What are the key factors affecting recovery after hysterectomy. How does the surgical method impact healing and scarring. What are the potential long-term effects of uterus removal. How does oophorectomy during hysterectomy affect women’s health.

Understanding Hysterectomy: A Comprehensive Overview

A hysterectomy is a major surgical procedure that involves the removal of the uterus, an organ essential for reproduction in women. Located in the female pelvis, the uterus is flanked by fallopian tubes and ovaries on each side. During pregnancy, this organ plays a crucial role in nurturing the developing fetus.

What happens after a hysterectomy? Following the procedure, a woman will no longer experience menstruation and cannot become pregnant. This significant change in reproductive capability underscores the importance of understanding the recovery process and long-term implications of the surgery.

Types of Hysterectomy Procedures and Their Impact on Recovery

The method used to perform a hysterectomy greatly influences the recovery process. There are several approaches, each with its own set of considerations:

• Abdominal hysterectomy
• Vaginal hysterectomy
• Laparoscopic-assisted vaginal hysterectomy

Abdominal Hysterectomy: Recovery and Scarring

An abdominal hysterectomy involves a 5- to 7-inch incision in the abdomen. How is this incision closed? Typically, surgeons use dissolvable stitches or surgical staples. In cases where non-dissolvable stitches or staples are used, they will need to be removed by a doctor during follow-up care.

Vaginal Hysterectomy: A Less Invasive Approach

A vaginal hysterectomy, performed without laparoscopic assistance, leaves no visible scarring. The surgeon makes a small incision in the vagina, which is closed with internal, dissolvable stitches. This method often results in a quicker recovery compared to abdominal hysterectomy.

Laparoscopic-Assisted Vaginal Hysterectomy

In this procedure, the surgeon uses a laparoscope and other instruments inserted through small abdominal incisions. Patients can expect two to four incisions, each less than 1 inch long. These are typically covered with Steri-strips that fall off within a week, leaving minimal scarring.

Emotional and Psychological Aspects of Hysterectomy Recovery

The emotional impact of a hysterectomy can vary significantly among women. Dr. Leena Nathan, assistant clinical professor at UCLA Health Obstetrics and Gynecology, notes that reactions can range from relief to a profound sense of loss.

Why do some women feel relief after a hysterectomy? For perimenopausal women suffering from fibroids or bleeding issues, the procedure often provides a permanent solution to their problems, leading to a sense of relief.

Conversely, why might younger women experience negative emotions? Women of childbearing age who undergo hysterectomy for cancer or precancer may grapple with feelings of loss, disappointment, and guilt, particularly if they had plans for future pregnancies.

Long-Term Health Considerations Post-Hysterectomy

The long-term effects of a hysterectomy can vary based on several factors, including age, overall health, and which specific organs were removed during the procedure. Recent research has shed light on potential health risks that were previously not well understood.

Cardiovascular Health and Hysterectomy

How does hysterectomy affect heart health? Dr. Shannon Laughlin-Tommasso from the Mayo Clinic highlights recent studies indicating long-term risks, including an increased likelihood of coronary artery disease and congestive heart failure. These findings suggest that the impact of hysterectomy on cardiovascular health may be more significant than previously thought.

Oophorectomy: The Impact of Ovary Removal During Hysterectomy

Oophorectomy, the medical term for ovary removal, is sometimes performed alongside hysterectomy. Historically, preserving the ovaries was considered beneficial due to their continued production of estrogen, which supports bone health and heart function.

However, recent research has challenged this assumption. Studies now indicate that some health risks associated with hysterectomy may occur even when the ovaries are preserved. This new understanding emphasizes the need for careful consideration and thorough discussion with healthcare providers when planning a hysterectomy.

Post-Operative Care and Recovery Timeline

Recovery after a hysterectomy is a highly individual process, with some women bouncing back quickly while others require more time. What factors influence recovery time?

• The type of hysterectomy performed
• The patient’s overall health and age
• The reason for the hysterectomy
• Adherence to post-operative care instructions

How long does it typically take to recover from a hysterectomy? While experiences vary, most women can expect to return to normal activities within 4 to 6 weeks after an abdominal hysterectomy, and 3 to 4 weeks after a vaginal or laparoscopic hysterectomy.

Key Recovery Milestones

1. Immediate post-op: Focus on rest and pain management
2. First week: Gradual increase in light activities
3. 2-3 weeks: Return to light household tasks
4. 4-6 weeks: Resumption of most normal activities, including work (depending on job requirements)
5. 6-8 weeks: Clearance for more strenuous activities and exercise

Managing Post-Hysterectomy Symptoms and Complications

While hysterectomy is generally a safe procedure, it’s important to be aware of potential symptoms and complications that may arise during recovery.

Common Post-Operative Symptoms

• Vaginal bleeding or discharge
• Abdominal pain and bloating
• Fatigue
• Constipation
• Emotional fluctuations

How can these symptoms be managed? Most can be addressed with proper rest, pain medication as prescribed, gentle exercise, and a balanced diet. However, it’s crucial to communicate any concerns with your healthcare provider.

Recognizing Potential Complications

While rare, complications can occur after a hysterectomy. What signs should prompt immediate medical attention?

• Heavy vaginal bleeding
• Severe abdominal pain or swelling
• Signs of infection (fever, chills, foul-smelling discharge)
• Difficulty urinating or having bowel movements
• Chest pain or shortness of breath

Prompt recognition and treatment of these symptoms can prevent more serious complications and ensure a smoother recovery process.

Lifestyle Adjustments and Long-Term Health Management

A hysterectomy often necessitates certain lifestyle adjustments and ongoing health management strategies. What are some key considerations for long-term health after hysterectomy?

Hormone Replacement Therapy (HRT)

If the ovaries were removed during the hysterectomy, especially in younger women, hormone replacement therapy may be recommended. HRT can help manage symptoms of surgical menopause and protect against bone loss and cardiovascular issues.

Bone Health

Women who have undergone hysterectomy, particularly with ovary removal, may be at increased risk for osteoporosis. How can this risk be mitigated? Regular weight-bearing exercise, adequate calcium and vitamin D intake, and bone density screenings are important preventive measures.

Cardiovascular Health

Given the potential increased risk of heart disease following hysterectomy, maintaining cardiovascular health becomes crucial. This includes regular exercise, a heart-healthy diet, stress management, and routine check-ups to monitor blood pressure and cholesterol levels.

Sexual Health and Intimacy

How does hysterectomy affect sexual function? While many women report no change or even improvement in their sex lives after hysterectomy, others may experience changes in libido or sexual response. Open communication with partners and healthcare providers can help address any concerns and ensure a satisfying intimate life post-surgery.

In conclusion, while a hysterectomy is a significant surgical procedure with both immediate and long-term implications, proper understanding, preparation, and follow-up care can lead to a successful recovery and maintain overall health and well-being. As medical research continues to evolve, staying informed and maintaining regular check-ups with healthcare providers remains crucial for women who have undergone this procedure.

Recovery After Hysterectomy: What to Know

A hysterectomy is a surgical operation to remove the uterus, the organ located in the female pelvis.

Attached to the uterus on each side is a single fallopian tube and one ovary.

During pregnancy, a fertilized egg implants itself in the lining of the uterus where the developing fetus is nourished prior to birth.

The uterus, or womb, is crucial for reproduction. After undergoing hysterectomy, a woman will no longer menstruate and she cannot become pregnant.

Hysterectomy Surgery and Recovery: Factors to Consider

As with any surgery, recovery varies from person to person. Some women recover more quickly and resume their everyday activities fairly quickly, while others need a bit more time.

But in the case of hysterectomy, the surgical method used to remove the uterus will determine the type of recovery to expect.

Methods Matter: What to Know About Hysterectomy Side Effects, Scarring, and Long-Term Healing

The way in which a hysterectomy is performed can play a major role in your recovery.

If you have an abdominal hysterectomy, you will have a 5- to 7-inch incision that needs to heal. This incision is usually closed with stitches — commonly the dissolvable kind — or surgical staples. If staples or nondissolvable stitches are used, they will have to be removed by your doctor. (1)

If you have a vaginal hysterectomy without the assistance of a laparoscope, you will have no visible scarring from the small incision in the vagina made by the surgeon. The internal stitches used will likely dissolve on their own. (2)

If you’ve had a vaginal hysterectomy and your surgeon inserted a laparoscope or other instruments into your abdomen, expect to have about two to four incisions, each less than 1 inch long covered with Steri-strips that will most likely fall off within a week. (2)

The Emotional Impact After the Uterus Is Removed

“Women have a wide range of emotions when it comes to having hysterectomy,” says Leena Nathan, MD, assistant clinical professor at UCLA Health Obstetrics and Gynecology in Westlake Village, California. “For women who are perimenopausal and suffering from fibroids or bleeding issues, there is a sense of relief when they have a permanent solution to their problems.”

“For women of childbearing age who have a hysterectomy for cancer or precancer, there can be a profound sense of loss, disappointment, and guilt,” adds Dr. Nathan.

Hysterectomy and Potential Long-Term Effects

Long-term effects vary from woman to woman depending on age, health, which organs were removed, and other factors.

Oophorectomy: When Ovaries Are Removed During Hysterectomy

Oophorectomy is the medical term for removing a woman’s ovaries.

For many years, research has indicated that whenever possible, it’s best not to remove the ovaries with hysterectomy because the organs will continue to produce estrogen that is essential for bone health and can help protect you from heart disease.

However, some recent research seems to indicate that some of these problems occur even when the ovaries are preserved or not removed. “Several recent studies have also shown long-term risks, including coronary artery disease and congestive heart failure,” says Shannon Laughlin-Tommasso, MD, obstetrician and gynecologist, as well as research consultant, at the Mayo Clinic in Rochester, Minnesota. Dr. Laughlin-Tommasso authored one such study. (4)

Editorial Sources and Fact-Checking

1. Abdominal Hysterectomy: About. Mayo Clinic. April 27, 2021.
2. Vaginal Hysterectomy: About. Mayo Clinic. February 25, 2021.
3. Patient FAQs After Surgery. UNC School of Medicine.
4. Laughlin-Tommaso SK, Khan Z, Weaver AL, et al. Cardiovascular and Metabolic Morbidity After Hysterectomy With Ovarian Conservation: A Cohort Study. Menopause. May 2018.

Additional Sources

• Elsamadicy EA, Mehta S, Le C, et al. Length of Hospital Stay and Costs Associated With Laparoscopic Versus Vaginal Hysterectomy: Study of 1,553 Patients [4L]. Obstetrics & Gynecology. May 2019.
• Charoenkwan K, Matovinovic E. Early Versus Delayed Oral Fluids and Food for Reducing Complications After Major Abdominal Gynaecologic Surgery. Cochrane Database of Systematic Reviews. December 2014.
• Hot Flashes: Symptoms and Causes. Mayo Clinic. May 20, 2022.
• Hysterectomy — Vaginal — Discharge. MedlinePlus. March 31, 2020.
• Hysterectomy. National Women’s Health Network. July 9, 2015.
• Hysterectomy. Office on Women’s Health. February 22, 2021.
• Pain Control After Surgery. Cleveland Clinic. October 16, 2020.
• Feltmate CM. Patient Education: Care After Gynecologic Surgery (Beyond the Basics). UpToDate. October 22, 2021.
• Postoperative Bleeding. Drugs.com. October 3, 2022.
• Weed HG, Baddour LM, Ho VP. Fever in the Surgical Patient. UpToDate. July 11, 2022.
• Precancerous Changes to the Cervix. Texas Oncology.
• Raghvendra KP, Thapa D, Mitra S, et al. Postoperative Pain Relief Following Hysterectomy: A Randomized Controlled Trial.  Journal of Mid-Life Health. April–June 2016.

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Timescales, tips, and what to expect

A vaginal hysterectomy is a procedure to remove the uterus. Most people can go home within 24 hours of surgery, but it often takes 6 weeks to return to daily activities. There may also be long-term hormonal effects.

A hysterectomy through the vagina is minimally invasive, so recovery is normally shorter and easier than other types, such as abdominal hysterectomy. It also leaves no visible scar.

In this article, we look at what to expect after a vaginal hysterectomy, including timescales for returning to work, exercising, and driving. We also discuss recovery tips, long-term effects, and possible complications.

Share on PinterestA woman can usually go home within 24 hours of a vaginal hysterectomy.

Surgeons can perform several types of hysterectomy, with each option dependent on a person’s specific condition. The options are:

• Vaginal hysterectomy: An incision is made inside the vagina, and the uterus is removed through this incision.
• Laparoscopic hysterectomy: A thin, lighted tube and a small camera are inserted into very small cuts in the abdomen. The uterus is removed through the cuts.
• Abdominal hysterectomy: A larger incision is made in the abdomen to remove the uterus.

The American College of Obstetricians and Gynecologists (ACOG) recommend a vaginal hysterectomy for benign disorders where possible. Surgeons may use this method for the following conditions:

• small uterine fibroids or benign growth in the uterus wall
• heavy or irregular menstrual bleeding that does not respond to other treatments
• uterine prolapse when the uterus has slipped out of place
• adenomyosis or the uterus lining growing into the uterine wall, causing pain and heavy bleeding

Each woman’s recovery after a vaginal hysterectomy is different. The following timescales are a guide to what a person may expect after this surgery.

Immediately after surgery

It is normal to feel drowsy and tired for several hours after surgery while the effects of anesthesia wear off. Nurses and other medical staff may be monitoring blood pressure, pain, and how the body is recovering, plus other factors.

Some women will be discharged from the hospital on the same day as their surgery, while others may need to stay for a day or longer. This depends on the success of their surgery and if any complications occur.

Right after the procedure, a woman may have:

• Stitches inside the vagina that dissolve on their own and do not need to be removed.
• Gauze, similar to a tampon, placed inside the vagina to help reduce bleeding from the surgery. This should be removed before going home.
• A small tube that is sometimes inserted into the vagina to help drain blood and fluid. This is also removed by a nurse before the individual is discharged.
• A urinary catheter inserted until she can walk around and has the feeling back to urinate. The catheter will be removed, and the doctor or nurse will make sure the woman can empty her bladder before she is discharged.

In the first few weeks

In the first few weeks after a vaginal hysterectomy, it is normal to have:

• bleeding similar to a light period that comes and goes but decreases over time
• some mild pain and discomfort in the lower belly
• bloating or constipation because the bowel has temporarily slowed down

Going home

Some women can go home on the day of their surgery or within 24 hours. Others may be in the hospital a day or two longer, depending on any complications or medical concerns that may arise.

Although a vaginal hysterectomy is less invasive than other kinds, it still takes some time to recover from and get back to normal activities. After a person leaves the hospital, it is essential that they limit activities for a few weeks and follow the surgeon’s home care instructions.

Returning to work

Some women can go back to work after 2 to 3 weeks with their doctor’s permission. Others may have to wait up to 6 weeks, depending on their job and how quickly they are recovering.

Driving

A woman may be able to drive after 2 to 3 weeks, or once they are:

• not taking any painkillers or other medication that can cause sleepiness
• able to comfortably sit in the car, wear a seatbelt, and use the controls without pain
• able to suddenly stop if needed by quickly moving their foot onto the brake pedal
• able to turn and twist their body to see in all directions

If a woman is getting some exercise each day, she may be able to get back to her workout routine after 4 to 6 weeks. She should talk with a doctor before resuming strenuous exercise, including HIIT (high-intensity interval training), weight-lifting or contact sports.

Exercise

Most surgeons advise women to get plenty of rest during the first few weeks after a hysterectomy, though it is important to get up and move around too.

Light exercise, such as walking, helps get the bowels moving and may help reduce the risk of a blood clot. Starting with a short walk and making it longer each day helps build up endurance safely and can help increase energy levels.

Things to avoid

There are several things to avoid for a smooth recovery:

• Avoid putting anything in the vagina for at least 4 to 6 weeks. This means no tampons, douching, or sexual intercourse during this time.
• Heavy lifting should be restricted during the first 6 weeks. Avoid picking up children or moving furniture.
• Avoid doing strenuous tasks, for example, mowing the lawn, for the first 6 weeks.
• Avoid swimming until a doctor has confirmed that the vaginal stitches have healed completely.

Tips for a healthy recovery

Share on PinterestGetting plenty of rest is recommended for a healthy recovery.

If a womn follows the recommendations below, her body will heal quickly and successfully after a vaginal hysterectomy:

• Get lots of rest. Aim for at least 8 hours sleep a night and more if fatigue is an issue.
• Keep up with a nutritious diet. Eat plenty of fruits, vegetables, whole grains, and lean protein. Healthful foods contain nutrients that help the body heal and increase energy levels.
• Eat high-fiber foods. Constipation is common after surgery and can be made worse by certain pain medicines. If bowel movements are painful or difficult, even with a high-fiber diet, consider a stool softener or gentle laxative, and increase water intake.
• Avoid smoking. Smoking harms the body’s healing processes and makes it more difficult to recover from surgery. Stopping smoking before the surgery reduces the risk of lung problems from anesthesia. Ask a doctor about smoking cessation plans or nicotine replacements before surgery if needed.
• Attend follow-up appointments. The doctor will recommend regular follow-up visits, which give a person the opportunity to discuss the healing process and ask any questions.

The ACOG reports that a hysterectomy is safe and has a low risk of complications when performed by a qualified surgeon. Though uncommon, complications include:

• infection
• heavy bleeding
• damage to nearby organs, including bladder or bowel
• blood clots in the leg
• anesthesia problems, affecting breathing or the heart, although these are rare

An individual can expect certain long-term effects after her uterus has been removed. These include:

• Menstrual periods that stop completely. This can be beneficial to women with irregular or heavy bleeding, endometriosis, or other issues related to their periods.
• A woman will no longer be able to get pregnant, but protection from sexually transmitted infections (STIs) is still necessary.
• If the ovaries are removed (oophorectomy), a woman will start going through menopause soon after the surgery. Symptoms may be more extreme than in women who have not had their ovaries surgically removed. If menopausal symptoms are interfering with life, a gynecologist can help with options for relief.
• If the ovaries are not removed, a woman will not experience menopause right away.

Depending on the route of a hysterectomy, a woman will still need regular Pap tests if the cervix was not removed. Other screenings also may be needed if cancer or precancerous cells are found.

Some women experience depression, emotional changes, or a sense of loss after a hysterectomy. They may also find that their interest in sex changes, especially if the ovaries were removed.

If a woman Is struggling with any of these issues, they can talk with a doctor who can offer advise on support, therapy, or medications that may be helpful.

Share on PinterestIf a vaginal hysterectomy is not appropriate, then a doctor or gynecologist may suggest other kinds of hysterectomy.

The American College of Obstetricians and Gynecologists (ACOG) recommend vaginal hysterectomy as the first choice for benign conditions. It is less invasive than other types of hysterectomy, recovery is usually faster and easier, and there is no visible scar.

In some cases, a vaginal hysterectomy is not appropriate, and other kinds of hysterectomy are recommended instead. This is a decision that should be made jointly with a woman and her gynecologist.

Vaginal hysterectomy is usually avoided if a woman has:

• cancer or suspected cancer in a reproductive organ
• large uterine fibroids
• endometriosis
• an enlarged uterus
• scarring or adhesions from prior surgeries

A hysterectomy may involve more than the removal of just the uterus. The variations in this surgery include:

• Total hysterectomy. The entire uterus and cervix are removed. The cervix is the lower end of the uterus; it is a narrow passage that connects to the vagina.
• Radical hysterectomy. This is a total hysterectomy that also includes ligaments attached to the uterus and the upper portion of the vagina. It sometimes includes lymph nodes close by, as well.
• Partial hysterectomy. Only the upper part of the uterus is removed. The cervix is left in place. This is also called a subtotal or supracervical hysterectomy. This type of hysterectomy cannot be performed by the vaginal method. It requires an abdominal incision.

It is important to know that the term ‘hysterectomy’ refers to removal of the uterus. When the fallopian tubes are removed it is called a salpingectomy, and when the ovaries are removed it is called oophorectomy.

When talking with a doctor about surgery, a person should make sure they ask if these procedures are planned in addition to the hysterectomy.

Most women recover quickly from a vaginal hysterectomy and can get back to healthy, active lives.

Making an informed decision about a vaginal hysterectomy will require a conversation with a gynecologist and surgeon to determine whether this surgery is the best option.

Removal of the uterus – recovery after surgery. Hormone therapy

After the removal of the uterus, a woman can have several rehabilitation periods. During the first day after surgery, therapy is aimed at preventing bleeding, blood clots and bacterial complications. Then, for one or two months, they limit physical activity, prescribe a special diet aimed at restoring the body, and physiotherapy. If a radical operation was performed with the removal of appendages, hormone replacement therapy is prescribed. The drugs continue to be taken even a year after the operation, and in most cases they are taken for 5-10 years.

Early rehabilitation after amputation of the uterus

Removal of the uterus is carried out in a hospital under general anesthesia. From the operating room, the patient enters the intensive care unit for a while, then is transferred to the ward. Treatment after surgery is aimed at relieving pain, preventing bleeding and thrombosis, and infectious complications. Infusion therapy is also carried out, which helps to remove intoxication after anesthesia and replenish the volume of lost blood. Immediately after the intervention, it is advised to drink only water, then liquid broths, yogurt, kefir are allowed. In the future, they switch to a fractional meal 5-6 times a day, in small portions. Products should not cause bloating, while providing all the body’s needs for nutrients.

Recovery from early hysterectomy is quite fast. If the intervention was performed by laparoscopy, the patient is discharged home on the second or third day. After laparotomy, patients stay in the hospital for 5-10 days. Complications after amputation of the uterus in the first days may be as follows:

• Bleeding
• Inflammation and suppuration of sutures
• Peritonitis
• Pulmonary embolism
• Thrombosis of leg veins
• Urinary disorders

Adequate therapy must be used to avoid these complications. To prevent bleeding and thrombosis, drugs that regulate blood clotting are prescribed. Infectious complications are prevented by prescribing antibiotics. So that the consequences of the removal of the uterus and ovaries are not very pronounced, and rehabilitation is faster, it is advised than to get out of bed early. After laparoscopic intervention – after 4-5 hours, after a conventional operation – after one day.

Removal of the uterus and recovery in the first months

The consequences of the removal of the uterus and ovaries in the first months require adherence to a certain regimen and diet. The rehabilitation period lasts about four weeks after laparoscopy, and six weeks after laparotomy. At this time, the following complications may occur in a woman:

• Pain in the lower abdomen
• Vaginal prolapse
• Urinary incontinence
• Discharge after removal of the uterus from the vagina
• Thrombophlebitis
• Neurotic disorders

The consequences of the removal of the uterus and ovaries in the first months often depend on the age of the patient, the presence of concomitant pathologies, the volume of the operation, complications in the first days or weeks after the intervention. All patients are advised not to lift weights (more than 3 kg) during this time, to limit physical activity. During the first four or six weeks, sex is prohibited after the removal of the uterus, and it is also not advised to go to the pool or swim in the bathroom for two months.

How to reduce negative consequences after surgery? What can be done other than following the above recommendations? Patients after surgery need to eat right. To avoid anemia, you should eat red meats, apples, pomegranates, take iron supplements. Food should be rich in vitamins and microelements. The menu must include all the substances necessary for the body, proteins, fats, complex and simple carbohydrates. To prevent such consequences after removal of the uterus and ovaries as constipation, you should eat food that contains fiber. It is desirable to exclude smoked products, baking, sweets in the first weeks. Do not drink alcohol, carbonated drinks.

How to care for the suture after surgery? When the uterus is removed, the suture can be large or small, depending on the surgical technique. If absorbable material was used to close the wound, after 6 weeks the threads fall off on their own. Otherwise, the surgeon removes them in a hospital setting. In the first days, the postoperative wound should be treated with special antiseptics to avoid infection. Wash the seam gently under the shower, using ordinary soap. When the sutures are removed, the scar can be treated with a cream or gel, which accelerates its resorption.

Compression stockings should be worn to prevent thrombophlebitis. Physiotherapy is recommended during the rehabilitation period. Exercise therapy will help prevent the formation of adhesions. To avoid such consequences of the removal of the uterus and ovaries as urinary incontinence, you need to do a set of Kegel exercises. They are aimed at strengthening the muscles of the pelvic floor.

Long-term consequences after removal of the uterus and ovaries

Life after surgery almost does not change for many women. But there are consequences and complications that manifest themselves in the remote period. First of all, it is posthysterectomy and postovariectomy syndrome. Both of them are associated with hormonal disorders. The isolation of the removal of the uterus, as an operation with the risk of endocrine disorders, has occurred relatively recently. Previously, it was believed that the saved ovaries can function normally and do not lead to a failure in hormone synthesis. In fact, after the removal of the uterus, the blood supply to the gonads is disturbed, which leads to their ischemia and partial necrosis. As a result, women experience hormonal imbalances.

Post-hysterectomy syndrome may occur one year after surgery or a little earlier. Manifested by mood swings, hot flashes, tachycardia, arrhythmia. Some women develop chronic pelvic pain that is difficult to relieve with pain medication. Ultimately, this leads to asthenia, neurotic disorders. Treatment for removal of the uterus of these symptoms should be complex, we will talk about it a little lower.

Postovariectomy syndrome appears after removal of the uterine appendages. It is associated primarily with the shutdown of the endocrine function of the ovaries. It always occurs, and much faster than posthysterectomy. More pronounced after removal of the uterus and both ovaries, along with the cervix. It is characterized by three groups of symptoms:

• Neurovegetative. Develop after removal of the uterus and ovaries during the first two years. Manifested by dizziness, weakness, headache.
• Psycho-emotional (irritability, nervousness, mood swings).
• Violation of metabolism (decrease in the body’s tolerance to glucose, fluid retention in the body).

Removal of the uterus causes consequences for the body in the form of a number of diseases. Women may develop atherosclerosis, coronary heart disease, hypertension, cardiomyopathy. Often, after a couple of years, patients are diagnosed with type 2 diabetes mellitus, cholelithiasis, and osteoporosis. Removal of the uterus takes place with significant trauma to the surrounding tissues. This leads to the frequent formation of adhesions. Symptoms of adhesive disease are pain, flatulence, defecation and urination disorders.

Hormonal therapy after amputation of the uterus

After removal of the uterus, recovery is carried out with the help of hormones in cases where the woman has a pronounced post-hysterectomy syndrome. After removal of the uterine appendages, it is indicated for all women of productive or premenopausal age. Hormone replacement therapy is carried out with the help of estrogens and progestins. Natural estrogens are obtained from the urine of women carrying a child, they are included in drugs such as premarin, hormoplex. Synthetic hormones are analogues of estradiol and estriol. Also, partially modified esters of estradiol are used for HRT. Gestagens or progestins are used in combination with estrogens. They reduce the number of hormone-dependent estrogen receptors, which allows you to remove the symptoms of early postoperative menopause and reduce the dose of estrogens.

Treatment for hysterectomy with hormones is short-term, medium-term and long-term. In the first case, hormones are prescribed for 2-3 years. This therapy is mainly used in older patients. With the preservation of symptoms, a high risk of osteoporosis, diabetes, heart disease, the drug is continued for 3-8 years. Long-term treatment for removal of the uterus with appendages is indicated for young women. Its duration is about ten years.

Hormone replacement treatment is contraindicated after removal of the uterus and ovaries in case of severe liver diseases, porphyria, tendency to increased thrombosis. Also, it is not carried out with estrogen-dependent tumors of the uterus and mammary glands, both in the patient herself and in her closest relatives. You can not prescribe hormones for melanoma, malignant neoplasms of the kidneys. Relative contraindications to HRT are pancreatitis, cholecystitis, hypertension, edematous syndrome, allergies, endometriosis, uterine fibroids, pathology of cerebral vessels. Since the removal of the uterus has serious consequences for the body, the decision to operate is made individually, if it is impossible to carry out conservative therapy.

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Page content:

• How is hysterectomy performed?
• Features of the rehabilitation period after removal of the uterus
• Nutrition after hysterectomy

Hysterectomy (removal of the uterus) in gynecology is a fairly common practice. It is prescribed for malignant tumors of the uterus, advanced fibromas and endometriosis. It is important to understand that any doctor tries to save the reproductive organ, if possible. But in some cases, the pathological processes occurring in the uterus threaten the patient’s life or greatly spoil its quality. Therefore, it is necessary to resort to a hysterectomy.

How is the uterus removed?

When hysterectomy and ovaries are indicated , laparoscopy is considered the best method. Such an operation takes place with minimal tissue injury and virtually no blood loss. This allows you to solve all the typical problems that patients who have undergone hysterectomy have previously encountered. The rehabilitation period, instead of several months, is reduced to several days, while physical activity is not particularly limited, there are no scars.

When laparoscopic hysterectomy is performed, the operation involves three punctures in the abdomen instead of a huge incision through the entire abdomen. The organ is carefully dissected, placed in an endocontainer, and removed from the abdominal cavity. At the same time, it is possible to perform a resection by the supravaginal method, preserving the neck, which makes it possible to reduce the loss of quality of life in the future. When all the manipulations are carried out, hemostasis is controlled, the punctures are closed with 1-2 sutures.

Features of the rehabilitation period after removal of the uterus

If the intervention was performed laparoscopically, the patient can get out of bed after 4-5 hours. The woman spends about 3 days in the hospital, after which she returns to her usual life. However, there are still some limitations and recommendations for it, because the loss of any important organ is stress for the body. In particular, hysterectomy leads to hormonal imbalance, changes in intestinal motility and other problems. That is why it is important to properly conduct rehabilitation.

To ensure a successful recovery after hysterectomy, the following recommendations should be followed:

• Limit physical activity in the first 3 weeks, do not lift loads heavier than 5 kg
• Follow the diet – eat foods rich in fiber, proteins, vitamins
• Wear compression stockings to prevent thrombophlebitis
• Do Kegel exercises to avoid urinary problems
• Take hormonal drugs prescribed by a doctor
• Exclude visits to saunas, baths, solariums, hot baths
• Take enzyme preparations and fermented milk products to improve intestinal motility

If the patient did not comply with the recommendations, and complications occur, you should see a doctor. The reason for this may be suspicious vaginal discharge, pelvic pain, urinary incontinence, constipation, fistula formation. In this case, it is important to start treatment as soon as possible in order to avoid more serious consequences.

Features of nutrition after removal of the uterus

During the period of rehabilitation after a hysterectomy, a correct diet is needed , helping to restore the vitality of the body. It is better to give preference to cereals and soups, meat and fish can only be boiled (with water or steam). It is recommended to exclude alcohol, smoked meats, fast food, pastries, sweets, carbonated drinks, coffee. It is also better not to eat foods that provoke bloating: cabbage, white bread, legumes, chocolate, corn. And in order to avoid anemia, it is advisable to add iron preparations and products that help hematopoiesis to the diet: pomegranates, honey, dried apricots.

You can get more detailed advice on the regimen after hysterectomy at the Bilyak clinic.