Recovery after surgery. Recovery after surgery

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Removal of the uterus with appendages is perhaps one of the most serious and heavy 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 it goes postoperative period after removal of the uterus, what features it has and what recommendations should be followed at this stage of treatment are 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. 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, in most in the first weeks, deterioration of health.

Taking into account individual characteristics 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 performed, 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 - antibiotics are taken. a wide range steps to avoid infection.

You need to pay attention to your general state – heat 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 also not required.

Hysterosalpingo-oophorectomy

Not only the body of the organ is removed, but also the appendages - the ovaries and the 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 period after removal of the uterus, it is advisable to refuse 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 life within 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 a minimum. After the first week of rehabilitation, therapeutic exercises can be added, which prevent the formation of adhesions, etc. After a full rehabilitation period, you can again do gymnastics and aerobics in moderate amount 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. Concerning 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. Need physical exercise 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 enough light food– natural vegetable broths and puree. 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 must meet the requirements healthy eating, 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.

Effects

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 early menopause when removing not only the cavity, but also the ovaries.

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

Conclusion

Regardless of the method of surgical intervention to remove an 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.

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perspective surgical intervention frightens many: operations are associated with a risk to life, and even worse - to feel helpless, lose control over own body, trusting doctors for the duration of anesthesia. Meanwhile, the work of a surgeon is only the beginning of the path, because the result of treatment depends half on the organization. recovery period. Doctors say that the key to success is in right attitude the patient himself, who is ready to work on himself in close cooperation with specialists.

Features of postoperative rehabilitation

At rehabilitation therapy many goals. These include:

• warning possible complications operations;
• relief of pain or restrictions in mobility;
• speed up recovery and psychological recovery after illness;
• the return of the patient to an active healthy life.

At first glance, nothing complicated - it may seem that the human body itself is able to recover from a serious illness or traumatic surgical intervention. Many patients naively believe that the most important thing in the postoperative period is healthy sleep and good nutrition and the rest will heal by itself. But it's not. Moreover, self-treatment and carelessness in relation to rehabilitation measures sometimes nullify the efforts of physicians, even if the initial outcome of treatment was assessed as favorable.

The fact is that the recovery of patients after operations is a complete system medical events, which is being developed whole science, rehabilitation. The civilized world has long abandoned the idea of ​​providing patients with complete rest for a long time after surgery, because such tactics aggravate the patient's condition. Moreover, with the introduction of medical practice minimally invasive operations, the focus of rehabilitation has shifted from healing skin in the area of ​​the scar for recovery full-fledged work organism already on the second or third day after the intervention.

It is not necessary to get hung up on thoughts about the intervention itself during the preparation for the operation, this will lead to unnecessary worries and fears. Rehabilitologists advise you to think in advance what you will do when you regain consciousness on the first day after the operation. It is useful to take a player, a book or a tablet computer with your favorite movie with you to the hospital, which will help you escape from unpleasant sensations and tune in a positive way.

The competent organization of the recovery period after surgery is especially important for elderly patients who are more difficult to tolerate surgical interventions. In their case, the feeling of helplessness and forced restriction of mobility often develops into severe depression. People aged sometimes endure pain and discomfort until the last, embarrassed to complain medical staff. Negative mental attitude prevents recovery and leads to the fact that after the operation the patient will never fully recover. Therefore, the task of relatives is to think in advance about how the rehabilitation period will go, to choose a suitable clinic and a doctor responsible for fast recovery and good health elderly person.

Recovery period after surgery

The length of recovery after surgery depends on many factors. The most significant of these is the nature of the operation. So, even a person with good health after a small intervention on the spine will need at least 3-4 months to return to full life. And in the case of extensive abdominal surgery, the patient will have to follow a strict diet for several years to prevent the formation of adhesions. Separate conversation - operations on the joints, which often require numerous sessions of physiotherapy and therapeutic exercises, aimed at restoring lost functions and mobility of the limb. Well, after emergency interventions for a stroke or heart attack, the patient sometimes has to recover for many years in order to regain the ability to be independent and work.

The complexity of the operation is far from the only criterion for the duration of rehabilitation. Doctors draw Special attention on the age and sex of the patient (women tend to recover faster than men), the presence concomitant diseases, bad habits and level physical training before surgery. The motivation of a person to recover is also important - therefore, psychologists work in good rehabilitation centers along with doctors.

Methods for restoring the body after surgery

The arsenal of rehabilitation therapy includes an impressive number of methods, each of which has its own strengths and weak sides. Most patients in the postoperative period are advised to use a combination of several appointments, along the way fixing what exactly brings the greatest health benefits in each case.

• Medications . Pharmacological support is an important aspect of comfortable recovery after surgery. Patients are prescribed painkillers, as well as vitamins and adaptogens - substances that increase vitality (ginseng, eleutherococcus, pantocrine and other drugs). After some types of interventions are prescribed special preparations: during neurological operations, patients are often shown botox therapy - injections of botulinum toxin, which relieve muscle spasms, reducing tension in different areas the patient's body.
• Physiotherapy implies a beneficial effect physical factors(heat, water, electric current etc.) on the human body. She is recognized as one of the most safe methods treatment in modern medicine, but requires a competent approach and careful fixation of the result. Experienced Specialists on laser therapy, electromyostimulation and diadynamic therapy are in high demand today, because they help accelerate wound healing, relieve inflammation and reduce pain after any type of surgical intervention.
• Reflexology . This method of rehabilitation involves the impact on biologically active points on the human body with the help of special needles or "cigars" (moxa). It is classified as alternative medicine, but the effectiveness of reflexology has been repeatedly confirmed in practical activities many rehabilitation centers.
• exercise therapy ( physiotherapy) useful both for people who have undergone surgery on the bones and joints, and for patients recovering from cardiac surgery or a stroke. The built-in system of regular exercises helps not only to physical level, but also psychologically: the joy of movement returns to a person, mood improves, appetite increases.
• Mechanotherapy , despite the similarity with exercise therapy, refers to independent method rehabilitation of patients after surgery. It involves the use of simulators and special orthoses that facilitate the movement of debilitated patients and people with disabilities. physical abilities. In medicine, this method is gaining more and more popularity due to the introduction of new, improved devices and devices into practice.
• Bobath therapy - a technique aimed at eliminating spasticity (stiffness) in the muscles. It is often prescribed for children with cerebral palsy, as well as adults who have had acute disorder cerebral circulation. The basis of Bobath therapy is the activation of movements by stimulating the patient's natural reflexes. In this case, the instructor with his fingers acts on certain points on the body of his ward, which tones up the work of the nervous system during classes.
• Massage prescribed after many surgeries. It is extremely useful for elderly people suffering from diseases. respiratory system who spend a lot of time in horizontal position. Massage sessions improve blood circulation, increase immunity and can be a transitional stage that prepares the patient for active methods rehabilitation.
• diet therapy not only allows you to create proper diet in the postoperative period, but also plays a role in the formation healthy habits at the patient. This method of rehabilitation is especially important in the recovery of patients after bariatric operations (surgical treatment of obesity), people suffering from metabolic disorders, and debilitated patients. Modern rehabilitation centers always make sure that the menu for each patient is compiled taking into account his individual characteristics.
• Psychotherapy . As you know, the development of many diseases is influenced by the thoughts and mood of the patient. And even quality health care will not be able to prevent the recurrence of the disease if a person has a psychological predisposition to feeling unwell. The task of the psychologist is to help the patient realize what his illness was connected with, and tune in to recovery. Unlike relatives, a psychotherapist will be able to objective assessment situation and apply modern methods of treatment, if necessary - prescribe antidepressants and monitor the person's condition after the end of rehabilitation.
• Ergotherapy . The most painful consequence serious illnesses is the loss of self-care ability. Ergotherapy is a complex of rehabilitation measures aimed at adapting the patient to habitual life. Specialists working in this field know how to restore self-care skills to patients. After all, it is important for each of us to feel independence from others, while loved ones do not always know how to properly prepare a person after surgery for independent action, often overprotect him, which prevents proper rehabilitation.

Rehabilitation is a complex process, but you should not consider it an impossible task in advance. Experts recognize that the main attention should be paid to the first month of the postoperative period - the timely start of actions to restore the patient will help him develop the habit of working on himself, and visible progress will become the best incentive to a speedy recovery!

Any surgical operation is a serious intervention in the body, and one should not expect that everything will be “as before” after it. Even if the surgeon who performed the operation is a real genius of medicine and everything went well, rehabilitation is necessary to restore the strength and functions of the body.

Rehabilitation after surgery: is it really necessary?

“Why do we need rehabilitation after surgery? Everything will heal, and the body will recover itself, ”so, alas, many people in our country think. But it should be borne in mind that in a weakened organism, the possibilities for self-healing are reduced. Some operations, in particular on the joints and spine, require mandatory restorative measures, otherwise there is a risk that a person will never return to habitual way life. In addition, without rehabilitation after surgery, there is a high risk of complications caused by prolonged immobility. And not only physical ones - such as muscle atrophy and bedsores, as well as pneumonia caused by congestion- but also psychological. A man who until recently could move and serve himself, is chained to a hospital bed. This is a very difficult situation, and the task of rehabilitation is to return a person to both good health and spiritual comfort.

Modern rehabilitation provides not only recovery motor functions, but also the removal pain syndrome.

Stages, terms and methods of postoperative rehabilitation

When to Start postoperative rehabilitation? The answer is simple - the sooner the better. In fact, effective rehabilitation should begin immediately after the end of the operation and continue until an acceptable result is achieved.

The first stage of rehabilitation after surgery called immobilization. It continues from the moment the operation is completed until the plaster or sutures are removed. The duration of this period depends on what kind of surgery the person underwent, but usually does not exceed 10-14 days. At this stage, rehabilitation measures include breathing exercises for the prevention of pneumonia, preparing the patient for physiotherapy exercises and the exercises themselves. As a rule, they are very simple and at first they represent only weak muscle contractions, but as the condition improves, the exercises become more difficult.

From 3-4 days after the operation, physiotherapy is indicated - UHF therapy, electrical stimulation and other methods.

Second phase , post-immobilization, begins after the removal of plaster or sutures and lasts up to 3 months. Now great attention is given to increase the range of motion, strengthen muscles, reduce pain. The basis of rehabilitation measures during this period are physiotherapy exercises and physiotherapy.

Post-immobilization period divided into two stages: inpatient and outpatient . This is due to the fact that rehabilitation measures should continue after discharge from the hospital.

Stationary stage involves intensive recovery measures, as the patient must leave the hospital as soon as possible. At this stage, the rehabilitation complex includes physiotherapy exercises, classes on special simulators, if possible - exercises in the pool, as well as self-study in the ward. Important role physiotherapy also plays, especially its varieties such as massage, electrophoresis, ultrasound treatment (SWT).

Outpatient stage is also necessary, because without maintaining the results achieved, they will quickly come to naught. Usually this period lasts from 3 months to 3 years. AT outpatient settings patients continue their physical therapy classes in sanatoriums and dispensaries, outpatient physical therapy rooms, medical and physical education dispensaries, as well as at home. Medical control condition of patients is carried out twice a year.

Features of the recovery of patients after medical manipulations of various types

Abdominal operation

Like all bedridden patients, patients after abdominal operations must fulfill breathing exercises for the prevention of pneumonia, especially in cases where the period of forced immobility is prolonged. Physiotherapy exercises after surgery are first performed in the supine position, and only after the stitches begin to heal, the doctor allows you to perform exercises in a sitting and standing position.

Physiotherapy is also prescribed, in particular, UHF therapy, laser therapy, magnetotherapy, diadynamic therapy and electrophoresis.

After abdominal operations, patients are shown a special sparing diet, especially if the operation was performed on the gastrointestinal tract. Patients should wear supportive underwear and bandages, this will help the muscles quickly restore tone.

Joint operations

The early postoperative period during surgical manipulations on the joints includes exercise therapy and exercises that reduce the risk of complications from the respiratory system and of cardio-vascular system, as well as stimulation of peripheral blood flow in the extremities and improvement of mobility in the operated joint.

After that, strengthening the muscles of the limbs and restoring the normal movement pattern (and in cases where this is not possible, developing a new one that takes into account changes in the state) comes to the fore. At this stage, in addition to physical education, methods of mechanotherapy, exercises on simulators, massage, reflexology are used.

After discharge from the hospital, it is necessary to maintain the result with regular exercises and conduct classes to adapt to normal daily physical activity (ergotherapy).

Endoprosthetics of the femoral neck

Despite the seriousness of the operation, rehabilitation for femoral neck prosthetics usually passes relatively quickly. On the early stages the patient needs to perform exercises that will strengthen the muscles around the new joint and restore its mobility, as well as prevent blood clots from forming. Rehabilitation after hip arthroplasty also includes learning new motor skills - the doctor will show you how to sit, stand up and bend over correctly, how to perform normal daily movements without the risk of injuring the hip. Great importance have exercise therapy classes in a swimming pool. Water allows free movement and relieves the load on the operated hip. It is very important not to stop the rehabilitation course ahead of schedule - in the case of hip surgery, this is especially dangerous. Often people, feeling that they can safely move around without outside help, quit classes. But weak muscles quickly weaken, and this increases the risk of falling and injury, after which everything will have to start over.

Medical rehabilitation is not a new idea. Also in Ancient Egypt healers used some occupational therapy techniques to speed up the recovery of their patients. Doctors of ancient Greece and Rome also used physical education and massage in the treatment. The founder of medicine Hippocrates owns the following saying: "The doctor must be experienced in many things and, among other things, in massage."

Operations on the heart

Such operations are a real miracle of modern medicine. But a speedy recovery after such an intervention depends not only on the skill of the surgeon, but also on the patient himself and his responsible attitude to his health. Yes, heart surgery does not restrict mobility in the same way that joint or spinal surgery does, but that does not mean that rehabilitation treatment can be neglected. Without it, patients often suffer from depression, and their vision deteriorates due to swelling of the structures of the eye. Statistics show that every third patient who has not completed a course of rehabilitation soon finds himself on the operating table again.

The rehabilitation program after heart surgery necessarily includes diet therapy. Patients are shown dosed cardio loads under the supervision of a physician and physiotherapy exercises, classes in the pool (six months after surgery), balneotherapy and circular showers, massage and physiotherapy. Main part rehabilitation program psychotherapy, both group and individual.

Is it possible to carry out rehabilitation at home? Experts believe not. At home, it is simply impossible to organize all the necessary events. Of course, the patient can perform the simplest exercises without the supervision of a doctor, but what about physiotherapy procedures, exercises on simulators, therapeutic baths, massage, psychological support and others necessary measures? In addition, at home, both the patient and his family often forget about the need for systematic rehabilitation. Therefore, recovery should take place in a special institution - a sanatorium or rehabilitation center.

There are more and more operations to remove ovarian cysts by laparoscopy every year. This trend is due to the deterioration in the quality of life - malnutrition, unfavorable environmental situation, constant stress, and most importantly, a careless attitude to their own health. All this eventually leads to the appearance of not the most dangerous, but quite insidious tumor- ovarian cysts, which can seriously reduce the chances of pregnancy. That is why everything more women lie down on the operating table to remove the cyst and live a healthy, fulfilling life.

In this article, we will understand the reasons for the formation of a cyst, as well as talk about how surgery is carried out and how to restore the body after surgery.

Why does a cyst appear

In medicine, a cyst is called a benign tumor that occurs against the background of hormonal failure. Violation of hormone production leads to a situation in which the egg, which in certain moment must leave the follicle and connect with the sperm, does not leave the ovary, and a little later the follicle is filled with fluid, becoming a cyst. In itself, such a neoplasm is not dangerous, however, a tumor that has appeared at any time can begin to grow in size and fester, increasing the risk of rupture and the development of peritonitis. In addition, it is often the cyst that prevents a woman from becoming pregnant, which means that in order not to endanger her health and have a chance to have a baby, a woman decides to have an operation.

Surgeons perform cyst removal using the least traumatic method - laparoscopy. During this procedure, performed under general anesthesia, the patient is made three small punctures in the lower abdomen, introducing medical instruments and a camera through them. And so that nothing interferes with the removal of the cyst, a specially prepared gas is pumped into the patient's peritoneum. Such an operation is carried out for no more than 40 minutes, and the result of surgical manipulations is getting rid of the cyst and three almost imperceptible sutures.

Postoperative rehabilitation

It is worth noting that recovery process after the laparoscopic method of removal is much faster than after normal operation. And in order to speed up recovery and avoid postoperative complications, it is important to adhere to the basic stages of rehabilitation prescribed by the gynecologist. Let's list them:

1. Taking hormonal drugs. To facilitate the functioning of the ovaries and prevent re-education cysts, the patient may be prescribed antigonadotropins or synthetic progestins. Usually they are taken from the first day until the next menstruation.

2. Magnetotherapy with impact on the operated area. This procedure helps to pain and prevent inflammation.

3. Laser radiation. This low-intensity radiation helps prevent possible relapses.

4. Phonophoresis. Improves metabolic processes in tissues and promotes their speedy recovery. It is better to start the procedures a month after the intervention, combining the effects of phonophoresis with the use of drugs, for example, hydrocortisone.

5. Ozone therapy. The procedure improves blood microcirculation, increases immune defense body and has a bactericidal effect.

In addition, for a month after the surgery, the patient should adhere to a fractional diet food, drink vitamin complexes(required to include ascorbic acid), and engage in moderate physical activity.

Pain after surgery

Pain is a constant companion of the postoperative recovery period. And even if the pain after skin punctures is incomparably easier than after a conventional operation, for several days and even weeks they can be serious problem for the operated patient. To minimize discomfort, a woman is prescribed painkillers, and it is also recommended not to make sudden movements.

Another thing is the gas that fills the peritoneum for the operation. It puts a lot of pressure on internal organs, which is why a few days after the intervention, the patient feels aches and pains in the lower back and back. In order to quickly normalize the condition, it is necessary to walk more, making hiking 2-3 r / day. Medicines in such a situation do not bring relief.

Possible discharge after surgery

During the recovery period, various uncharacteristic discharges may appear from the patient's vagina. During the first 3-4 days, they can be bloody, which, with a small volume, can be considered the norm. For two weeks after the intervention may be allocated clear slime and that's fine too. It is necessary to sound the alarm in the case when copious blood discharge appears or the appearance of yellowish thick mucus is observed.

When they are discharged from the hospital and the stitches are removed

We must say right away that already three hours after the operation in question, the patient can stand on her own feet. Moreover, doctors strongly recommend that you immediately start moving, the main thing is to do it smoothly so as not to damage the seams.

If the surgery was successful, the woman can be discharged from the hospital on the 3rd day. However, practice shows that in most cases, discharge occurs on the 5th day, after which she will be on sick leave for up to 10 days. For recovery to be more intense, it is important to observe medical recommendations, namely:

• for 1 month do not take a bath and do not go to the bathhouse (shower only);
• within thirty days after the operation, any physical exertion should be avoided;
• lifting weights after such an operation is prohibited for 3 months;
• it is worth abandoning long hikes and travels;
• sexual intercourse should be avoided for 4 weeks, and unprotected intimacy a few more months, as experts do not recommend getting pregnant for the first six months after removing the cyst.

If we talk about the seams (one is located in the navel, and two are slightly lower), then every day for a week they need to be disinfected, and, if necessary, drained. Complete healing of the sutures takes about 8-10 days, after which they become almost invisible. By this time, the woman should visit a doctor to remove the stitches.

Period after surgery

If the surgery went without complications, the menstrual cycle should begin on time. However, the majority of patients undergoing this operation reported that menstruation appeared only two cycles after laparoscopy. Such a period of delay can be considered the norm, but if it drags on even longer, you need to visit a doctor and undergo an examination. In addition, the first months after surgery may change the duration and nature menstrual flow which should also be noted. In this regard, heavy and prolonged periods should be alarming.

Postoperative nutrition

Doctors strongly advise against eating on the day of surgery. It is only allowed to accept clean water without gas. In the first week after the operation, it is allowed to consume liquid or well-ground puree-like food, which is preferably steamed. from fried and canned food, spicy and salty foods, as well as all kinds of sauces and marinades, the first 25–30 days after the operation should be abstained. Smoked meats, offal, and flour products should not be consumed. In addition, it is not recommended to eat raw vegetables and fruits for a week after the intervention.

During the recovery period, it is useful to consume liquid soups and cereals, as well as pre-boiled and grated vegetables and fruits. You can start returning to your previous diet in about a month.

Most women are afraid of gynecological operations. We asked Evgenia Petrovna Tishchenko, a certified osteopath of the Russian Osteopathic Association, about the intricacies of their implementation and the features of high-quality recovery to return to the previous way of life.

Types of operations and their features

How to bounce back after gynecological surgery

Recovery after surgery depends on a number of objective factors:

• whether the operation was emergency or planned;
• condition general health women before surgery;
• volume and complexity of surgery. The complexity of the operation determines its duration, and, therefore, the time spent under anesthesia;
• whether there was a laparoscopic or laparotomy operation or a perineal and vaginal approach was used;
• what type of anesthesia was used: endotracheal or epidural anesthesia.

There are also subjective factors- this is a woman's reaction to the need to undergo surgery on the most precious thing she has, the reproductive organs.

From the experience of working with patients, I know that an operation, for example, on gastrointestinal tract it is psychologically better tolerated than a small gynecological operation.

What is the difference between laparoscopy and laparotomy?

In laparoscopy, the operation is performed with small, elegant instruments inserted into the abdominal cavity through several small openings on the abdomen. A camera is inserted into one of them, which displays the image on a large screen. Doctors' hands move from the outside, actuating instruments inside the abdomen.

This approach can significantly reduce tissue trauma, blood loss during surgery, and the risk of adhesion formation.

Holes on the abdomen heal quickly and become invisible after 2-3 months. And no one, looking at you in a bikini, will guess that you had surgery.

The disadvantage of laparoscopy is that only endotracheal is used for it or, speaking plain language, general anesthesia. That is, a special tube is inserted into the windpipe, drugs are injected that block their own breathing. During the entire operation, artificial lungs breathe for the patient. However, modern equipment allows minimizing complications from this type of anesthesia.

Laparotomy is an operation through an incision in the abdomen, which in modern medicine is carried out along the pubic hairline.

The laparotomy approach is used in operations that require the removal of a large part of the organs and in emergency situations that involve the presence of a large amount of blood in the abdomen. For example, rupture of the tube during an ectopic pregnancy.

During laparotomy, both endotracheal anesthesia and epidural anesthesia are used. As a method of choice for anesthesia, epidural anesthesia is much safer than general anesthesia.

Into the hole between the second and third lumbar vertebrae an anesthetic is injected through a thick needle. The patient completely loses the sensitivity of the body below the navel. During the operation, she can be conscious or doze off under the influence of sleeping pills, but all the vital activity of the body is preserved, the lungs breathe on their own.

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Gynecological operations that are performed "from below" are operations with lowering pelvic organs or plastics of the perineum with a divergence of its muscles.

Operations by vaginal or perineal access are performed more often under epidural anesthesia, which contributes to good general well-being after the intervention.

The easiest way is recovery after the removal of small benign tumors ovaries. The most common of these are simple serous cystadenomas, endometrioid cysts and teratomas. The operation is performed laparoscopically and takes 30-40 minutes. This also includes gynecological cosmetology.

The patient will be at home the next day. Subject to the recommendations of the surgeon, recovery in this case occurs quickly.

It is much harder to recover from the removal of the uterus and its appendages, including, possibly, the ovaries. And there may be various options events.

I have patients who say: "I'm so tired of these fibroids, bleeding, abdominal pain." And they easily pass through the removal of the uterus. They quickly and correctly recover after the operation and happily live on.

There are those who, despite the totality of disturbing symptoms and objective indicators of gynecological ill health, make a decision about an operation with great difficulty. Almost doomed. “Yes, I know that there is no other way…” And they have already tried everything: traditional and non-traditional.

And the saddest thing. The patient was going to be removed small tumor ovary or myomatous node, and after the operation the surgeon said that "everything had to be removed."

Recovery after complex gynecological operations

How do patients react and what to do after a complex intervention?

First. "I won't be able to have children anymore"

It concerns isolated cases. Modern gynecological surgery is aimed at organ-preserving operations. And she fights with all her might for the possibility of motherhood for women. And even if necessary big operation in patients reproductive age it is possible to save eggs, cryoembryos, use donor eggs, surrogacy.

Second. "And if I have a premature menopause?"

If the ovaries are preserved during surgery, then all physiological changes menstrual cycle persist, only there is no menstruation. Removal of the uterus does not bring menopause closer. It occurs in accordance with the biology of the organism.

If it starts to change for the worse, or if the ovaries were removed during the operation, it makes sense to discuss with the gynecologist the transition to replacement hormone therapy. Fortunately, modern pharmacology now provides a large number of quite effective and safe hormonal drugs.

Third. "But what about sex after?"

Very often, women are worried about their sexual life after a major surgery. I will answer from my great experience communication with patients after major gynecological operations. Libido is not reduced. Moreover, the disappearance of associated gynecological disease symptoms, such as intermenstrual blood secretions, the disappearance of the fear of pregnancy makes sex life brighter and more saturated.

No man will ever feel your "internal anatomy" during sex. A partner's doubts about his feelings in sex can only begin if a woman describes in detail to him the operation she went through.

If dryness occurs in the vagina, various lubricants can be used.

Are there other health problems after surgery and what should patients do?

The first is weakness. Patients often complain about persistent long time weakness and fatigue. In order to recover faster after surgery, it is necessary to assess the degree of anemia. For this, indicators such as serum iron and the iron-binding capacity of the blood are used, and not hemoglobin as such. It is also important to donate blood for trace elements and vitamins and add to the diet those that are lacking.

Balanced diet and enough Sleep is the key to any recovery.

Next comes the pain. Postoperative pains usually bother no more than 2-3 weeks and they are dictated by the fact that the wounds inside the body must heal. The pain is rather aching in nature, does not require the use of painkillers and intensifies after physical exertion.

For patients with a large operative volume and a weakened abdominal wall, it is recommended to wear postoperative bandage. For everyone, there is a limitation of lifting weights of more than 2-3 kg.

What if the pain persists longer, sometimes dragging on for months, and when examining the reasons for them, they do not find?

Postponed gynecological operations can lead to chronic pelvic pain. In the presence of, for example, a large uterine fibroids, the entire pelvis of a woman twists around her for a long time. And after the removal of the organ, the ligaments and muscles of the pelvis need to find a new balance. The body does not always have enough strength for this and with the help of pain it tells about the need for help.

Sometimes after surgery, the outflow of blood from the pelvis may be disturbed and venous congestion talks about himself with bursting aching pains.

Adhesions may also form after surgery. And they are not related to the quality of the operation, but are more determined by the genetic predisposition to adhesive processes.

In such situations, osteopathic treatment provides a good opportunity for recovery. Osteopaths are able to create a new healthy balance of the pelvis, reduce adhesive process remove venous congestion. And after 3-4 sessions, the pain goes away forever.

I would also recommend that every patient undergo at least one osteopathic session as a preventive measure. This will allow you to check the condition of muscles, bones and ligaments after surgery, to loosen the tension of the suture on the anterior abdominal wall. Osteopaths are able to erase the “memory” of anesthesia from the body.

How to restore the mobility of the tissues of the pelvis, anterior abdominal wall and perineal tissues?

Physical activity can be started 2-3 months after surgery. But in order to create a good churn venous blood from the pelvic cavity, to prevent weakening of the abdominal press and the pelvic diaphragm, I would recommend starting to do the “vacuum” exercise already 2-3 weeks after the operation.

The exercise is performed strictly lying on a comfortable surface. Legs should be slightly bent at the knees. Point the chin slightly towards the chest. 2-3 full breaths are taken with the stomach. Then, as you exhale (!!), you need to draw in your stomach, imagining that you are zipping up tight jeans, pulling your navel towards your spine, and your abdominal diaphragm up. Hold the breath out as far as possible. Then a smooth inhalation and 2-3 inhalations-exhalations. Repeat "vacuum".

Such a session can be performed 5-7 minutes a day. The result will be a feeling of lightness in the abdomen and a good tone of the abdominal wall. If the exercise brings pain and discomfort in the abdomen, it should be postponed for a week.

As for the restoration of the muscular corset, especially the transverse abdominal muscle after laparotomy, I would recommend starting classes strictly with an exercise therapy doctor or a medical fitness instructor. First of all, the deep muscles of the abdomen and pelvis are subject to restoration. Alone or on group lessons such a result is practically unattainable.

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Separately, I would like to dwell on the recovery after operations for the prolapse of the pelvic organs. That they were "raised back" surgically, does not mean that they will not fall again. Definitely needed physical rehabilitation, and these are not just Kegel exercises, the physiology of which I, as a gynecologist and osteopath, have great doubts about.

After such operations, jewelry work is required to strengthen the short muscles of the pelvis, adductor muscles of the thigh and the entire abdominal press. Only then the effect of the operation will last for years.

Thank you very much!

Be healthy!

Evgenia Tishchenko, osteopath of the Clinic for Restorative Medicine “Quality of Life”, Candidate medical sciences, obstetrician-gynecologist. Medical experience since 1992