse, displacement or prolapse of internal organs;
chronic pain;
endometriosis;
breakthrough bleeding;
rapidly developing uterine fibroids.

Methods of performing the operation can be:

open or abdominal - in which the uterus or other organs are removed through an incision on the surface of the abdomen;
vaginal - in which resection and removal of the uterus is carried out through a cut in the vagina;
laparoscopic - when resection and examination are carried out through small punctures on the surface of the abdomen, and the uterus is removed through the vagina or a small incision in the lower part of the peritoneum.

Rehabilitation

The overall recovery period from the surgery is approximately 1–2 months. In the early postoperative period, the main complaints of patients are: pain, difficulty urinating and bleeding. As a rule, after 1–2 days, acute symptoms subside, and the woman can gradually return to her usual way of life.

The recovery period and the presence of certain complications largely depend on the method by which the operation was performed.

Recovery after laparoscopy

This method of removing the uterus is considered the most gentle and requires only a few days to recover from it. Due to the absence of an extensive incision on the surface of the peritoneum, there are much fewer complications, the main of which is pain.

Pain during recovery is noted at the puncture sites and in the lower abdomen. In the first days, such pain intensifies significantly with every movement. During the recovery period, strong painkillers are prescribed to reduce pain. After discharge, these complications do not require any special therapy and go away on their own.

Often, during the recovery period after laparoscopic surgery, patients complain of nausea, weakness and bloating. All these signs can be a consequence of the use of anesthesia and also do not require treatment. To reduce flatulence and bloating on the first day after surgery, it is recommended to use simethicone-based products.

Sutures are removed after laparoscopy on days 10–14. Healing of small punctures occurs quite quickly and no complications are observed. For several months, small scars of a bright purple color are noted at the site of the sutures. There is also no need to worry about this, since after some time the puncture sites heal and become completely invisible.

Abdominal hysterectomy

Open abdominal surgery is the most difficult method of removing the uterus, and the number of complications after it is quite high.

In the early period of recovery after the procedure, when the patient is being monitored in an inpatient setting, the main care tasks become:

eliminate severe pain after open hysterectomy surgery;
improve bowel function during recovery;
provide the patient with a balanced diet with sufficient iron content;
the incision site should be treated daily with special antibacterial solutions;
together with painkillers, antibiotics and drugs for general strengthening of the body may be prescribed;
preventing the formation of blood clots - for this, it is recommended to begin physical activity in the first postoperative days.

To prevent blood clots in the lower extremities, the patient should wear specialized compression garments for the first time after surgery.

During the rehabilitation period, an integrated approach to restoring health is required. In addition to mandatory drug treatment, the patient is recommended to adhere to a special diet.

Diet after hysterectomy

In the first hours after the operation, eating is prohibited. You are only allowed to drink still mineral water in small quantities.

Starting from the second half of the day, meals should consist of easily digestible liquid foods, for example: broths, kefir and low-fat yogurt. It is not recommended to refuse food, since you need to improve your intestinal function as quickly as possible.

In the following days of recovery after surgery to remove the uterus, the menu is allowed to include: lean meats and fish, steamed, rice, and some vegetables.

In the future, you are allowed to gradually return to your usual diet, but you should remember that it is better to refuse fried, salty, fatty and smoked foods and replace them with healthy, fortified foods high in iron.

In what cases should you consult a doctor?

Despite the fact that the recovery period for each woman is different, and the severity and severity of complications is strictly individual, there are a number of signs that should be detected immediately by a specialist. These include:

severe swelling, pain, redness or suppuration in the suture area;
bleeding in the scar area;
rise in body temperature above 38 degrees;
dizziness, loss of consciousness;
problems with urination (severe pain or complete cessation of urine output);
the appearance of severe nausea and vomiting;
severe abdominal pain that is not relieved by standard painkillers.

Physiotherapeutic treatment

Physiotherapeutic measures are prescribed in the late recovery period after removal and may include the following procedures:

physiotherapy;
therapeutic massage course;
acupuncture;
radon baths;
balneotherapy.

Despite the fact that a hysterectomy is a fairly complex operation, disability after it is extremely rarely prescribed, and a woman, after a recovery period, usually has no disabilities.

Disability after surgery to remove the uterus can be assigned only if the treatment of malignant tumors is unsuccessful or if severe complications are detected that cannot be completely eliminated.

You can undergo an examination and receive a result on the assignment of disabled status in the hospital where the hysterectomy was performed.

Return to sexual activity

It is allowed to resume sexual activity no earlier than 2 months after recovery. Even if the patient is in good health and there are no complications, returning to sexual activity at an earlier date is not recommended. This period of abstinence is necessary so that the internal stitches are healed and all existing wounds have time to heal.

According to experts, in terms of sensations, the woman will not feel any significant changes and will be able to fully enjoy her sex life, as before.

Consequences of removal of the ovaries and uterus

Recovery after removal of the uterus and ovaries requires a longer period, since the operation itself causes a more significant blow to the woman’s body. This is due to the complete cessation of the production of female sex hormones.

Artificially induced menopause is most difficult for women of childbearing age to endure. In addition to standard complications after removal of the uterus and ovaries, they have to endure severe hormonal imbalances and psychological discomfort.

Often during the recovery period, patients begin to feel:

strong fears;
depression;
hot flashes associated with menopause;
deterioration of the condition of the skin, nails and hair;
mental instability;
deterioration of sleep.

This condition is also dangerous because when hormone production stops, the risk of developing osteoporosis and cardiovascular diseases increases significantly.

To prevent this kind of complications, a woman is prescribed hormonal replacement therapy. Antidepressants and tranquilizers prescribed by a specialist help relieve psychological discomfort during the recovery period.

ginekola.ru

2018 Blog about women's health.