Where do the body parts go after the operation?

To prevent prolapse, it is recommended not to lift heavy objects and do Kegel exercises. If the situation is more advanced, a vaginoplasty is performed to strengthen the ligaments.

Hysterectomy – removal of the uterus

hysterectomy - An operation to remove the uterus. Her other name is amputation of the uterus. Every year, Russian gynecologists perform hundreds of thousands of hysterectomies, of which only 10 % are performed because of cancer. The remaining 90 % are performed due to benign diseases, mainly uterine fibroids.

Hysterectomies account for 38 % of all gynecological surgeries in Russia. The average age of the operated women is 40 years.

And this despite the fact that there are now other organ-preserving treatment options for fibroids. In most cases they can be avoided. Unfortunately, many gynecologists still operate according to the old method. Let's talk about what diseases require removal of the uterus, what complications this entails, and how to get rid of a fibroid without losing an important organ of the female reproductive system.

Indications and contraindications for hysterectomy

Among the indications for the removal of the uterus, fibroids are still often named first. According to some reports, up to 40 % of all hysterectomies are performed for this condition.

This is mainly because the nature of the fibroid and the function of the uterus have been misunderstood in the past. It used to be thought that the fibroid was a benign tumor that was caused by a hormonal imbalance. The uterus, on the other hand, was viewed as an organ dedicated solely to carrying a fetus to term. Therefore, gynecologists often preferred to act radically and suggested immediate removal of the organ, especially in women who did not plan to become pregnant in the future. Today it is known that the causes of fibroids are much more complex and that the uterus is an important organ that influences a woman's overall health. With current approaches, hysterectomy is not indicated in most cases of fibroids. She is the last resort. One should always try to save the uterus - and there are now effective organ-preserving treatments. We will discuss these below.

In general, there are only two absolute indications for a hysterectomy for fibroids:

Other indications for hysterectomy (according to the American College of Obstetricians and Gynecologists):

• endometriosis.
• Prolapsed uterus.
• Abnormal uterine bleeding.
• Chronic abdominal pain.
• Malignant tumors of the uterus and ovaries.

Not all of these indications are mandatory. There are other organ-sparing treatment options for non-cancer diseases. A hysterectomy is indicated when other measures have failed and surgery is necessary to prevent complications and save the patient's life.

The main contraindications to elective hysterectomy are: severe respiratory and cardiovascular diseases, blood coagulation disorders and the risk of severe bleeding during surgery, peritonitis, inflammatory diseases, abdominal wall infections.

Types and procedures of cervical amputation surgery

Cervical amputation is performed in two different ways:

Laser, electric current, ultrasound, radio frequency and, in addition, cold can also be used. The average duration of the procedure is about half an hour. If there are complications (such as bleeding), it may take longer.

General and local anesthesia are used. Recently, regional anesthesia has become very popular: An injection is given into the spinal canal to numb the entire lower body. Once the patient is asleep under anesthesia, the doctors perform the operation.

Removal of the cervix can be performed using three methods:

• Schroeder, in which the tissue of the anterior and posterior lips of the cervix is excised in a wedge shape;
• Sturmdorf – the removed part has the shape of a funnel (cone) that penetrates deep into the cervix;
• High amputation – complete removal of the cervix with incisions in the vaginal lining.

Depending on the complexity of the disease, the operation can remove only the cervix or the cervix with part of the vagina. The doctor then sews up the threads. In most cases, self-absorbable sutures are used, less often Capron sutures.

All other organs are preserved so that the woman can become pregnant and give birth to a healthy child in the future.

Even if the operation is performed correctly, complications can occur, e.g. B.

• a relapse – the disease may come back after some time;
• Bladder injury – most commonly occurs when the bladder has not been emptied prior to surgery;
• Dislocated ligature that can cause bleeding;
• High risk of infection (sepsis, sclerosis, peritonitis);
• prolapse of bowel loops through the vagina;
• Necrosis of the vaginal dome.

If these consequences cannot be treated conservatively, additional surgery is required.

Recovery after cervical amputation

The patient stays in the hospital under medical supervision for about one to two weeks. Symptoms experienced by the woman after the operation include lethargy, sluggishness, apathy and rapid fatigue. In the first few days there is pain in the lower abdomen, which is why painkillers are prescribed. There may also be a dark brown discharge. The patient is also given antibiotics to rule out a possible infection. A urinary catheter is placed for the first time.

After discharge from the hospital, rehabilitation is not over, but continues at home for another 1-1.5 months. During this period, the following rules must be observed:

• Do not swim in open water, in swimming pools, do not go in saunas and steam rooms.
• Do not engage in sexual intercourse.
• Do not use tampons when menstruation is present.
• Avoid possible pregnancy for at least six months.
• Do not lift heavy weights more than 4-5 kg.
• Walk frequently, but not for too long.
• Do light yoga and Pilates exercises from about 3-4 weeks.
• You should definitely see your doctor two weeks after the cervical vertebra amputation.
• The further examinations and tests at the gynecologist take place in the following order:
  • 1.5 months after the operation gynecological examination, cytology, colposcopy, MRI (if necessary):
  • every three months for a year cytological smear;
  • If the underlying surgery was a cancerous tumor, we will have quarterly check-ups every five years.

  Preparing for cervical surgery and how to prepare for it

  Before the operation, the patient undergoes a comprehensive examination using ultrasound, radiological procedures and biopsy. A visit to the anesthetist is also required. Since the operation is performed under general anesthesia, it must be clarified whether the patient is allergic to any medication. The day before surgery, the woman should eat a healthy, light meal. The intestines must be cleaned with an enema.

  The method of removing the uterus depends on several factors:

  In surgical gynecology, the removal of the uterus can be done in different ways, in fact:

  • Abdominal – the doctor makes an incision on the anterior abdominal wall;
  • Transvaginal – almost no traces remain after surgery and recovery;
  • Laparoscopy - small incisions are made in the lower abdomen through which the surgery is performed.

  The abdominal surgery takes about an hour and leaves a horizontal or vertical scar about 20 cm long. A bandage must be worn after the operation to allow the scar to heal better.

  Laparoscopy is a gentle method of removing the uterus that avoids making large incisions in the abdomen. You need special equipment for this procedure. The procedure is as follows: Tubes are inserted through small incisions in the abdomen, through which a video camera and surgical instruments are inserted into the abdominal cavity, which are used to remove the uterus.

  All procedures are performed under general anesthesia. Women may also be given a sedative shot on the day of the procedure to reduce anxiety. The relationship of trust between doctor and patient is very important. If the doctor is benevolent to the woman and enlightens her about the operation, its consequences and her way of life, the woman can correctly assess the situation and avoid stress or, worse, nervous disorders.

  Postoperative period after removal of the uterus

  Recovering from a hysterectomy is a long physical and mental process that requires a lot of strength not only from the woman but also from her family. Postoperative rehabilitation is usually divided into two phases: the early and the late phase. These are explained in more detail below.

  In the first phase (at least 3-4 days) the patient is in medical care. Immediately after removal of the uterus, treatment is aimed at eliminating pain sensations, restoring body functions, preventing bleeding, inflammatory processes and anemia. The doctor also monitors how the sutures 'behave', if there is any genital discharge and how the bowels are functioning.

  Immediately after the operation, the patient is given an intravenous drip with antibiotics, detoxifiers, painkillers, vitamins and other solutions. If necessary, proserine is administered intramuscularly to facilitate the distension of the intestine. A urinary catheter is placed for the first two days to help the woman urinate.

  The woman's diet should be balanced in the first few days and aimed at restoring intestinal motility. On the first day, the woman is given only plain water without gas. Fat-free broths and yoghurt can be consumed from the second day. Two new foods are added every day, so the diet gradually becomes more varied. At the first stage, it should be easily digestible and low-fat foods (baked apples, chicken breast, pomegranates, honey, porridge). Foods that can cause constipation (cabbage, corn, legumes, chocolate, and coffee) should be avoided. Eat frequently (4-5 times a day) and in small portions. Drink about 1.5 to 2 liters of water a day, although your doctor may recommend 3-4 liters if you're an individual.

  Possible complications after the operation

  Surgery of this type can lead to a number of major and minor complications. However, many women do not experience any complications after a hysterectomy. Studies show that it depends on the type of procedure and the experience of the doctor. The consequences of a hysterectomy after the age of 60 are almost impossible if the doctor has done everything correctly and as gently as possible. After the removal of the uterus, there may be physical consequences:

  • heavy bleeding;
  • damage to the bowel or bladder;
  • pulmonary embolism;
  • Pains;

  

  Emotional disorders are not uncommon. A woman may experience hot flashes, irritability and fatigue. This can lead to depression due to loss of libido, loss of fertility, and diseases like osteoporosis. If this is the case, counseling is required. It's also important to have someone standing by your side and helping you.

  

  However, don't think that avoiding amputation is the solution. Ignoring the problem can be more dangerous, if not worse, than the surgery itself. Benign growths that are not removed in time can have serious and dangerous consequences for the body, or eventually develop into a malignant form, that is, cancer.

  Peculiarities of the postoperative period

  After the operation to remove the uterus, the woman has to be monitored by gynecologists in the hospital for a certain period of time. In a number of cases, the consequences of a hysterectomy in women over the age of 50 can occur, including:

  • adhesions;
  • Thrombosis;
  • infectious processes;

  

  In the first period after the operation, any physical activity is strictly prohibited. Women should get into the habit of taking walks in the fresh air. Doctors recommend following a diet and avoiding sweets, smoked foods, pickles, and fried foods. It is best to eat small portions and to enrich the diet with grains, vegetables, dairy products, fruits, lean meats and fish fillets.

  

  If the doctor ordered an operation to remove the uterus, then this is the only way to prevent the progression of a dangerous disease and start a new life. If this is the case, you should agree without any doubts or fears. Refusal to perform the necessary surgical intervention can lead to complicated, unpredictable and sometimes irreversible consequences.

  preservation of the body

  Now let's turn to the last function of the morgues - the one that the common man knows best. The morgues store the bodies of the deceased between death and burial, not only during dissection and analysis, but also for several days afterwards. Storing corpses in inappropriate conditions (e.g. at home) is not safe: corpses emit toxins, bacteria, viruses and fungi that can cause infectious diseases - not to mention that without special storage conditions corpses quickly begin to smolder and Flies and other insects can deposit their larvae in it. In short, a corpse is a source of danger, which is why it should be stored in a specially designated room - a morgue. There temperature and humidity are sufficient to prevent decomposition, insects do not live there because sanitary and hygienic measures are taken, and there are only professionals around the corpse who know how to handle a corpse to avoid diseases or get poisoned.

  In the Russian Federation, mortuaries are obliged to keep the deceased free of charge for seven days. This period can be extended to fourteen days if the deceased's relatives cannot be located immediately or if it takes a long time to reach the morgue (e.g. if the deceased's relatives lived in another city or country) . This period can also be extended in the interests of the investigations. At the request of the deceased's legal representatives, the body may remain in the morgue for a longer period of time, but a fee will be charged. In practice, of course, some unidentified corpses remain in the morgues for several months if there is no lack of space.

  preparation for the burial

  After the autopsy, the organs are reinserted into the body, the incisions are sutured, the blood is drained, and the body is anatomically corrected. In this case, none of these measures are necessary. Finally, an interesting aspect of the legacy of the Soviet healthcare system is that the morgues in Russia and many other CIS countries also offer some additional services that in most other countries are exclusively in the hands of undertakers. For example, the legal representatives of the deceased can arrange for the corpse to be embalmed in the morgue for a fee, thereby preserving the perishability of the remains for a certain period of time, and they can also arrange for the corpse to be restored – for example, if it was damaged by an accident or violence has been severely damaged. It is usually sufficient for the pathologists to wash, shave, and dress the corpse and give relatives instructions on how to store the corpse until burial. However, if necessary, they can cover your face with an anatomical mask to hide the damage, make and insert artificial eyeballs of the right color if your own are no longer representative due to the injury, etc.

  Remember that there is a list of services that the funeral home must provide you with free of charge in any case. Some unscrupulous medical professionals may attempt to charge for free services or invent non-existent paid services and threaten that without those services your loved one's body could be neglected. You should be wary of this type of scam and best of all know what benefits you are legally entitled to.

  Possible consequences and complications

  The most common complications in the form of intestinal paralysis, hernias and shortness of breath occur after the operation.

  • infections, wound abscesses;
  • internal bleeding;
  • formation of calculi in the ducts, blood clots in the blood vessels;
  • damage to the bile ducts.

  Important! If the stones are not removed in time, calcification of the gallbladder walls, gallbladder cancer occurs, and if the organ perforates, bile acids leak into the abdominal cavity, which threatens to form an abscess and fistula.

  feedback from a patient.

  'I had my gallbladder removed four years ago. For the first six months I followed a strict diet and lost some weight. Now I eat everything, twice a year I take cholera herbs'.

  'Everything was fine for the first six months after the operation, but then I got serious problems with my pancreas - nausea, severe diarrhea after eating, poor digestion of food, no pills to help.'

  'Six months ago I had a laparotomy cholecystectomy, I feel fine, the stitches are barely visible, the diet has only brought me benefits – I've lost weight, my complexion has improved, I've mastered many healthy food recipes.

  Gallbladder removal is not a complicated operation and rarely takes more than 2 hours. Cholecystectomy requires prior preparation, examinations and post-surgery follow-up of all doctor's orders throughout the rehabilitation period.

  Causes of gallstones in the elderly

  Gallstones in the gallbladder are usually caused by an excess of one of the components of bile. This separates out in the form of sand. If this sand is not removed from the body in time, it crystallizes and gallstones form.

  Gallstones are particularly common in older people, especially women, people who are overweight, have high cholesterol and people with diabetes.

  Gallstones are the most common cause of gallbladder removal.

  Can my gallbladder be removed if it has gallstones?

  Up to a point, gallstones can only show up as a feeling of heaviness, bitterness and heartburn 30-40 minutes after eating. Many people do not pay attention to these unpleasant sensations and only discover the presence of stones during routine ultrasound examinations. These stones are usually small in size. With long-term treatment, small cholesterol stones can be removed, but this often leads to serious complications if the stones are not cholesterol stones but have a different composition.

  As a rule, the gallstones are not uniform in their composition. They cause upper abdominal pain, constant pain, and nausea and vomiting. If the stone is more than 2 centimeters in diameter, doctors usually opt for surgery, since gallstones cause pain, among other things

  • jaundice;
  • an acute inflammation of the pancreas;
  • the formation of numerous liver abscesses;
  • gallbladder gangrene;
  • intestinal obstruction;
  • Intestinal perforation and many other complications.

  Gallstones in the gallbladder are a ticking time bomb and it is better to get rid of them in time.

  Can stones be removed without completely removing the gallbladder?

  Gallstones cannot be removed or destroyed if the gallbladder remains intact. In addition, they can form again within a short period of time. Therefore, in many cases, cholecystectomy (removal of the gallbladder) is the only option to treat symptoms and diseases of this organ, which can be traced back to various causes.

  Surgery to remove the gallbladder

  Surgical removal of the gallbladder - cholecystectomy - is a routine surgical procedure that usually does not cause any complications. It is performed under general anesthesia and can be done laparoscopically through the abdomen or traditionally through an open abdominal incision.

  Conventional (open) cholecystectomy

  Conventional cholecystectomy is an older procedure in which the gallbladder is removed through an open abdominal incision. The operation is performed under general anesthesia. The abdominal cavity is opened via a 15 cm long incision, which is located about 2 cm below the right costal arch. The gallbladder is removed through the incision. The operation takes between one and one and a half hours. This type of surgery is performed when other surgical interventions are contraindicated or when there is acute inflammation.

  Laparoscopic cholecystectomy

  Today, 90% of all operations are performed laparoscopically. The gallbladder is removed minimally invasively through a so-called keyhole. The basic principle of laparoscopic surgery is to insert surgical instruments and a laparoscope (a small camera with a light source) into the abdominal cavity through 4 small incisions. The instruments can be controlled from outside while the camera transmits live images to a monitor. Using the instruments, the gallbladder is removed under visual control and brought out through one of the incisions.

  Single port cholecystectomy

  This surgery to remove the gallbladder is performed laparoscopically through an incision in the umbilicus. The surgeon performs all manipulations through a flexible port using three different surgical instruments through the puncture. After the operation, a minimal scar remains on the skin, which quickly fades.

  Advantages of Laparoscopic Surgery

  • no postoperative pain syndrome;
  • low risk of trauma to the abdominal wall;
  • small scars and therefore better cosmetic results;
  • short hospital stay – discharge on day 2-4.

  Early rehabilitation after uterine amputation

  The removal of the uterus takes place in a hospital and general anesthesia is used. The patient is briefly transferred from the operating room to the intensive care unit. Postoperative care is aimed at relieving pain, preventing bleeding and clots, and preventing infectious complications. Infusion therapy is also used to relieve intoxication after anesthesia and to replenish lost blood volume. Immediately after the operation, it is advisable to drink only water, after which liquid broths, yogurt and kefir are allowed. Thereafter, the patient should eat frequent, small portions 5-6 times a day. The food should not cause bloating, but provide all the nutrients that the body needs.

  Early recovery after a hysterectomy is quite quick. If the procedure was performed by laparoscopy, the patient can be discharged home on the second or third day. After laparotomy, patients are hospitalized for 5-10 days. Complications after a uterine amputation can look like this in the first few days:

  • bleeding
  • Inflammation and hardening of the sutures
  • peritonitis
  • pulmonary embolism
  • Thrombosis in the veins of the lower limbs
  • Disorders of urination

  Appropriate therapy must be carried out to avoid these complications. Anticoagulants are administered to prevent bleeding and thrombosis. Infectious complications are prevented by prescribing antibiotics. In order for the effects of the removal of the uterus and ovaries not to be too severe, and for the rehabilitation to occur more quickly, it is advisable to get out of bed early. This is four to five hours after laparoscopic surgery and one day after normal surgery.

  Removal of the uterus and recovery for the first few months

  In the first few months after the removal of the uterus and ovaries, you must follow a specific program and diet. The rehabilitation period lasts about four weeks after laparoscopy and six weeks after laparotomy. During this time, the woman may experience the following complications

  • abdominal pain
  • prolapse of the vaginal wall
  • urinary incontinence
  • Vaginal discharge after removal of the uterus
  • thrombophlebitis
  • neurotic disorders

  The consequences of a hysterectomy and ovary removal in the first few months often depend on the patient's age, the presence of concomitant diseases, the extent of the procedure and the complications in the first days or weeks after the procedure. All patients are advised not to lift weights (more than 3 kg) and to limit physical activities during this time. In the first four to six weeks after the removal of the uterus, sex is forbidden, and for two months it is recommended not to go to the pool or take a bath.

  How can I reduce the negative effects after surgery? What else can I do besides the above recommendations? Postoperative patients must follow an appropriate diet. To avoid anemia, you should eat red meat, apples and pomegranates, and take iron supplements. Meals should be rich in vitamins and micronutrients. The menu should contain all essential substances, proteins, fats, complex and simple carbohydrates. To avoid consequences such as constipation after removal of the uterus and ovaries, you should eat foods containing fiber. Smoked foods, pastries and sweets should be avoided for the first few weeks. Do not drink alcohol or carbonated beverages.

  How do I care for the scar after the operation? After the uterus is removed, the suture can be large or small, depending on the surgical technique. If absorbable material is used to close the wound, the sutures will fall out by themselves after six weeks. Otherwise, the surgeon will remove them in the hospital. In the first few days, the surgical wound should be treated with a special antiseptic to avoid infection. The suture material is gently washed off in the shower with normal soap. After the stitches are removed, the scar can be treated with a cream or gel to help it dissolve.

  Physiotherapeutic rehabilitation

  In addition to mandatory drug treatment, various physiotherapeutic measures are recommended during rehabilitation, including.

  • electrotherapy;
  • electroplating
  • therapeutic massage
  • acupuncture
  • remedial gymnastics;
  • spa treatment, including radon baths, hydrotherapy and balneotherapy;
  • Proper nutrition with adequate amounts of healthy micronutrients and vitamins while avoiding unhealthy foods.

  In addition to medical treatments, a number of contraindications must be observed during the rehabilitation period. For 6 weeks after the hysterectomy it is forbidden to:

  • swimming in bodies of water, going to pools, baths (these should be replaced with daily showers);
  • Lifting heavy objects weighing more than 4.5 kg;
  • to endure excessive cold;
  • to have sexual intercourse;
  • use tampons.

  indications

  Recovery after a hysterectomy is recommended for all women without exception, but is especially necessary when the following symptoms occur:

  Electroses can be used to relieve these symptoms. This treatment greatly facilitates adaptation to the new condition and reduces the likelihood of neuropsychiatric disorders. In the case of urinary tract problems, neuromuscular stimulation with modulated currents is used.

  Applied in time, these rehabilitation methods undoubtedly contribute to the prevention and treatment of various disorders and diseases, allowing the woman to return to her normal lifestyle and minimize the effects of the hysterectomy.

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