Hysterectomy - a surgical procedure to remove the uterus. Operation eliminates the possibility of further pregnancy. If a woman has not reached menopause, the menstrual cycle is terminated, regardless of age.
The female reproductive system consists of the following organs:
- Uterus - a pear-shaped organ where the baby develops.
- Cervix - the lower uterine segment.
- Sheaths - muscular tube disposed below the cervix.
- Fallopian tube, uterus connecting the ovaries.
- Ovaries - pair of female reproductive glands.
Indications for hysterectomy
It is a major operation recommended in cases where other treatments have failed. The most common reasons for which is assigned to conduct this surgery:
- Abundant menses (menorrhagia) caused by, for example, myoma.
- Severe pain provoked by endometriosis, adenomyosis or myoma.
- uterine prolapse.
- Cancer of the uterus, ovaries or cervix.
Many women lose large amounts of blood during menstruation. In addition, there are other symptoms such as pain and abdominal cramps. Sometimes it has a significant impact on quality of life. Abundant periods may also be caused by fibroids, but in many cases there is no obvious cause.
Sometimes, removal of the uterus may be the only way to stop heavy menstrual bleeding:
- When other treatments have been ineffective.
- Plentiful monthly significantly impair quality of life.
- The woman no longer wants to have children.
Inflammatory diseases of the small MAZ
These pathologies develop due to a bacterial infection. When it is detected early use of antibiotics. However, if it spreads, it is able to damage the uterus and fallopian tubes, causing constant pain.
Removal of the uterus and fallopian tubes may be recommended if a woman is suffering from severe pain, and is not planning a pregnancy.
This is a condition in which the cells lining the uterus, penetrate into other areas of the reproductive system (ovaries, Fallopian tubes) and organs (bladder, rectum). As a result, they cause inflammation and damage. This leads to pain, heavy and irregular menstruation and infertility.
With hysterectomy may remove portions affected endometrium. However, this operation is considered only if other less invasive procedures do not work as well as the woman decides not to have children.
Fibroid tumor is not malignant, it is composed of muscle and fibrous tissue. Symptoms are:
- heavy and painful menstruation;
- pelvic pain;
- frequent urination or constipation;
- pain or discomfort during sex.
Hysterectomy may be advised if large fibroids, there is severe bleeding, pregnancy is not planned in the future.
A disease in which endometrial cells begin to grow in the muscular wall of the uterus. This additional tissue causes a particularly painful menstruation and of pain in the pelvic area.
uterine hysterectomy can be considered only when other methods have failed, and she no longer wants to have children.
Uterine prolapse occurs when the tissue and ligaments that support the body becomes too weak. Symptoms include back pain, sense of movement in the vagina, urinary incontinence and difficulty in sex. Prolapse often is a result of childbirth.
uterine hysterectomy is recommended that tissues and ligaments are too weak, and further births are planned.
Hysterectomy is carried out under the following types of cancer: cervical cancer, ovarian cancer, fallopian tubes, and a cancer edometriya (uterus).
If the disease has spread, surgery may be the only viable treatment option.
types of hysterectomy
There are several types of this operation. The choice affects the underlying disease and the ability to secure the conservation of the reproductive system:
- Total hysterectomy - the most frequently performed surgical procedure involves removal of the uterus and cervix. It is the most preferred embodiment after subtotal hysterectomy because There is a chance of developing cervical cancer.
- Subtotal hysterectomy removes the main body, but retains the cervix. This procedure is performed infrequently, because the risk remains of cervical cancer, will require further regular checks. It is important to discuss with your surgeon any risks associated with the conservation authority.
- Total hysterectomy with bilateral removal of the epididymis: resecting the uterus, cervix, fallopian tubes and ovaries. This operation is recommended if there is a possibility of further problems, for example, have ovarian cancer in the family history. The doctor informed about all the pros and cons of surgery.
- A radical hysterectomy involves removal of the uterus and surrounding tissues, including the fallopian tubes, the vagina, the ovaries, lymph nodes, and adipose tissue. Usually, it is carried out for the removal and treatment of cancer, when other methods, such as radiation and chemotherapy can not be used or have failed.
There are three methods of hysterectomy:
- Vaginal method: the uterus is removed through an incision in the upper part of the vagina. Use special surgical instruments, separating the body from the ligaments that hold it. After the incision was sutured hysterectomy, surgery lasts about an hour. Use of general anesthesia or epidural anesthesia. Typically vaginal method is more preferable as compared with abdominal because less invasive and requires a short hospital stay. The recovery period is also smaller.
- Abdominal method: the operation is performed through an incision in the lower abdomen. It can perform horizontally along the bikini line, or vertically, from the navel to the bikini line. Vertical incision is used for large fibroids or some types of cancer. The operation is performed under general anesthesia and lasts about one hour. Adbominalnuyu recommend a hysterectomy, the uterus is enlarged or when there is pelvic tumors that can not be removed through the vagina, as well as the need for resection of the ovaries.
- Laparoscopic hysterectomy involves the operation through several small incisions in the abdomen using special medical equipment and general anesthesia. To date, it is considered the preferred method of treatment.
What to look for
The decision on the transaction is based on medical history, doctor recommendations and opinions very patient. It is important to know about the different types of hysterectomy and their consequences.
cervical removal (radical hysterectomy)
If diagnosed with cancer of the cervix, ovaries or uterus can recommend a total view of the operation in order to prevent the spread of disease.
Many women are concerned that removing the cervix will lead to loss of sexual function, but there is no evidence of this. Some seek to preserve as much as possible organs of the reproductive system. In this case, it is very important to discuss with your surgeon the risks associated with cervical preservation. There will also be permanent screening tests needed in the future.
Spaying (total hysterectomy with bilateral appendages removal or radical surgery)
Oophorectomy is recommended if there is a serious risk of ovarian cancer to prevent the disease in the future, for example, when the family history of ovarian cancer or breast cancer.
The doctor at the clinic Assuta discusses the pros and cons of surgery with the patient. Together with resection of ovarian fallopian tubes are removed.
In the absence of a family history of the disease, surgeons may not offer the operation because the ovaries produce more female hormones, which can help protect against conditions such as osteoporosis. In addition, they affect the sexual desire and pleasure.
It is important to discuss all the fears and concerns with your doctor.
After total or radical hysterectomy, when the ovaries are removed, menopause immediately after the operation, irrespective of age. If surgery does not affect the ovaries, menopause is likely within five years after surgery.
Despite the fact that with the onset of menopause hormone levels decline, the ovaries continue to produce testosterone for another 20 years. It plays an important role in stimulating sexual desire and enjoyment of sex.
In addition, after the onset of menopause, the ovaries continue to produce small amounts of estrogen. Its deficiency causes the symptoms of menopause - hot flashes, depression, vaginal dryness, insomnia, fatigue and night sweats. Hormone replacement therapy is typically used to alleviate these symptoms.
Hormone replacement therapy (HRT)
After removal of the ovaries at the clinic Assuta can be offered this type of treatment. It replaces the natural hormones and relieves any manifestations of menopause.
Most likely, you will need to try different medications and doses, before there is a suitable alternative.
HRT is contraindicated. It is not suitable for women who have had hormone-dependent breast cancer or liver disease.
After removal of the ovarian hormone replacement therapy is continued until, until the patient has reached the normal age of menopause (average -52 years).
The process of preparing
If you have to hysterectomy, it is important to overall health as much as possible is good. This will help reduce the risk of complications and speed up the healing process.
The following steps should be taken:
- Quit smoking, if there is such a habit.
- Eat a healthy and balanced diet.
- Exercise regularly.
- Lose weight when there is excess weight.
A few days before the surgery, you may need to pass some blood tests and undergo a general medical examination to ensure that the patient is ready for a hysterectomy. It is also a good opportunity to discuss any concerns and ask questions of the doctor in Assuta.
After surgery, marked fatigue and pain sensation, to reduce employing analgesics. Installed drip and a urinary catheter, after abdominal hysterectomy - also drainage. After a day - two of them removed.
The next day, after a hysterectomy patient is offered a short walk, it reduces the risk of complications such as deep vein thrombosis.
Physiotherapist showing some exercises for the pelvic floor muscles and exercises that promote mobility, to speed up the healing process.
After 5-7 days, remove the sutures.
Temporary side effects after hysterectomy
There is a probability of occurrence of some of the undesirable effects of surgical treatment.
Irregularities in the bladder and bowel
Sometimes there is the development of urinary tract infections or constipation. These side effects are easy to handle. It is recommended to drink up to two liters of fluid a day, increase the number of fruits and whole fiber in the diet to intensify the work of the bodies. For the first time after a hysterectomy , you may need a laxative to avoid muscle strain.
After surgery, notes some vaginal bleeding and discharge up to 6 weeks. It is necessary to consult a doctor if the bleeding is strong enough, there are blood clots.
In connection with the removal of the ovaries develop symptoms of menopause: hot flashes, anxiety, mood swings, night sweats. May require replacement hormone therapy in the form of injections, pills, or subcutaneous implants. It usually takes about a week before the effect appears.
After a hysterectomy, the uterus woman can feel a sense of loss and sadness. This is especially observed in patients with advanced cancer, where there is no other treatment options.
Women who have not reached menopause, there is a loss, because they can no longer have children. Others feel less feminine. In some cases, a hysterectomy becomes an impulse to depression.
The doctor at the clinic Assuta will assist and advise on available treatment options. Also chat with other women who have had this operation can have emotional support and bring comfort.
The consequences of the uterus hysterectomy
As with all types of surgery, hysterectomy can lead to certain complications.
- General anesthesia. Very rarely have serious complications after general anesthesia (1 10 000). These include nerve damage, allergic reactions and death (1: 100,000). Good overall health reduces the risk of problems.
- Bleeding. Operation is quite large, you may need a blood transfusion.
- Damage to the ureter, its probability is 1%.
- Damage to the bladder or bowel. Very rarely experiencing these complications. They can cause infections, urinary incontinence or frequent urination. May require temporary measures: urinary catheter or colostomy.
- Infection. There is always a risk of infection after surgery. It may be a urinary tract infection, respiratory or vaginal infections. For the treatment and prevention clinic Assuta used antibiotics.
- Thrombosis. Inside the vessel is formed a blood clot which prevents the circulation of blood and oxygen supply to the tissues. The likelihood of blood clots increases after uterine hysterectomy, because the patient is in a state of immobility. It is recommended as soon as possible begin to move. Also anticoagulation can be provided in the clinic Assuta, such as warfarin.
- Vaginal problems. If vaginal hysterectomy has been performed, there is a risk of disturbances in the upper part of the vagina, where the cervix has been removed from slow healing to prolapse in later years.
- Ovarian failure. Even if the ovaries were not affected during the uterus hysterectomy, may be some problems within five years after surgery. This is due to the fact that part of the organ perfusion was in the uterus, which was removed.
- Early menopause. Oophorectomy results in symptoms of menopause - hot flushes, sweating, vaginal dryness and sleep disturbances. Menopause stops ovulation. If the woman is younger than 40 years before the start of menopause increases the risk of osteoporosis, because it reduces the level of estrogen. Depending on the age and circumstances, you may need medication to prevent bone disease.
Recovery after a hysterectomy
hospitalization period will depend on the age and general health of the operation.
After a vaginal or laparoscopic hysterectomy the hospital stay will be from one to four days, with abdominal - not less than five. After 4-6 weeks, will need to visit the doctor, follow-up meetings, as a rule, it is not required if there are no complications.
Full recovery from abdominal hysterectomy is 6-8 weeks after laparoscopic vaginal or much less. During this time, you need to rest as much as possible and do not raise anything heavy.
Return to normal life after a hysterectomy, the uterus
As soon as the patient can return to work depends on how she is feeling and what activity is involved. If the work does not involve manual labor and heavy lifting, the recovery period will last 4-8 weeks.
Drive the car will be after 3-8 weeks. There is an opportunity to talk with a therapist about this issue before proceeding.
Doctors at the clinic Assuta advise on the options exercise after hysterectomy. All absolutely recommend walking. You must start slowly, do not lift heavy objects in the recovery period.
Sex may be resumed for at least six weeks after surgery, when to stop any discharge from the vagina, the woman will feel comfortable and relaxed. If the ovaries have been removed, and is not carried out HRT, sometimes there is some vaginal dryness. Many women have a loss of sexual desire, but it usually returns after a complete recovery.
At the time of the study show a reduction in pain during sex, increase orgasm power, sexual desire and activity after a hysterectomy.
Contraception is not necessary, but it is important to use condoms to protect themselves from infection, sexually transmitted diseases.
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