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

Hysterectomy is one of the most common gynecological surgeries that involves the complete removal of the uterus. Chronic severe pain, diagnosis of a malignant tumor, severe bleeding - all this can cause such an operation.

If it is possible to achieve a stop of uterine bleeding by other methods, they try not to carry out 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 that occur 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 uterine tissue extends beyond it, causing cramps, infertility, and occasional bleeding.
• Chronic pain. Women often suffer from constant pain in the lumbo-pelvic region. If they cannot be diagnosed and other treatment prescribed, surgery becomes the only way out.
• Hemorrhage. In rare cases, it becomes a consequence of a caesarean section. The only way to stop excessive bleeding is with a hysterectomy.
• Prolapse of the uterus. and its prolapse is 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 a hysterectomy

After the removal of the uterus and ovaries in the female body, hormones cease to be produced. 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 activity 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 can 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 do not recover well. 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 the removal of the uterus and ovaries, many women note an improvement in the quality of life. Former patients are not bothered by pain and bleeding, as well as concerns about pregnancy. A positive attitude can be achieved by patients who have already had menopause and have children.

Some women also have their ovaries removed after some time after the uterus due to the risk of developing cancer. But lighter operations are also carried out 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, premature menopause, the formation of adhesions, impaired urination, and the development of vein thrombosis should be expected. After removal of the uterus, failures 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 abroad, the following types of operations are carried out:

• A radical hysterectomy is the removal of the uterus with the cervix and all appendages.
• Amputation of the uterus with preservation of the cervix and appendages.
• Extirpation is the removal of the uterus with a 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. It is possible to perform laparoscopy.

For hysterectomy, the latest surgical equipment is used. The presence of robotics allows for more accurate and safer operations.

Many patients prefer to be treated abroad also because special training can be done before surgery. The best psychologists work with patients, who set them up for positive. A positive attitude plays an important role in the successful conduct of the operation. In Russia, a similar technique for preparing for an operation is not used.

After the operation, the woman must spend at least two weeks in the hospital. Staples are removed from the sutures 6-8 days after the hysterectomy. 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 balance and blood. The duration of rehabilitation may vary depending on the methods of surgery and indications.

Replacement Hormone Therapy

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

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

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

Medications

The lack of estrogen in the female body will help to compensate for a drug such as Estrimax in the form of tablets. It contains estradiol, identical to that produced by the ovaries. A similar effect has "Estrofem" in tablets.

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. For external use, "Divigel" is suitable. It refers to progestin preparations that excite estrogen cell receptors. It is recommended to use Divigel for osteoporosis and thrombophlebitis (after hysterectomy).

Kegel gymnastics

Exercises are prescribed to strengthen the muscles and ligaments of the pelvic floor. Therapeutic gymnastics helps to solve problems associated with urination and defecation. Before performing the Kegel exercise, it is imperative to empty the bladder. They are performed in a sitting, standing or lying position.

The essence of Kegel gymnastics is the periodic tension of the muscles of the pelvic region. But the muscles of the abdomen and buttocks should be in a relaxed state. 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 the muscles strengthen, you can maintain tension for up to 7-10 seconds in a row. Breathing should be calm - no deep breaths in and out during exercise.

Diet

For weight loss after removal of the uterus, it is recommended to follow the following dietary rules:

• Drink plenty of clean drinking water up to 3.5-4 liters.
• It is necessary to take food in small portions 5-6 times a day at regular intervals.
• The calorie content of meals should be increased gradually.

The following foods must be included in the diet:

• Boiled meat and broth (lean beef and chicken).
• Fat-free dairy products.
• Mashed vegetable puree.
• Fresh fruits, except pomegranate and grapes.
• Green tea and loose cereals, which have a beneficial effect on intestinal motility.

Prohibited products include:

• Liquid cereals and jelly.
• Cocoa and chocolate, strong coffee.
• Smoked, fatty and salty products.
• Alcohol.
• Bean products.
• White bread, sweet pastries.
• High fat curd.

You need to see a doctor for a special diet. Deviation from proper nutrition can lead to postoperative complications.

Despite the generally accepted belief, the removal of the uterus and ovaries does not significantly affect sexual life. Women are very worried that they lose their sexual attractiveness and can even plunge into a depressive state. But it's not. Patients may well count on a full-fledged sex life and enjoyment of sexual intercourse. From such a surgical intervention 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 a lubricant, since the operation leads to increased dryness of the vagina.

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

What are the indications for hysterectomy?

What can serve as an indication for this operation? There are several main reasons, and all of them are quite serious and can threaten a woman with a fatal outcome. This is primarily cancer of the ovaries and uterus. Very often, this female organ is surgically excised and with myoma, fibrosis (benign tumor), less often with endometritis. In rare cases, removal of the uterus is performed after childbirth, for example, with 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. 5-8 days after the hysterectomy, the doctor will remove the staples from the seam. The healing process and its speed depend on the physiology of each patient. After the removal of the uterus, the postoperative period requires therapy aimed at restoring blood, water balance in the body and preventing inflammatory diseases. Also, be sure to pay attention to the psychological mood of a woman, because any operation is stressful, not to mention gynecological surgery. A sick leave is issued for recovery after removal of the uterus for up to 45 days.

Rehabilitation after removal of the uterus

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 outlines the postoperative period strictly. Strong tea, chocolate, coffee, cottage cheese, white bread should be excluded from it. In order for the intestines to work again after the operation, 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 to weaken the intestines (meat broth, cereals, sour-milk products). The main rule: follow the diet prescribed by the attending physician.

Recovery after removal of the uterus should eliminate or minimize the load - you can not lift objects weighing more than 5 kg. You can return to your usual way of life 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 blood to stagnate, and therefore the recovery process will come faster.

Complications associated with hysterectomy

The postoperative period, which takes women of different times in duration, may be accompanied by some complications. There may be pain of varying intensity, appearing due to bleeding or adhesions. Such symptoms are typical, as a rule, only for the first days after surgery. More serious consequences of the procedure can be deep vein thrombosis of the legs, suppuration of the suture, urinary and stool disorders, and hematomas. Often, after such operations, a woman may experience all the symptoms of menopause: a decrease in sexual desire, dryness in the vagina, a sharp change in mood. But such complications are quite rare, they are not the rule. Also, patients may develop atherosclerosis and osteoporosis.

In what cases you need to urgently visit a gynecologist

There may be some bloody discharge after a hysterectomy. In the presence of the following factors, it is urgent to visit a antenatal clinic:

• Vaginal discharge has an unpleasant odor.
• They have the color of rot with an admixture of blood.
• Nausea.
• Urinary incontinence.
• Large blood clots come out of the vagina.
• There is a need to change pads many times within an hour.
• Bright red discharge from the vagina.

Collapse

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

Duration

How long does the rehabilitation of the patient after such an intervention actually last? To some extent, this is influenced by its method and volume. For example, if the uterus with appendages was 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 period. Early is understood as the first three days after the operation, and the first 24 hours have the maximum value. Late means the rest of the period - up to one and a half to two months.

Quick Recovery

How to quickly recover after removal of the uterus? Express methods of recovery after this intervention does not exist. This intervention is quite serious and voluminous, accompanied by hormonal changes in the reproductive system. And also, they have their own effects and symptoms of the disease, due to which it was necessary to amputate the organ. 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 the state of health improved after 2-3 weeks, this does not mean that the implementation of the doctor's recommendations should be stopped.

Within 24 hours after the laparotomy was carried out, it is necessary to observe bed rest. It takes a lot of time just to get out of anesthesia. You should not sit down and get up even to the toilet. Although by the end of the first day, gently, with the help of hands, it is already permissible to roll over on its 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 half-sit in bed, get up to use the toilet, roll over on her side. There should still be liquid and semi-liquid food, by the third day starting to include easily digestible ordinary food. It is important to control the work of the intestines so that there is no 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 operation was performed, antibiotic treatment ends. Often, at this stage, hormone treatment may be prescribed to facilitate entry into menopause (when the ovaries are removed). At the same stage, consultations of a psychologist are appointed, if they are needed.

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

Rehabilitation after removal of the uterus excludes saunas, baths, any overheating. You can not swim in natural reservoirs, you can maintain hygiene with the help of a shower.

What should be done 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 removal of the uterus, the postoperative period in which is short. 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 about the same, you can return to sexual activity no earlier than two months later. 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 with appendages is a rather difficult operation, involving a long, up to two months, rehabilitation period. The scheme of the procedure in the photo in the material.

Radical hysterectomy

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

intimate life

During the entire recovery time after removal of the uterus, it is advisable to abandon intimate life. Although in many ways this can be determined only on the basis of the method by which the intervention was carried out. For example, when only the uterine cavity is removed and the vagina and cervix are completely preserved, doctors are allowed to resume sexual activity after a month and a half. If the cervix and the upper third of the vagina were removed, then the period of abstinence may be longer, since the suture after the intervention may be injured.

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

Sport

When can I exercise after hysterectomy? This question can only be answered taking into account the type and intensity of loads. At the initial stages of recovery after the procedure, any physical activity should be at a minimum. After the first week of rehabilitation, therapeutic exercises can be added to prevent the formation of adhesions, etc. After a full rehabilitation period, you can again do 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, bodybuilding, the time to start such exercises should 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 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 it’s no longer worth lying too much. Physical activity is needed to avoid stagnation of blood and the formation of adhesions. That is, bed rest should still be observed, but not excessively - taking into account sleep, it is worth spending 13-15 hours a day in bed, the rest of the time it is better to sit, walk, do simple, non-stressful household chores.

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

Diet Example

As already mentioned, the first three days it is better to eat fairly light food - natural vegetable broths and mashed potatoes. Then you can gradually introduce food of the usual consistency, and by the end of 5-6 days the patient should switch to a diet of the general table. Although the food should meet the requirements of a healthy diet, it is necessary to avoid fried, fatty, canned, smoked, and in addition, sweet, preservatives and dyes. For example, the diet might be:

1. Breakfast - oatmeal porridge, egg, black tea;
2. Late breakfast - fruit, cottage cheese;
3. Lunch - vegetable or chicken / meat broth soup, lean beef with rice, rosehip broth;
4. Snack - vegetable / fruit salad or yogurt;
5. Dinner - white fish with fresh or stewed vegetables, tea.

In general, after the operation to remove the uterus, it is necessary to adhere to the rules of a healthy diet, eat fractionally, do not overeat. The calorie content of the diet should remain the same.

Consequences

The consequences after removal of the uterus in the recovery period are possible if the rules for its passage are violated, as well as with some features of the body. For example, complications such as:

1. Depression, nervous breakdowns, other complications of an emotional and psychological nature;
2. Bleeding due to poor healing of sutures or stress on them;
3. Suture endometriosis - a condition in which the endometrium begins to form on the peritoneum (it is extremely rare);
4. Infection of the blood or peritoneum, neighboring organs in the hodge operation manifests itself just during this period;
5. Prolonged and persistent pain syndrome that develops when the nerve trunks are damaged;
6. Inflammatory process, temperature after removal of the uterus is its sign;
7. Accession of viruses and infections, fungi, as a result of reduced local immunity;
8. Some deterioration in the quality of sexual life, which usually disappears after hormone therapy;
9. Decreased libido, which is also regulated by hormones;
10. Possible problems with the intestines, constipation;
11. Symptoms of early menopause when removing not only the cavity, but also the ovaries.

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

Conclusion

Regardless of the method of surgical intervention to remove the organ, a well-conducted recovery period is no less important than careful preparation for the intervention and its high-quality conduct. It is now that healing is taking place, and it depends on it whether the patient will be worried about 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 are not formed, which can later cause pain, the scar will be more or less aesthetically smoothed out, etc.

←Previous article Next article →

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

Specificity of hysterectomy

Tumor in the uterus

The operation to remove the uterus is called a hysterectomy. Such an intervention is carried out as a last resort when other methods of treatment have proven ineffective or emergency assistance is needed. Sometimes, along with the organ, the uterine (fallopian) tubes, ovaries are cut out (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;
• omission, prolapse of an organ (with such a pathology, the patient needs to wear tight pants to support muscle tissue).

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

Types of hysterectomy

1. Vaginal (the organ is removed through the vagina without damaging the muscular layer of the abdominal cavity; it can be carried out only if certain conditions are met: the small size of the organ, the elastic walls of the vagina).
2. Abdominal-wall or cavitary (intervention occurs through an incision in the anterior abdominal wall).
3. Laparoscopic (the doctor makes several small incisions from 5 to 10 mm and, using special laparoscopic instruments, an optical system, endoscopic equipment, separates the uterus, removes it through the vagina; thanks to this method, you can also take a biopsy of the uterus - a tissue sample for laboratory research).
4. Supravaginal extirpation (removal of the organ with preservation of the neck).
5. Robotic (the intervention is carried out using laparoscopy technology, but with a three-dimensional image; it is difficult to learn how to work, so these are not done in all countries and rarely).

Laparoscopic surgery

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

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

• salpingo-ovariolysis (removal of adhesions to restore patency);
• fimbriolysis (the surgeon separates the fimbriae - the villi at the ends of the tube, which advance the fertilized egg into the uterus);
• salpingoneostomy (creation of a new lumen of the fallopian tube);
• salpingotomy (removal of an ectopic pregnancy with preservation of the organ);
• tubectomy (complete removal).

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

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

Recovery after removal of the uterus: principles of rehabilitation therapy

After the removal of the uterus, the woman will not be able to endure and give birth to her child. If the fallopian tubes, 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, consequences, but the next period does not always bring relief. In order for a woman not to consider herself inferior, 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, condition of the ovaries, the operation is performed with their preservation or cut out along with the uterus. Such an intervention is carried out strictly according to indications. To correct the hormonal background, the endocrinologist will prescribe a special treatment.

Almost all women in the postoperative period show clinical symptoms of posthysterectomy syndrome. It manifests itself in approximately 32-79% of patients. Depending on the stage, its signs can be early (starting from the 1st day) and late - the 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.

For the first time after the operation, to relieve pain, the woman will be given painkillers and electrophoresis. It is also necessary to follow a diet, the diet is expanded gradually. Its basis should be protein easily digestible food. Stable bowel 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, vitamins. Postoperative underwear (underpants) will make you feel more comfortable and support your muscles. After being discharged home, the second stage of recovery begins.

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

Rehabilitation after removal of the uterus includes:

• therapeutic exercises (to avoid problems with urination, defecation, you need to do Kegel exercises that strengthen the walls of the vagina, the muscles of the pelvic floor, prevent the formation of adhesions in the pipes, but you can’t do fitness and running);
• physiotherapy (electrosleep, low-frequency magnetotherapy, limb massage for edema);
• medication support (to avoid the development of specific diseases - atherosclerosis, diabetes mellitus, after removal of the uterus, the patient should take prophylactic drugs, hormones, if the ovaries are excised);
• acupuncture (impact on active points on the human body contribute 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 can not take a bath, lift heavy things, have sex. When the stitches heal, they gradually return to their usual hobbies: fitness, going to the pool, running.

Tip: 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 even more so the appearance of neoplasms. Even tiny fibroids detected during ultrasound should immediately become a therapeutic target. Expectant tactics will only aggravate the situation and can lead to radical methods of surgical treatment - removal of the uterus, fallopian tubes.

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

Extirpation of the uterus, fallopian tubes - surgical removal of the organ, is today in second place in terms of the frequency of all surgical interventions 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% (at stage 1) and 79% (at 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 usefulness as much as possible.

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

vseoperacii.com

Postoperative period after removal of the uterus

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

Naturally, when an operation is performed to remove the uterus, the consequences depend on the type of operation and many factors. How the uterus is removed, the video can be viewed on the official websites of specialized clinics. In general, when a high-quality removal of the uterus is carried out, the consequences, reviews do not give reason to doubt a positive result. Even if the most difficult removal of the uterus with fibroids is carried out in a good clinic, the consequences and reviews make it possible to make a very optimistic prognosis.

The essence of the problem

Surgery to remove the uterus or hysterectomy is considered to be a well-established and common method of surgical treatment for some serious pathologies that threaten serious problems for women's health. The statistics of world medicine claims that almost 1/3 of all women after the age of 40 are forced to undergo such a procedure.

Any surgical intervention causes injuries of varying severity associated with damage to various vessels and tissues. After the operation to remove the uterus, characteristic damage also remains, and a certain amount of time is needed for the complete restoration of the tissues. 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 removal of the uterus, what indications are needed? The following reasons stand out:

• heavy and prolonged uterine bleeding;
• myomatous nodes;
• metroendometritis, not amenable to therapy;
• oncological diseases;
• endometriosis;
• uterine prolapse.

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

Operation types

• removal of only the uterine body (subtotal amputation);
• removal of the uterus and uterine 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 the abdominal technology associated with the opening of access by cutting the wall of the peritoneum. Another option is the vaginal method when making an incision in the vagina. The least dangerous method is the removal of the uterus by laparoscopic method, when a special laparoscope is used, which allows making a minimal incision. When laparoscopic removal of the uterus is performed, the consequences are less dangerous.

General principles of postoperative rehabilitation

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

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

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

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

The late stage of rehabilitation is carried out at home by appointment and with the advice of a doctor. In the case of surgical intervention without complications, this stage lasts an average of 28-32 days, and with a complex operation it is extended to 42-46 days. At this stage, complete restoration of tissues, improvement of the general condition and strengthening of immunity, normalization of the psychological state, and full restoration of working capacity are ensured.

What measures are taken immediately after the operation

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:

1. Anesthesia. After the operation, the woman feels natural pain in the lower abdomen, inside. Strong drugs are used for pain relief.
2. 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.
3. Providing a diet. It is important to restore normal intestinal motility. The menu is dominated by broths, mashed foods, drinks. If at the end of the first day there is an independent defecation, then the measures were carried out correctly.

Medical treatment immediately after surgery includes the following:

• antibiotics to exclude infection (course - 5-8 days);
• anticoagulants to exclude blood clots in blood vessels (introduced within 2-3 days);
• infusion effect by intravenous droppers to normalize blood circulation and restore blood volume.

Infusion influence by intravenous droppers to normalize blood circulation

The main problems in early rehabilitation

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

1. Inflammation of the site of tissue dissection. Such a phenomenon, when it occurs, is characterized by such signs as redness, swelling, purulent exudate. Possible seam split.
2. Violation of the process of urination. The main manifestations are pain and pain during urination. A complication occurs, as a rule, when the mucous membrane of the urinary canal is damaged during surgery.
3. Internal and external bleeding. Their intensity depends on the correctness of hemostasis during surgery. External blood discharge may have a scarlet or dark red, brown tint, and blood clots may come out.
4. 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.
5. Peritonitis. In case of violations in the process of operational exposure, damage is possible that can cause an inflammatory reaction in the peritoneum. The danger of peritonitis lies in the rapid spread to other internal organs and the development of sepsis.
6. Hematomas. In the area of ​​scarring of damaged tissues, hematomas often occur, associated with damage to small blood vessels.
7. Pain syndrome. Often becomes the result of an adhesive process. With such pains, enzymatic agents are introduced: Trypsin, Chymotrypsin, Longidase, Lidase, Ronidase.
8. Fistula formation. This problem occurs with poor-quality sutures and infection. Often it is necessary to carry out an additional operation to remove fistulas.

An important early postoperative measure is the exclusion of infection during the first 1-3 days. An increase in temperature to 38.5 0C indicates the penetration of infection. To eliminate the risk of infection, antibiotics are administered, an antiseptic treatment of the suture area is carried out. The first dressing change and wound treatment 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 for sutures.

Support bandage helps weakened abdominals in the postoperative period

Fighting peritonitis

When carrying out total and radical operations, especially in case of emergency, there is a high probability of developing peritonitis. Such a pathology is expressed by such obvious symptoms:

• a sharp deterioration in general well-being;
• temperature increase up to 40.5 0С;
• intense pain;
• peritoneal irritation.

As treatment, the active administration of several types of antibiotics is carried out. Salt solutions are introduced. With a low efficiency of therapy, a second operation is performed to remove the uterine stump, and the abdominal cavity is washed with antiseptic preparations with the installation of a drainage system.

What should be done in late rehabilitation

After discharge from the clinic, a woman should not stop restorative procedures. Rehabilitation at a late stage helps the body to fully recover after surgery. The following activities are recommended:

1. Wearing a bandage. The supporting corset helps weakened abdominals in the postoperative period. When choosing a bandage, one should adhere to the condition that its width exceeds the length of the wound scar by 12-15 mm from above and below.
2. Exclusion of lifting loads over 2.5 kg and limitation of physical activity. Sexual contact should be avoided for 1.5-2 months after surgery.
3. Gymnastic exercises and exercise therapy. Kegel exercises are recommended to strengthen the muscles of the vagina and pelvic floor using a special simulator called the perineum. Serious sports activities are possible only after 2.5 months after the operation.
4. Saunas, baths and hot baths are prohibited for the entire period of late rehabilitation. Swimming in open water should be significantly limited.
5. Organization of proper nutrition. A sparing diet is an important element of the recovery phase. In nutrition, measures should be taken to prevent constipation and flatulence. The menu is recommended to introduce fiber and liquids (vegetables, fruits, coarse bread). Avoid alcoholic beverages and strong coffee. It is necessary to increase the intake of vitamins.

In the diet, measures should be taken to prevent constipation and flatulence.

What should you 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, a premature menopause occurs. Since most often, when the uterus is removed, the appendages also suffer, incl. ovaries, then menopause occurs immediately after surgical treatment. Such an artificial menopause stops the functioning of the menstrual cycle. In this case, you should not worry about sexual opportunities. After removal of the uterus, sexual intercourse is allowed already 2-3 months after the operation. Naturally, with the loss of the uterus, reproductive abilities are also lost. Due to the removal of the cavity for the development of the fetus, 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 full recovery of the body after surgery. To do this, it is important to comply with all necessary measures of early and late rehabilitation.

antirodinka.ru

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 background 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 in the treatment of women over 40 years of age, because it leads to the loss of the ability to have children and is more difficult to tolerate by younger patients, both physically and psychologically.

Each woman decides for herself whether to have surgery or not. But, even in the case when it comes to saving lives, and surgical intervention is inevitable, you can minimize its impact on the body. Awareness of the possible consequences, attentive attitude to one's health and compliance with the doctor's recommendations allow avoiding many complications and continuing to lead a normal lifestyle.

Postoperative period

Removal of the uterus and ovaries

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

• wear a tightening bandage for at least two weeks from the date of surgery;
• avoid lifting weights over 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 start physical activity as soon as possible. These can be simple gymnastic exercises agreed with the doctor. It is also necessary to follow a diet: exclusion from the diet of sweet, smoked, flour, alcoholic beverages and other products that irritate the mucous membrane.

Impact of hysterectomy on later life

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

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

Consequences of the operation

Most of the time, the surgery is well tolerated.

In most cases, after the removal of the uterus and ovaries, the patient does not experience any special health problems. But they are at an increased risk of developing cardiovascular disease and osteoporosis. It is also possible to experience discomfort during intercourse and a decrease in desire.

In addition, women who have undergone a total hysterectomy often experience anxiety, irritability, fatigue, and signs of depression. Due to the loss of childbearing function, a feeling of 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 the lack of hormones, and hormone replacement therapy (HRT) helps to successfully cope with problems.

Possible Complications

Adhesions are also a hysterectomy complication.

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

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

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

The appearance of another possible complication is due to the fact that during a total hysterectomy, the ligaments that support the organ are excised. This leads to displacement of the intestines and bladder, as a result of which difficulties with defecation and urination may appear. To solve and prevent this problem, women who have undergone removal of the uterus and appendages are recommended to perform Kegel exercises to maintain the tone of the pelvic floor muscles.

You need to keep yourself in good physical shape, within reason

Recovery and maintenance of health

Rehabilitation after hysterectomy should be comprehensive. To prevent undesirable consequences and improve the well-being of a woman, the following medical support is carried out:

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

Family support plays a huge role

The patient herself should also follow a number of recommendations:

• Start sexual activity only after the expiration of the period prescribed by the doctor. Usually it is 6-8 weeks.
• Strengthen your pelvic muscles by doing Kegel exercises.
• Monitor blood pressure and take blood biochemistry.
• Regularly examined by a gynecologist, especially if the operation was caused by an oncological disease, since the risk of recurrence in this case remains.
• Follow a diet to prevent weight gain. It is recommended to exclude fried and spicy dishes, as well as flour products from the diet, giving preference to fermented milk products, fruits and vegetables.
• Move more, stay in good physical shape by leading an active lifestyle and engaging in non-injury sports.

Operation option

Although a hysterectomy is a major surgical procedure with consequences, sometimes it is a life 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 prescriptions can minimize possible complications, and the quality of life only improves after the problem is eliminated.

Here is how this operation can be carried out (video clip):

dr911.ru

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 surgery to remove the uterus are:

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

Operation methods can be:

• open or abdominal - in which the removal of the uterus or other organs is performed 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 total recovery period from the operation 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 a 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 it takes 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 early days, such pain is significantly increased with each movement. During the recovery period, strong painkillers are prescribed to reduce the pain symptom. After discharge, these complications do not require any special therapy and disappear 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 need treatment. To reduce flatulence and bloating on the first day after surgery, it is recommended to use products based on simethicone.

The removal of sutures after the laparoscopy is carried out on the 10-14th day. The 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. You should not worry about this either, because after a while the puncture sites heal and become completely invisible.

Removal of the uterus by the abdominal method

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

In the early period of recovery after the procedure, when the patient is still being monitored in a hospital, the main tasks of care are:

• eliminate severe pain after surgery to remove the uterus in an open way;
• 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 can be prescribed;
• preventing the formation of blood clots - for this, it is recommended to start physical activity in the very 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 the mandatory drug treatment, the patient is advised to follow a special diet.

Diet after hysterectomy

In the first hours after the operation, eating is prohibited. It is only allowed to drink mineral water without gas in a small amount.

Starting in the afternoon, meals should consist of easily digestible, liquid foods, such as broths, kefir and low-fat yogurt. It is not recommended to refuse food, because it is necessary to establish bowel function as quickly as possible.

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

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

When should you see 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 you should immediately consult a specialist. These include:

• severe swelling, pain, redness or suppuration in the suture area;
• bleeding in the area of ​​the scar;
• 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 pain medications.

Physiotherapy 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 rather complicated operation, disability after it is extremely rare, and a woman, after a recovery period, usually has no disability.

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

You can undergo an examination and get a result on the appointment of a disabled status in the hospital in which 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 feels well and there are no complications, it is not recommended to return to sexual activity at an earlier date. Such a period of abstinence is necessary so that the internal seams are tightened, and all existing wounds have time to heal.

According to experts, in terms of sensations, a woman will not feel any significant changes and will be able to fully enjoy her sexual 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 tangible 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 the standard complications after removal of the uterus and ovaries, they have to endure severe hormonal disruptions and psychological discomfort.

Often during the recovery period, patients begin to feel:

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

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 hormone replacement therapy. Antidepressants and tranquilizers prescribed by a specialist help relieve psychological discomfort during the recovery period.

ginekola.ru

2018 Women's Health Blog.