Surgery to remove uterine fibroids everything from a to z. Features of the operation to remove uterine fibroids Narcosis when removing uterine fibroids

Uterine fibroids is a tumor-like neoplasm that is benign and localized on the walls of the uterus. Gynecological disease occurs at any age and worries 40% of the female population. The causes of the disease are still unknown, but there are a number of theoretical assumptions about this. It is believed that the disease rarely transforms into a cancerous pathology if the patient is regularly monitored by the attending physician. But due to the absence of symptoms at an early stage of development and rapid growth a woman turns to a gynecologist with myomatous nodes already of a decent size, and then surgery becomes relevant.

Most often, fibroids are discovered by chance during a profile examination of the patient. Gynecologists use expectant tactics, explaining that it is undesirable to disturb the uterine nodes at the initial stage of development. The following symptoms of the patient lead to surgical intervention:

heavy bleeding before, during and after the menstrual cycle;
pain in the pelvic area;
pathologies of large sizes, creating a feeling of fullness in the lower abdomen and interfering with the functioning internal organs;
the occurrence of anemia due to regular and significant blood loss;
problems with urination and frequent constipation;
headaches, weakness, nausea, dizziness;
the tumor causes deformation of the reproductive organs;
yellow or brown discharge after menses.

The presence of all of the above symptoms in the patient forces an urgent surgical intervention. When making a serious decision, the doctor should take into account the age of the patient, the size of the pathology, individual intolerance to drugs, the location of uterine formations and postoperative complications.

Removal of fibroids surgically

Surgery for fibroids has been used in medical practice for a long time and is a budget option. The surgeon should be chosen carefully, since the quality of the operation depends on the ability to bear children and the quality of life of the patient. A common type of surgical intervention is an open abdominal operation, which has two varieties: laparotomy and hysterectomy. Tumor sizes for surgery are measured in millimeters or centimeters.

Surgery has several varieties.

Removal of fibroids by laparoscopic method

It is aimed at removing tumor-like formations on the walls of the uterus and the complete preservation of the reproductive organ, since the absence of the uterus will not make it possible to have children in the future. Preparation for the operation is the passage of a six-month course of medication. Common drugs are Goserelin and Gestrinone, which reduce the size of the pathology and reduce heavy bleeding during the operation. Subserous localization of the uterine tumor excludes the preparatory stage and the operation is started immediately.

Laparoscopy is performed only in the following cases:

the dimensions of one node reach four or five centimeters;
the contractility of the uterus is broken and the cavity is deformed;
inability to bear children and bear a child;
anemia due to numerous blood loss;
pathology interferes with the functioning of neighboring internal organs, causing frequent constipation, urinary problems and intestinal dysfunction;
the rapid growth of pathology.

The operation is life-threatening for the patient in the following cases:

the size of myoma nodes did not change after preparatory therapy;
the presence of malignant diseases of the reproductive organs;
diseases respiratory system and liver failure;
multiple uterine fibroids;
Availability excess weight at the patient.

Of great importance during the operation is the type, size and localization of the tumor. The procedure consists of four steps: exfoliation of the uterine nodes, restoration of myometrial deficiencies, extraction of pathology and homeostasis of the abdominal cavity. The operation is considered traumatic and leaves scars and scars.

The postoperative period lasts from three to seven days, and the full recovery of the body and the resumption of physical activity occurs after four weeks. After laparoscopy, patients are prohibited from sexual activity for six weeks. Possible further complications after the procedure, including damage to Bladder, intestines and ureters due to the low location of the uterine nodes, abdominal hernia and difficulties during pregnancy.

Laparotomy

It is a more sparing option for surgical intervention, since during this operation the surgeon has the opportunity to better control bleeding in the process of husking the uterine node, especially if the pathology is located at a depth of ten centimeters or more.

Preparation for the operation plays an important role, since the outcome of the surgical intervention depends on it. The patient should go cytological examination, take a biopsy, determine the degree of purity of the vagina, conduct an excretory urography and take a blood test. These items help determine the method of surgical intervention, the size of the nodes, the location of the incisions and diseases of the reproductive organs.

In the presence of anemia, it is advisable for the patient to prepare donor blood in advance for transfusion in case of heavy blood loss. Indications for removal are the same as for laparoscopy. It is desirable to use this method for multiple myomatous nodes and in the presence of anemia in the patient. If the tumor is gigantic, surgeons prefer laparotomy, while preserving the uterus.

The operation takes place in several stages: the abdominal cavity is cut, a nodular capsule is found, on which an incision is also made and the uterine tumor is removed. The surgeon puts two or three stitches due to the removal of large nodes. After the operation, the patient takes a sick leave for two weeks and limits as much as possible physical activity. The procedure eliminates further complications in the form of damage to internal organs or uterine rupture during pregnancy.

Hysterectomy

This is a radical removal of the uterus, used in severe cases. This method is used for abnormal bleeding, acute pain lower abdomen, uterine prolapse and endometriosis. Benign and malignant tumors that have reached a solid size and are eliminated along with the uterus are subject to removal.

The procedure is performed through an incision in the abdominal cavity, through the vagina, or using a laparoscopic technique. Rehabilitation lasts three weeks, during which the patient is prescribed antibiotics and pain medication. The consequences of the operation include the occurrence of infection, numbness of the skin, scarring at the incision site, and the occurrence of adhesions in the abdomen. If the ovaries, uterus and fallopian tubes are removed along with the fibroids, women will go through menopause in advance. After removal of the uterus, sex hormones cease to be synthesized in the female body and the patient is prescribed hormone therapy.

Hysteroscopy

The method is used to remove small myoma nodes, reaching five centimeters in diameter. The presence of the stem and the mobility of the intrauterine node are indications for the use of this method. The procedure is carried out by inserting a hysteroscope into the vagina, excising the node into separate parts.

The operation to remove uterine fibroids is performed with the preservation of the reproductive organ, but reduces the chances of becoming pregnant in the future. The surgeon operates in the first week of menstruation, injecting the patient with an anesthetic drug. The advantages of this method include the short duration of the procedure, minimal blood loss, rapid recovery of the reproductive organs after surgery, and a small scar at the incision site, which quickly disappears. Patients stay in the hospital for five or seven days, and the rest of the recovery period is spent at home.

Myomectomy

During pregnancy, it is carried out in the presence of small, medium and giant nodes on the uterine mucosa. Signs of pathology are manifested in the form of heavy bleeding, pain in the lower abdomen and the presence of blood clots during menstruation. The tumor is removed with caesarean section predominantly in women over 30 years of age. The procedure is carried out with complete preservation of the uterus and fallopian tubes, if the size of the pathology does not reach an impressive size and does not deform the internal organs.

Indications for the operation:

on the submucosa of the uterus there are many myomatous nodes;
the appearance of single nodes;
pathology necrosis;
plentiful bloody issues with clots;
distension and pain in the lower abdomen.

After a caesarean section, the patient goes through a long recovery period, including diet food and thorough bowel cleansing. The operation site is recommended to be treated with antiseptic agents.

Alternatives to surgery

You can remove fibroids without surgery with the help of drug treatment, minimally invasive intervention, taking hormonal drugs and folk remedies.

Embolization of the uterine arteries

It is considered a progressive and effective method in medical circles. The operation is performed with punctures in the pelvic area, introducing emboli, consisting of a medical polymer, into the uterine arteries. They interfere with the blood supply to the uterine nodes, causing the death of the smooth muscle tissue of the pathology.

For the operation, doctors use a catheter that is installed in the abdominal aorta. First, embolization of the right and then the left uterine artery is performed. Connective tissue grows in place of myomatous neoplasms. Depriving the only source of nutrition and decreasing by three to four times, the myomatous node loses contact with the uterine mucosa and is pushed out. This phenomenon is called expulsion, or the birth of the uterine node.

Before surgery, the patient should lie in the clinic and take antibiotics to avoid infection after embolization. The operation is performed without anesthesia, since there are no nerve endings in the arteries. The patient feels warmth in the lower abdomen during the procedure. The process lasts a maximum of 15 minutes, but it depends on the surgeon.

This method is recognized as self-sufficient, since no additional medication or medication is required during or after the operation. folk treatment. It is strictly forbidden to perform the procedure during pregnancy and in the presence of oncological diseases and inflammatory processes of the reproductive organs.

Among the complications, doctors note rare cases of accumulation of purulent masses at the site of the operation, blockage of the arteries, damage to the internal organs of the small pelvis by the catheter, and the occurrence of hematomas in the area of the operation. The possibility of recurrence occurs only if technical difficulties arose during the procedure and the catheter was not inserted correctly. During rehabilitation, which lasts for eight hours, the patient has pain in the lower abdomen, minor bleeding and fever.

While at home, the patient should refrain from sexual intercourse, avoid physical activity and do not take hot baths for a month. It is advisable to follow the recommendations of the attending physician so that the recovery period passes quickly.

Medical treatment

It provides for the acceptance of available pharmaceutical products, hormonal preparations as prescribed by a doctor and promotes the resorption of uterine nodes without removal through surgery. Hormonal imbalance is considered a factor provoking the occurrence of pathology, therefore, this type of drug is still actively used in medical practice. The described type of treatment lends itself to a small tumor that is not prone to rapid growth. This type of drug is used in multiple myomatosis to suppress the growth of the remaining tumors.

Medicines are aimed at reducing the size of the pathology, stopping bleeding and reducing pain symptoms. A hormonal course is taken by women who have survived the removal of the uterus during menopause to synthesize hormones artificially. Parallel to drug treatment must be respected daily rate vitamins and minerals to improve vascular elasticity.

Non-traditional ways

During the main course, patients use non-traditional methods to achieve the best effect. Used to treat fibroids herbal infusions and decoctions taken orally and as a compress. Among medicinal herbs yarrow, celandine, upland uterus, wormwood and chamomile are popular, reducing the size of the nodes. To relieve inflammation and swelling, you can make a compress from raw potatoes or aloe juice.

It is advisable not to remove uterine fibroids with the help of surgery in order to avoid further complications during childbirth and diseases of the reproductive organs. But if the patient is faced with this disease, this option cannot be completely ruled out. The myomatous node behaves unpredictably and can change the growth rate or spread to the uterine mucosa in the form of multiple fibrosis at any time. To avoid such troubles, it is necessary to do a regular examination of the reproductive organs, which allows you to control the size and stage of development of the pathology.

In the case of an increase in the myomatous node and the occurrence of heavy bleeding, the patient should be operated on immediately and not try to get by with medication or the use of folk remedies, since fibroids at a late stage of development pose a danger to the life of a woman. Doctors recommend treating myoma in a complex way: combine medications, unconventional methods, lead a healthy lifestyle and do not forget to undergo regular examinations to identify the focus of the disease at an early stage of development.

Uterine fibroids is a gynecological disease, which is a hormonal dependent tumor characterized by a benign course. For the treatment of fibroids, conservative methods are used, and, in addition, surgical methods associated with the removal of a pathological formation. The therapy is based on drug hormone replacement therapy, but it is far from always possible to cure fibroids without surgical intervention. It is in this regard that in the presence of uterine fibroids, the most suitable, and at the same time, in an efficient way, is the operation. The cost of breast cancer surgery depends on several factors.

Indications

Uterine fibroids, like any neoplasm, can vary in size, ranging from a small pea to a large knot that can weigh about one kilogram. This disease can be manifested by only one focus, or immediately multiple or distributed over the surface of the uterus, or they can be grouped together.

Often, fibroids differ in nodular growth and can be located in any layers of the organ, for example, in muscular wall, and, in addition, under the mucosa and above it. Only a doctor can answer the question of whether it is necessary to remove fibroids. The method of treating fibroids is prescribed by a gynecologist after basic laboratory and instrumental studies. Indications for surgery to remove fibroids are the following factors:

The presence of intensive progressive growth of myomatous nodes.
The development of menometrorrhagia, leading to the appearance of anemia, which requires urgent treatment and correction.
Activation of tumor growth during menopause.
The process of degeneration of a benign formation into cancer.
The presence of intense pain.
The presence of concomitant endometriosis and ovarian tumors.
The development of necrotic lesions of the nodes.
Inability to bear a fetus (frequent miscarriages) or infertility.
Submucosal nature of the location of the pathological focus.
The position of the fibroids is not far from the cervix, and, in addition, directly on it.
Failure of the functioning of nearby organs due to compression by their pathogenic node.

Despite the great effectiveness of conservative methods, surgery in the presence of fibroids is the main method of treatment.

Operation types

In modern surgery, there are two types of operations to remove fibroids:

Types of surgical therapy

In the treatment of this disease, preference is always given to organ-preserving operations, but, unfortunately, they are not always effective. In which cases is it necessary to completely remove the organ? This can only be determined by the attending physician. This kind of intervention is prescribed mainly to patients who are in reproductive age.

In addition to age, the location of the pathological focus along with its size and degree of neglect plays an important role. Modern operative gynecology offers various ways to remove uterine fibroids.

Among the most commonly used methods are abdominal surgery, laparoscopy, hysteroscopy and total abdominal hysterectomy.

Abdominal surgery to remove fibroids

Cavity removal is indicated in case of torsion of the pedicle, which usually holds the tumor. In addition, such an operation can be prescribed for necrotic lesions or in the presence of large fibroids. Another indication for abdominal surgery to remove uterine fibroids is a significant degree of deformation of the organ.

The essence of surgical intervention is to remove lesions through an incision that is made on the abdomen. Specialists resort to abdominal surgery to remove fibroids only as a last resort because of the severity of the postoperative period and the high likelihood of complications.

True, laparotomy of uterine fibroids also has undeniable advantages. This technique allows surgeons to control bleeding at the stages of exfoliation of myoma nodes. In addition, it is possible to quickly apply several stitches to the patient at once, which is important for large tumors. During abdominal surgery to remove uterine fibroids, only general anesthesia is used.

Carrying out laparoscopy

Such an intervention is carried out in order to remove a small tumor. Laparoscopic surgery to remove fibroids is done through several small punctures in the abdomen, into which a laparoscope with a special nozzle is inserted. The advantage of this treatment technique is minimal tissue and organ trauma along with a low risk of postoperative adhesions. The rehabilitation period, as a rule, proceeds quite safely and quickly. Fibroids in the presence of pregnancy are mainly removed laparoscopically.

Surgery to remove fibroids can be done in any major clinic.

Carrying out hysteroscopy

Such an operation is a gentle surgical removal of fibroids, which is done using a hysteroscope. This operation is performed in order to remove small single fibroids, while the nodes that are located on the front or rear walls of the organ are operated on. Indications for such an operation are strictly individual.

Performing a total abdominal hysterectomy

This procedure is a complex operation, with it sometimes a radical section of the organ is performed. This is the most traumatic operation, which is used in very rare cases. Usually it is done when the fibroid is located in the thickness of the uterine muscles and is difficult to access. In addition, this technique is used in the presence of progressive growth of an already large node, and, in addition, during the climacteric age of the patient and against the background of "malignancy" of the tumor. This operation is performed under anesthesia.

Ways to remove fibroids

In modern gynecological practice, a minimally invasive method of treating fibroids is widely used, which does not require removal of the uterus. Thus, it is customary to distinguish:

Preoperative preparation

Immediately before each treatment, including the removal of fibroids, patients must undergo a series of instrumental and laboratory examinations to assess the risks and possibilities of performing a particular type of operation. Preparation for a surgical operation to remove fibroids, as a rule, includes the following activities:

Donating blood and urine along with biochemical analysis and coagulogram.
Conducting a blood group test.
Performing an electrocardiogram.
Passing an examination by a gynecologist and consulting a specialist with the obligatory taking of a smear from the vagina, and, in addition, from the cervical canal.
Performing a cytological study of biological material, which is taken from the neck of the cervical canal.
Carrying out polymerase chain reaction.
Performance histological examination(endometrium).
Conducting a colposcopic examination.
Performance ultrasound pelvic organs. In this case, doctors conduct a transvaginal or transabdominal examination.
Examination and consultation with a dentist and therapist.
Performing a chest x-ray.

When large ones are present during preoperative preparation, a three-month course is considered mandatory. hormonal treatment aimed at inhibiting the growth of formations. Consultations with a psychologist are also included in the preliminary preparation before a surgical operation aimed at removing fibroids. It is also important not to forget that ten days before the planned date of surgical intervention, patients taking antiplatelet drugs on an ongoing basis are required to stop taking the medication.

Immediately three days before the operation, only easily digestible and liquid food should be consumed. And in the morning before the operation, you need to clean the intestines with a cleansing enema. In order to make it easier to transfer anesthesia, it is forbidden to eat or drink anything eight hours before the operation.

How long does a fibroid removal surgery take? The answer to this question can be found below.

Performing an operation

The course of the operation associated with the removal of fibroids, exactly as well as the method of anesthesia, is determined by the surgeon and the anesthesiologist, who will directly deal with the treatment. The best option for pain relief is general anesthesia.

Now we will describe in detail how exactly the operation to remove fibroids of large and small sizes takes place. During the intervention through the vagina, the patient's legs are bent at the knees, parted to the sides, anesthesia is administered. With laparotomy or laparoscopy, this is not necessary. Legs and arms are fixed with special straps. Then the patient is given anesthesia, and the doctor begins to treat the surgical field with antiseptic agents.

During laparotomy, the surgeon cuts the abdominal tissue in layers with a scalpel, after which a thorough revision is carried out and an assessment is made of the condition of the myomatous nodes and uterus. Next, the doctor decides to remove some part or all of the organ. An organ with or without appendages can be removed. After removal of the uterus or part of it, hemostatic measures are carried out. Further, after the doctor makes sure that there are no bleeding areas left in the wound cavity, the incision is sutured in layers.

Surgery to remove fibroids is performed in different ways. Amputation of the uterus is a very complex operation, so various surgical procedures can be used in the process. In the event that the surgeon considers it necessary, he will put a drainage tube that will ensure the outflow of fluid that accumulates in the small pelvis.

When performing laparoscopy, a surgical instrument with a laparoscope camera is inserted into the punctures made in the abdomen. Before starting the operation, the patient's abdomen is inflated with air for better visibility, then the operation is performed in the same way as with an open abdomen. The removed organ is removed from the patient through the vagina. Sometimes the organ is removed after its previous division into small parts, through a tube (this is such a special laparoscopic tube).

Fibroids surgery time

How long the surgical operation will last depends largely on the type of access (cavitary or laparoscopic), as well as on the size of the uterus itself, the number of nodes, the presence of adhesions and cicatricial changes. On average, the duration of an uncomplicated operation is about an hour. In more severe cases, it can last up to three hours.

What happens after abdominal surgery to remove uterine fibroids?

Postoperative period

Any operation is extremely dangerous because of the risks of developing all sorts of complications. After surgery to remove uterine fibroids, much attention is paid to the prevention of the following complications:

Inflammatory and adhesive processes.
Restoration of blood composition, and, in addition, stabilization of the hemostasis system.
It is necessary to monitor the process of normalization of water and electrolyte balance.

For the full rehabilitation of women after abdominal surgery to remove fibroids, no more than one and a half months is needed. The rehabilitation period after laparoscopy usually takes about one month. As for the period of postoperative recovery, then after a vaginal hysterectomy it can very rarely last longer than four weeks.

After the operation to remove fibroids, women are issued a certificate of incapacity for work for a period of 25 to 45 calendar days. The cost of the operation largely depends on the methods used in the surgical intervention. Prices for surgical services can vary dramatically depending on the medical institution and its level of qualification, but on average the price will be from 35 to 75 thousand rubles.

Disadvantages of surgery for myoma

The main disadvantages of surgical removal of fibroids are the following negative factors:

Quite a high risk of relapse. In 7-14% of operated women, fibroids can be found again after one year.
After the operation, it is extremely difficult to plan a pregnancy, even in the long term. This will most likely require re-treatment.
To reduce the risk of relapse, women are forced to take hormonal medications, which does not always have a beneficial effect on the activity of some organs and systems of the body as a whole.
Any surgical intervention is always associated with various risks and entails negative consequences for the health of patients.
Sometimes there are situations in which, against the background of uncontrolled bleeding during operations, patients have to remove the uterus.
After the procedure, there is always a scar. Such a scar always creates an additional risk during pregnancy and may cause the need for a caesarean section, which is also an undesirable measure for women in labor.
Another possible complication is adhesions that occur in the pelvis, and as a result, this factor provokes tubal peritoneal infertility in women.

Benign tumors on the uterus are not such a rare occurrence that they usually begin to treat conservatively. And if the neoplasm is large, causes severe symptoms, it will have to be removed with an operation with cutting the abdominal wall, at best, laparoscopy.

Most patients are afraid of the intervention and its consequences. To avoid unnecessary worries, it is worthwhile to find out in advance what is the band operation of uterine fibroids, the postoperative period, and how to alleviate them as much as possible.

Read in this article

Early period after surgery

The first day after the intervention, the patient will have to spend in the intensive care unit. This is not due to the danger of the condition, which doctors may hide from her, this is a common practice for monitoring the performance of the body. After the anesthesia wears off, a woman may feel pain in the area of the incision, as well as in the depths of the abdominal cavity. Some types of anesthesia can cause nausea and even vomiting. But this happens once, does not fall out of the norm. This is how the body gets rid of the remnants of the drug. There is also a strong weakness.

Further recovery after removal of fibroids takes 7-10 days in the ward. On the second or third day, you can get up, turning on your side and leaning on your elbow.

Hospital stay

The first time a woman spends in a hospital room, she is provided with medical supervision. But she herself must monitor her feelings, talk about them to the doctor.

The postoperative period after removal of uterine fibroids with cutting of the abdominal wall lasts quite a long time due to the large area of tissue damage. Oddly enough, you can shorten it if you move. This will give a chance to avoid adhesions, which cause prolonged pain and subsequent infertility, may force an intervention to dissect them. But the load must be dosed, not torturing yourself, not to walk to the point of exhaustion.

Pain after removal of fibroids can be felt throughout the entire 7-10 days in the hospital and later. The intensity depends on the ability to endure them. But the sensations should not be unbearable, this already indicates the beginning of the inflammatory process. The usual pulling or aching pain is caused by irritation of the nerve roots affected by tissue damage during surgery, and is the norm. It is felt mainly in the area of \u200b\u200bthe seam. To reduce its severity, painkillers are prescribed. And the prevention of infections is carried out by the appointment of antibacterial agents.

The first couple of days may remain weak, in the evening the temperature rises. All this is a common postoperative reaction. Every day the strength will return, the body temperature will return to normal.

Nutrition

Since the intervention affected not only the reproductive system, but also the abdominal wall, it is important that the work of the organs located in the abdominal cavity is clear and does not provoke even more tissue trauma. Therefore, a band operation, in which uterine fibroids are cut out, requires the entire postoperative period to monitor nutrition, excluding some foods.

The first 2 days should be limited to broth, weakly brewed tea, yoghurts, that is, liquid, easily digestible food. Constipation should not be allowed, they force the abdominal muscles to great tension, which is now strictly prohibited.

Therefore, in the further diet you need to include vegetables and fruits. If health does not allow them to be eaten fresh due to increased gas formation, it is better to boil or stew. Flatulence must be controlled with drugs and moderate movement.

The diet after removal of the fibroids and upon returning home should consist of

Lean meat, fish;
Oatmeal, buckwheat porridge;
Soups on weak meat or vegetable broths;
rye bread;
Vegetables, herbs and fruits in any form;
Dairy products.

It is worth avoiding everything that provokes difficulties with defecation, increased formation of gases in the intestines, and interferes with tissue healing:

Jelly, jelly;
Rice, semolina;
Muffins, sweets;
Alcohol, strong coffee, tea;
soda;
Fatty meat.

What not to do after an abdominal intervention

In order for rehabilitation to proceed faster and better after removal of uterine fibroids, abdominal surgery forces one to a certain lifestyle even after discharge from the hospital. A woman should competently alternate physical activity and rest, regularly see a doctor, visit him if problems arise. There is a whole list of actions that should be temporarily postponed until a full recovery:

Load of any kind should be feasible. It's not just about fitness for the sake of beauty, but also household chores. This is especially true for the first month after discharge from the hospital. You can not stay in one position for a long time, it is strictly forbidden to lift weights over 2-3 kg for 3-6 months after the operation. For the next 2 years, you can pick up no more than 10 kg of weight;
After removal, you can not have sex for 1 to 3 months. This will have to be clarified with the doctor, guided by their own well-being;
It is impossible, wanting to protect yourself from complications, to spend a lot of time in an upright position. This contributes to the formation of adhesions, weakening of muscles, the appearance of thrombosis. You need to walk a lot in the fresh air, periodically resting;
Recovery after removal of uterine fibroids includes avoiding stress. Increased nervous stress in this period is contraindicated due to the fact that it prevents not only the healing of tissues, but also the normalization of the balance of hormones. And they are important for many aspects of rehabilitation, primarily in the reproductive sphere.

How to recover faster

The postoperative time does not require the abandonment of normal life, assuming only some restrictions. Recommendations after removal of uterine fibroids, if carefully followed, will help not only to recover faster, without complications, but also to avoid recurrence of the disease:

Limit exposure to the sun, generally try not to overheat. This is important for the healing of internal and external sutures, in cool conditions it goes faster. Until they are finally formed, no creams or physiotherapy can be used to smooth them. Moreover, a solarium and a bath are not shown. Before the seam heals, you need to wash in the shower, treating its surface with antiseptics;
To be shown to a specialist 2 times a year, to undergo an ultrasound of the small pelvis. It is also worth having a photo of the postoperative suture at different stages of healing, so that the doctor can compare it with what will come out in the future;
For those who have been diagnosed with uterine fibroids, recommendations after surgery include suggestions for nutrition. Smoked meats, salinity should be excluded from it, sugar should be limited. All this knocks down the balance of sex hormones, on the violation of which the development of a new benign tumor may depend;
Wear a bandage, you can take it only on the advice of a doctor. Both are not shown in all cases;
Control your own periods. Malfunctions in the reproductive system respond to the passage critical days, the amount of discharge, increased pain;
Take care of contraceptives. in the first year after the operation is undesirable, since the uterus may not be ready for bearing. Planning should be preceded by a consultation with a specialist, the necessary research.

Postoperative drug therapy

Getting rid of a neoplasm is not limited to surgery. Treatment after removal of uterine fibroids is almost always supplemented by the use of hormonal drugs that allow you to restore the overall balance of substances, to exclude the possibility of relapse. It can be:

Duphaston, Utrozhestan, stimulating the second phase of the cycle;
COC Jess, Regulon, Yarina, preventing excessive proliferative processes in the uterus.

Modern methods operations make it possible to save the neck of the organ. How uterine fibroids are treated also depends on age.

Myoma is a benign formation, the treatment of which often requires surgical intervention. The disease affects women aged 35-50 years, and sometimes younger. Cases are not uncommon late diagnosis when complications develop. In order for the therapy to be effective, it is necessary to detect the tumor in time and remove it. After the operation, the patient's body experiences severe stress, but after a while you can return to normal life. Removal is carried out in several ways, we will consider them below.

Types of treatment other than surgery

In addition to the surgical treatment of fibroids, medicine offers alternative methods in the form of embolization, laser therapy and FUS ablation. Sometimes they are combined with laparoscopic myomectomy when multiple myomatosis or subserous formations on a thin stalk are diagnosed.

Uterine artery embolization (UAE) is considered a popular but expensive therapy. If we compare the method with surgical removal, the recurrence of the pathology is possible only in 2% of cases. The doctor, under local anesthesia, inserts a catheter into the patient's femoral artery and releases a special solution. The vessels become clogged, as a result of which the supply of food and blood to the tumor stops, it shrinks and dies.

After the procedure, there is severe pain in the lower abdomen, which lasts for several hours. If the procedure is carried out incorrectly, complications are possible in the form of purulent processes and heart attacks in the uterus. UAE is not prescribed when subserous formations are detected.

Fuzz ablation is a conservative treatment option. The formation is evaporated by focused ultrasound through the tissues without disturbing their structure. The waves heat the problem area up to 90°C, cellular destruction occurs, the protein and collagen structure, as well as the vascular network is damaged, and tumor necrosis occurs.

The method is effective, but little studied, therefore, it is used in the localization of tumors on the bottom or walls of the uterus. Fuzz ablation is indicated for patients with formations of 2-9 centimeters. Contraindications - infertility, subserous nodes on the leg, unrealized reproduction.

Laser therapy is a gentle treatment method. The impact of the beam is dosed and clearly directed. During therapy, only the formation is excised, healthy tissue is not damaged. Such an intervention takes place without bleeding and does not leave scars on the surface. Rehabilitation is short, only 3 days.

Should myoma be removed?

Patients often ask the question, is it necessary to remove uterine fibroids or not?

Unfortunately, the nodes can grow, so treatment is needed as soon as the tumor is discovered. If it is small or medium, the patient is prescribed hormonal preparations, due to which the tumor gradually disappears.

Large nodes require removal, especially when there is abdominal pain, bleeding, etc.. Most often, abdominal surgery is used, when the entire uterus is removed along with the fibroids. It is used for women over the age of 40, when it is not planned to conceive a child. Surgery for uterine fibroids is used in severely neglected condition or the presence of concomitant diseases.

If it does not bother, does not grow and is small, the doctor simply observes the tumor. In some cases, a minimally invasive treatment method is prescribed, after which the woman can give birth.

Which therapy to choose, only the doctor decides after a thorough diagnosis.

Indications and contraindications for surgery

Myomectomy is an organ-preserving operation that is used to treat patients of reproductive age. Sometimes such surgical intervention helps to get rid of infertility. Removal of tumors is necessary in cases of ineffectiveness of conservative methods.

Indications for surgical treatment:

Recurrent uterine bleeding.
Submucosal and subserous nodules with pedunculated torsion or necrosis.
Severe persistent pain.
Squeezing, displacement or disruption of nearby organs.
Accelerated node growth.
The danger of oncology.
Submucosal myoma.
Violation of urination.

Myomectomy contraindications include:

Large or multiple tumors;
cervical location;
Active growth during menopause;
Violation of the functions of nearby organs, due to their displacement or compression by a large tumor;
Necrosis with concomitant bacterial infection, thrombosis, etc.;
Menometrorrhagia with anemia.

In difficult cases, partial or complete removal of the reproductive organ is necessary.

Myomectomy cannot be performed in the presence of septic, infectious diseases, somatic condition, contraindications to general anesthesia. In such a situation, one chooses alternative method therapy along with conservative. Sometimes the operation is temporarily postponed.

Training

Any surgical intervention requires careful preparation. In the preoperative period, the patient must pass tests of urine, blood, pieces of the tumor or the contents of the uterus. In addition, a colposcopic and ultrasound examination, as well as hysteroscopic diagnosis, is prescribed. The doctor determines the general state of health, studies the medical history.

After receiving the results, a method of surgical intervention is selected to eliminate fibroids, taking into account the age and degree of damage. Organ-preserving treatment is a priority, for mature women a hysterectomy is chosen, but the final decision is up to the patient. Preparation for the operation on the part of the woman is to shave off the pubic hair and take a shower.

Shown in the evening light dinner and sleeping pills so that the girl can sleep well and rest.

How are fibroids removed

Removal of the myomatous node is a full-fledged operation, which is prescribed when other methods are ineffective.

Therapy does not exclude risks for the patient, as complications and relapses sometimes develop.

Most often in practice, doctors use the following methods:

Abdominal surgery - is prescribed for large tumors and cancers.
Hysteroscopy of the uterus - is used to remove a single formation, which is localized on the anterior or posterior wall.
Laparoscopy - remove subserous nodes on a wide base or leg.
Laparotomy - is indicated for subserous and interstitial formations of a deep location.

Abdominal surgery is, in fact, a laparotomy, since access is made through incisions on the abdominal wall. This method of removal is rarely used in practice; sparing therapy is popular today. Most often it is prescribed for necrosis and torsion of the legs of the myoma. The rehabilitation period is 2 months. The operation is under general anesthesia, therefore, is not prescribed for patients with an allergy to anesthesia.

Hysteroresectoscopy is a minimally invasive method in which the submucosal node is removed.

During the operation, the integrity of the tissues and uterus is preserved, while there are no scars and significant blood loss. The woman remains fertile. The operation is performed using a hysteroscope equipped with a camera, which is inserted through the cervical canal. The doctor controls all his actions on the monitor, can take material for a biopsy and quickly stop bleeding, if any. This method removes tumors growing in the lumen of the uterus.

Laparoscopic myomectomy is one of the most gentle and most commonly chosen surgical methods.

All manipulations are done through special holes on the abdominal wall. The punctures do not leave visible scars and heal quickly, in about 7 days.

Endoscopic removal or laparotomy is rarely used. The procedure is recommended for the active growth of large tumors.

After the operation, the patient needs to spend several days in the hospital, healing takes place with discomfort, rehabilitation is 3-4 weeks.

Sometimes surgical removal myomatous nodes occurs together with low-traumatic methods when to prevent food formation. Before surgery, the doctor injects a solution through the femoral artery, which dries up the fibroids. The procedure is called fuzz ablation, it has not been fully studied, therefore it is used only in the early stages.

Today, the methods for removing fibroids are varied, which one to choose, the doctor decides after examining the node in the uterus and receiving the necessary information. Usually, doctors try to preserve childbearing functions, if this is not possible, at least the ovaries, cervix, tubes are left so as not to disturb the hormonal balance.

Postoperative period

Removal of the uterus is the most undesirable treatment option for fibroids. They try to avoid it using sparing methods. Usually the recovery is quick and calm, sometimes the patient is worried about pain and discomfort. The healing process is different for everyone, some women will need a week, others more than a month. Rehabilitation after removal of fibroids requires compliance with certain rules.

With a strong pain syndrome use analgesics. Intense blood loss requires a blood transfusion, as well as taking funds to normalize blood pressure. In the first two days after surgery, the doctor monitors the work of the intestines, since such therapy increases the risk of obstruction.

It is important to avoid constipation so that the seams do not open. For this reason, during the rehabilitation period, the patient must follow a diet and bed rest. The woman spends about two weeks in the hospital, after which the stitches are removed. Any gynecological intervention is stressful for the body. Psychological restorative measures are also used.

What is contraindicated

A woman must be familiar with the contraindications, especially after abdominal surgery. These include:

Sexual life can be started after 2 months;
You can not go in for professional sports, visit baths and saunas;
It is forbidden to lift weights;
It is recommended to wear a special bandage, and replace tampons with sanitary pads.

The doctor will tell you more about contraindications, based on the individual characteristics of the patient.

Nutrition

The diet is selected depending on the chosen operation, the presence of anemia and diseases. gastrointestinal tract. During the recovery period, it is necessary to exclude confectionery, strong tea and coffee, curd products, white bread and chocolate. It is recommended to eat often, but little by little. Drink 2-4 liters of water per day.

For a laxative effect, you can eat cereals, various meat broths and sour-milk products. The diet should include proteins - these are fish, nuts, meat and liver. It is recommended to eat more vegetables and fruits, especially those with a lot of iron. The patient should drink beetroot and pomegranate juice. good food- pledge of fast and proper recovery.

Complications

After surgery, various complications can occur, usually they can be avoided. However sometimes such negative manifestations are possible:

Disease relapse.
Infection.
Increased risk of breast cancer and development coronary disease hearts.

If a woman notices bleeding with clots, you should immediately consult a doctor. In the first days, the patient may experience pain in the peritoneum and the suture area, weakness, and malaise. During abdominal operations, inflammation of the scar or its dissection is possible. Urination is often disturbed, bleeding occurs. Later consequences include infertility, the formation of internal adhesions, early onset of menopause, osteoporosis, and.

The nature of whiter

Transparent selection without sharp bad smell after removal of nodes - a natural phenomenon. Sometimes during the operation, the walls of the vagina are injured, and bloody secretion appears. In this case, you need to visit a gynecologist who will prescribe therapeutic ointments. If after treatment the patient noticed a curdled secret, candidiasis is diagnosed.

Also, after the removal of the nodes, uterine bleeding is possible. It can be scarce or abundant. Sometimes such secretion is normal menstruation. After operations, the cycle shifts, and critical days come earlier. Abundant blood loss indicates a rupture of the vessel or suture. The condition is accompanied by fever and pain in the lower abdomen.

Secretion with a pungent greenish odor indicates the development of an infectious disease or bacterial vaginosis. Normal secretion should be colorless, without any odor. Any deviations require a visit to the doctor, especially when it comes to profuse blood loss with clots.

How long does the operation take

The duration of therapy depends on many factors - the chosen method, the age of the patient, the state of health, the stage of the lesion, etc.

It is also important that complications are possible during the procedure. Usually the operation lasts from 30 minutes to 2-3 hours. It is impossible to say exactly how long the removal will take, even the doctor is not 100% sure how the intervention will turn out.

sick leave after surgery

After surgical operations on the uterus, the patients lie in the hospital for some time, the exact number of days is determined by doctors. For this reason, a special document on temporary disability is necessarily issued. Almost every woman is interested in the question of how many days they give sick leave. It usually lasts 21-45 days, if necessary, employees of a medical institution extend this period, what it will be depends on the individual characteristics of the patient.

The possibility of pregnancy after the intervention

The probability of fertilization after removal of nodes is 40-55%. Even if a sparing method was used in therapy, the patient may not always become pregnant and give birth to a healthy child. It is recommended to plan conception not earlier than in 1 year. If scars remain on the uterus, a caesarean section is performed. If adhesions occur, complications are possible in the form of obstruction of the tubes, which leads to infertility. To say for sure whether there will be a pregnancy or not, only a doctor can, after a thorough examination.

Is a relapse possible?

In medicine, there is no such method of treating fibroids that would 100% guarantee the absence of recurrence, especially if the uterus is preserved. To avoid this, it is necessary to normalize the hormonal background and follow the recommendations of the doctor. If doctors manage to eliminate deviations in the hormonal balance, the risk of recurrence of fibroids is minimal.

Caesarean and removal of fibroids at the same time

Increasingly, fibroids are being diagnosed during artificial labor, and there are good reasons to remove them.

If the nodes are localized along the incision during caesarean section, they will be removed.

In other situations, the operation is prescribed for the period after childbirth, after some time.

There are good reasons for this:

Possible blood loss
An increase in bleeding is dangerous for mom and baby;
After the nodes are removed, adhesions are likely to form, and soon infertility.

Caesarean section increases the risk of recurrence, therefore, doctors recommend waiting a bit and using a gentle method called fuzz ablation. Then in the future there will be no problems with fertilization and childbirth.

What can be menstruation

After removing the tumors, menstruation is quickly restored, usually it takes 1-2 months. Thanks to the operation, soreness and profusion disappear, the woman is disturbed by pulling, but not severe pain. If there are heavy periods after removal of fibroids, a relapse is possible. Temperature increase, strong pain in the lower abdomen, chills, bloating - a reason to contact a gynecologist. In cases where the procedure was performed shortly before the critical days, scanty periods are observed.

How to get a quota for fibroid removal?

Organ-preserving surgery to remove fibroids is quite expensive, and not every woman can afford it. The state allocates a certain amount of money for the treatment of pathologies with high technologies. You can get a quota only after an in-depth examination if there are good reasons.

Quotas are required only when there is no cheaper alternative to treatment. If a woman goes through all the stages of the commission, the operation will be paid for by the state.

Price

After the diagnosis of uterine fibroids is confirmed, patients are interested in how much the operation costs. It depends on many factors - the region, the status of the clinic, the type, scope of work, etc. You can only calculate the approximate cost of the operation:

Hysteroscopy - up to 80,000 rubles.
EMA - up to 180,000 rubles.
Laparoscopy - up to 90,000 rubles.
Fuzz-ablation - up to 117,000 rubles.

The cheapest surgical intervention is the complete removal of the uterus. The price should not exceed 20,000 rubles. To save the genital organ, you will have to spend at least 50,000 rubles.

The most common surgical interventions in women are precisely those that are carried out on the organs of the reproductive system. This pattern is due to the fact that pathologies have a high incidence rate.

Hysterectomy

The operation to remove the uterus, hysterectomy is one of the most extensive gynecological operations. It is carried out only in cases where other methods of treatment or surgery will not make it possible to completely eliminate the pathology.

Indications for such surgery include:

Malignant tumors of the uterus
Rapidly growing benign tumors (a sign of a malignant process)
Uterine ruptures (most common during childbirth or major trauma)
Endometriosis (uterine mole)
Advanced forms of prolapse and prolapse of the uterus

Hysterectomy is a fairly extensive operation that requires special training and the creation of a rehabilitation course. The most common complication during a hysterectomy is bleeding. It is worth noting that such a complication can develop with any surgical intervention.

Hysterectomy leads to irreversible changes in a woman's body - she will no longer be able to have children. At the same time, due to the preservation of the ovaries, premature menopause may not occur, which allows you to maintain a normal hormonal background for a long time.

The operation to remove the uterus takes a different time. The duration of the operation depends on several factors, such as the skill level of the doctor, the indication for surgery, as well as the individual characteristics of the body (presence of adhesions in the abdominal cavity, etc.).

The operation to remove the uterus has the shortest duration, which is performed for indications such as endometriosis, early stages of cancerous tumors without sprouting into surrounding tissues, benign tumors, and total polyposis. In such a situation, with the proper level of skill of the doctor, the operation can last within 40 minutes, but rarely exceeds 1 hour.

At the same time, the duration of the operation may exceed 3-4 hours, as long as the doctor needs to completely remove the affected tissues.

Hysterectomy is performed under endotracheal and epidural anesthesia.

Full recovery takes at least six months, since the complete healing of the tissues of the anterior abdominal wall is a long process.

Removal of uterine fibroids

uterine fibroids are benign tumor which is formed from muscle tissue. The incidence of this pathology is quite high. Tumors of small size do not require urgent surgical intervention. Most gynecologists take a wait-and-see attitude - regular check-ups with a doctor in order to control the growth of fibroids.

Urgent removal of fibroids is necessary in cases where its active growth is observed. The acceleration of this process indicates that malignant cells appear in the tumor, which stimulates its growth.

The operation to remove fibroids can be carried out in two ways: laparoscopic and laparotomic. The laparoscopic view is more modern and less invasive, so most women prefer it. Endoscopic surgery has many advantages.

The only drawback of laparoscopic surgery is a narrow view, due to which the myomatous node on the uterus may go unnoticed. At the same time, after laparoscopic surgery, a woman can go home after a few days. Most often, endoscopic intervention is performed for small myoma nodes (less than 3 cm in diameter)

During laparotomy, access is through a Pfannenstiel incision (a transverse incision on the anterior abdominal wall just above the pubic joint). In rare cases, a lower median laparotomy is performed. The laparotomy method is used for large tumors.

The actual surgery to remove fibroids is called a myomectomy. If the intervention is performed using a laparoscope, then the operation to remove uterine fibroids lasts no more than 1 hour. When performing abdominal surgery, the time required to remove fibroids may be less.

These figures are approximate and may vary.

Intravenous, epidural, endotracheal, or local anesthesia may be given.

See also: uterine fibroids, treatment folk remedies

Extirpation

Extirpation is an operation during which the uterus is removed along with the cervix, as well as the adnexa. The appendage consists of the ovary and the Fallopian tube. This is the most radical intervention that is carried out in gynecology.

In most cases, the indication for this type of operation is an advanced form of uterine or ovarian cancer. Unlike hysterectomy, extirpation causes premature menopause, as the ovaries are removed, which are the only source of estrogen and progesterone in the woman's body.

Such surgical treatment causes severe psychological trauma, especially in young women, since after it serious changes occur, and most importantly, a woman cannot have children.

Extirpation is carried out only in cases where there is no other alternative method of treatment. Whenever possible, doctors always try to preserve the appendages, but this is not always possible. Elimination of the disease may require the most drastic measures.

The operation to remove the uterus and ovaries lasts as long as a hysterectomy. Under favorable conditions and no complications, the doctor can complete it within an hour. Difficult cases require more time.

Most often carried out general anesthesia in the form of endotracheal anesthesia. Loading...

Polypectomy

Another benign tumor disease of the uterus is polyposis. Polyps are small growths that grow in the uterine cavity. Most often, these formations are multiple, they can cover the entire surface of the endometrium.

Removal of polyps is carried out transvaginally, and can take place in a gynecological office. This is due to the fact that the removal of the polyp refers to small gynecological operations. It does not require special preparation or special management of the postoperative period. In most cases, women are advised to stay in the hospital for a day under observation, as there is a risk of bleeding.

Anesthesia can be used for local application.

The operation itself is performed using a laser, a diathermocoagulator or a cryodestruction apparatus. Such equipment can significantly reduce injuries and reduce the risk of damage to blood vessels to a minimum.

Depending on the severity of the polyposis process, the operation to remove the uterine polyp lasts from 20 to 45 minutes. After the manipulation, women are advised to refrain from sexual intercourse, physical activity and visiting the bath for 2-3 weeks, so that the wound surface has time to recover.

Trachelectomy

Removal of the cervix is one of the rarest gynecological operations. Usually, doctors practice extirpation of the uterus along with the cervix and appendages, or supravaginal amputation of the uterus.

A trachelectomy is the removal of all or part of the cervix. Trachelectomy is performed in the presence of such pathologies:

Cervical cancer. It is worth noting that this malignant disease is most often diagnosed in the early stages. This is due to the fact that all women during preventive examinations take a smear for a cytological examination. Atypical cells appear even at stage 0-1 of cervical cancer, when you can perform a gentle operation and completely get rid of the problem.
Erosion of the cervix. A fairly common pathology of the cervix is various erosions. They can cover a fairly large area of the body, which creates a risk of bleeding. (See also: What causes uterine erosion)
Dysplasia. Cervical dysplasia is a precancerous condition, so it requires immediate treatment.

Removal of the cervix is carried out through the vagina. For the purpose of anesthesia, local anesthetics such as lidocaine or novocaine are used. The operation to remove the cervix lasts an average of half an hour.

Rehabilitation usually does not last long - a few weeks.

Consequences

All surgical interventions have their consequences. These include:

Infertility after hysterectomy and extirpation
Activation of adhesive process in the abdominal cavity after open surgical interventions
Premature menopause after ovary removal

In order to reduce the risk of complications during surgery, special preparation is needed, which is prescribed individually, taking into account the characteristics of the organism.

It is also worth noting that the postoperative period requires full compliance with all doctor's recommendations. If they are not adhered to, then the risk of suture failure increases, which leads to bleeding and the development of pelvioperitonitis, which will endanger the patient's life.

The main restrictions in this period are:

Complete exclusion of physical activity, as well as light work for six months
Exclusion of sexual intercourse for at least 2 months
Periodic visits to the gynecologist to check and assess the condition
Regular ultrasound of the pelvic organs

If the operation was performed for malignant tumors, then you need to periodically donate blood for tumor markers in order to timely detect a relapse.

It is impossible to determine the exact duration of the operation. It may depend on a large number of factors and circumstances. Proper psychological preparation and high qualification of the operating doctor will help to easily endure the intervention and are the key to a favorable outcome.

Video: removal of the uterus and possible consequences

Video: removal of uterine fibroids - myths and facts

Video: Trachelectomy - treatment of cervical cancer while maintaining childbearing function

Video: Supravaginal amputation of the uterus

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Possible consequences after removal of fibroids along with the uterus

It is difficult to imagine how many women hear the diagnosis “uterine fibroids” addressed to them at the doctor’s appointment.

Pathology is a benign neoplasm of the uterus, which develops and grows under the influence of female hormones. The peculiarity of the pathology is that in the early stages the myomatous nodes do not make themselves felt, and when they are found, in most cases only surgical intervention is indicated. In especially advanced cases, fibroids are removed along with the reproductive organ. How is the operation to remove uterine fibroids performed? Does it require anesthesia? When is hysterectomy required for fibroids? How many options for the operation are there? What are the implications of this surgery? How long does rehabilitation take?

Having heard the diagnosis of "myomatosis of the uterus", the woman believes that her life is over. Undoubtedly, it is psychologically difficult to agree to an operation, but such measures will help get rid of heavy bleeding, severe pain, depression and weakness, improve family relationships, get rid of miscarriages and eliminate the problem of infertility. But in some cases, more drastic measures may be required, when the operation to remove fibroids involves the removal of the uterus itself. At the same time, it is possible to get rid of all the symptoms of the pathology, but for a woman the possibility of becoming pregnant is excluded.

How are uterine fibroids removed?

The decision on the choice of the method of conducting the operation is made by the surgeon, taking into account all the circumstances: the number, size and localization of myomatous nodes, the peculiarity of their structure, how old the woman is, the reaction to anesthesia, the presence of other chronic pathologies in the patient.

Today, as a treatment for pathology, doctors often use such a minimally invasive method as uterine artery embolization. However, this method can not be applied in every case, so the operation to remove the tumor is still used in medical practice.

Conventionally, surgical intervention aimed at removing myomatous nodes can be divided into myomectomy (an operation during which only fibroid nodes are removed, while the uterus is preserved) and hysterectomy (a radical operation in which the myomatous nodes are removed along with the uterus; it requires anesthesia ). It is possible to remove uterine fibroids with a laser, for which anesthesia is also used.

So, myomectomy is possible if:

nodes of small size;
the number of nodes is one or more and they are located in accessible places;
the presence of heavy bleeding, not associated with menstruation;
pressure of fibroid nodes on neighboring organs, disrupting the functioning of organs;
it is impossible to save the uterus (hysterectomy is performed);
the age of the myomatous node is more than 12 weeks;
severe symptoms of pathology in women over 45 years of age;
prolapse and prolapse of the uterus in the presence of myomatous nodes;
rapid growth of noogenesis;
the appearance of myomatous nodes in the cervix;
tumor on a thin long stalk;
frequent relapses of the disease after other types of pathology treatment;
the presence of concomitant diseases in a complex form.

Hysterectomy is indicated when all other treatments have failed. It is mainly used for women who have reached the age of menopause. However, sometimes such a radical operation is also performed on young women. How are uterine fibroids removed?

There are the following options for performing an operation to remove fibroids along with the uterus.

Laparoscopy. Narcosis is required. Several small incisions are made on the abdomen, through which the surgeon removes the uterus, affected by fibroids, in parts.
Laparotomy. Narcosis is required. One incision is made on the abdomen, through which the affected reproductive organ will be removed. The scar after the operation is small.
Hysteroscopy. Narcosis is required. The surgeon performs surgery through the neck of the reproductive organ, as a result of which no scars remain on the woman's body. But such a variant of the operation is possible only if the size of the myomatous nodes is small and the uterus is not greatly enlarged in size.

What can you expect after surgery to remove a uterus with fibroids?

As mentioned above, the removal of the uterus (hysterectomy) helps to eliminate all the pathologies of the genital organ along with itself, but the most unpleasant consequence of this is infertility, which can no longer be eliminated. Complications can arise during the operation, as well as immediately after it. Among them are the following:

anesthesia can adversely affect the patient;
nearby organs or vessels may be damaged by surgical instruments;
bleeding during surgery or during rehabilitation;
inflammatory processes;
intestinal obstruction(re-operation may be required);
peritonitis;
pulmonary embolism.

The consequences of hysterectomy can be divided into physiological and psychological. Even if a woman has already given birth, the very realization that she will no longer be able to give birth to offspring - due to the absence of a uterus - can cause severe stress.

After the operation, a syndrome (posthysterectomy) may also develop, which is expressed in disorders of the functioning of various body systems (endocrine, nervous, cardiovascular, and others). After removal of the uterus, the risk of developing serious pathological changes who, in particularly severe cases, may have a grandfather fatal outcome.

There are frequent cases when, simultaneously with the uterus, removal of the ovaries is also indicated (anesthesia is used), which not only causes hormonal imbalance, but can also cause the development of many diseases. Simultaneously with the uterus during the operation, using anesthesia, the surgeon removes a branch of the uterine artery, which leads to a violation of the blood supply to the ovaries. Even if the ovaries are not removed, they will still not be able to feed sufficiently through other vessels, which will cause dystrophic processes and, accordingly, the level of hormone production will decrease.

There are such possible negative consequences of hysterectomy:

relapse of the disease;
infertility;
diseases of the heart and blood vessels (if the ovaries were removed, the likelihood of developing serious pathologies of cardio-vascular system increases);
increased risk of breast cancer, kidney cancer, thyroid gland;
malfunctions of the urinary system (urinary incontinence, frequent urination);
sexual disorders: pain during intercourse, vaginal dryness, decreased libido;
the risk of prolapse of the machine of the vagina;
frequent and causeless depression, irritability, insomnia and memory impairment;
hair loss;
pain in the joints;
the development of osteoporosis, which makes the bones less strong (high risk of fractures, injury);
rapid weight gain due to endocrine disorders.

What can not be done after the operation to remove the uterus with fibroids? How long does recovery take?

After a hysterectomy, a woman will have to change her usual lifestyle:

it is allowed to eat only pureed food, cereals;
do not eat products made from white flour;
do not push - this can lead to rupture of the seams;
avoid physical exertion, walks should be moderate;
avoid household work associated with the load;
you can not stay in the sun for a long time, go to the solarium.

After quite a certain time (3-4 months) after the operation, the woman will be able to return to her usual way of life.

How long the recovery will take will depend on which method of surgical intervention was used. Open surgery involves a long rehabilitation process.

Sex life after surgery

Removal of uterine fibroids or the reproductive organ itself is not a reason for not having sex. If a woman feels pain during intercourse, and this means that her body has not yet fully recovered (especially if an abdominal operation was performed). In this case, you need to consult with the surgeon who performed the procedure.

If an abdominal operation was performed and it was possible to save the reproductive organ, it is necessary to discuss with the doctor the means of contraception that can be used. In the case when the uterus has been removed, the use of contraceptives is not required.

How long does it take before the patient regains sexual activity? How long should you abstain from sex? In most cases, after surgery to remove the uterus with fibroids, you can have sexual intercourse after about a month and a half.

What should be the nutrition after removal of the uterus with fibroids?

Nutrition after surgery requires compliance with certain rules:

the amount of fat in the diet should be minimal;
exclusion from the menu of fatty cheeses, meat, butter, eggs;
vegetable oil should replace animal fats;
obligatory presence of fish in the diet.

How long should this regimen be followed? Ideally, if a woman completely reconsiders her diet, excluding harmful products.

The categorical refusal to remove the uterus with fibroids is explained by the fact that women see from their relatives and friends what consequences this leads to. However, some patients note that their life after the operation has improved, pain and other unpleasant symptoms have disappeared. Therefore, the final decision whether to agree to the operation or not depends only on the woman herself. Hi, it is important to realize that the disease does not go away on its own.

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Surgery to remove uterine fibroids: sick leave, postoperative period, rehabilitation after laparoscopy

One of effective methods The treatment of uterine fibroids is a surgical intervention, during which the fibroids or the entire uterus are removed. Today, there are various options for the operation, each of which has both positive and negative sides. The decision to perform a certain type of operation is made by a specialist after a thorough examination of the woman.

Surgery is one of the ways to treat uterine fibroids

Modern surgery offers several ways to carry out surgical treatment this disease.

One of the most common gynecological diseases that can be diagnosed in a woman of any age is uterine fibroids. This pathology is a benign neoplasm, the site of which can be any part of the reproductive organ and its mucous membrane. The development of fibroids is usually considered the result of a change in the hormonal background of the female body and sometimes its size can reach several kilograms.

modern medicine the elimination of this pathology is carried out in various ways, among which the most effective is the operation to remove fibroids. Among patients who have undergone such treatment, there are different reviews about the types of surgical intervention. In the event that the tumor is small and does not cause any concern to the woman, most often specialists simply monitor her condition or use hormone therapy. The decision to conduct surgery is made in the presence of certain indications that can further worsen the condition of the woman.

Indications for surgery

Myoma surgery is performed in the following cases:

there is a rapid and rapid growth of the tumor and the result of this is compression of adjacent organs;
fibroids are the main cause of frequent and prolonged bleeding, which cause the development of anemia;
the size of a benign neoplasm exceeds more than 12 weeks;
a woman experiences severe pain in the lower abdomen;
in the place of localization of the myomatous node, the movement of blood is disturbed and the result of this is the development of necrosis;
the progression of uterine fibroids is combined with such gynecological pathologies as endometriosis and ovarian tumors;
a woman cannot become pregnant for a long time, and with a positive result, a spontaneous miscarriage occurs;
there is a danger that a benign neoplasm in the uterine cavity will degenerate into a malignant one.

Reviews of specialists and patients about operations are rather contradictory and the choice of a particular method of surgical intervention depends on many indicators and, first of all, attention is paid to:

tumor size;
its location;
the presence of comorbidities;
the age of the patient;
desires and opportunities to maintain childbearing function.

Varieties of the operation

The decision that it is necessary to operate on the uterus, the specialist takes into account the stage of development of fibroids and you can get rid of a benign neoplasm in the following ways:

myomectomy;
embolization
radical surgery.

Myomectomy

Reviews of many women indicate that today this method of getting rid of uterine fibroids is considered one of the most effective, since it allows you to cure the tumor and at the same time preserve the reproductive organ. Most often, this type of operation is used when the tumor has not reached a large size. In medical practice, the following types of myomectomy are used:

Laparoscopic myomectomy is a type of surgical intervention that is done using a special device - a laparoscope. The laparoscopic operation lasts 20-40 minutes and during its implementation, a specialist inserts a special device with a video camera and medical instruments into the abdominal cavity. Most often, treatment with this method is used when there is a need to remove subserous neoplasms from the uterine cavity. The positive feedback from patients about this method of treatment is explained by the fact that laparoscopic myomectomy is a less traumatic method, since after it the recovery is quick and quite successful. In addition, the use of this type of surgical intervention helps prevent adhesions in the abdominal cavity. However, the removal of fibroids by the laparoscopic method can cause the formation of seals and it is for this reason that it is recommended to be constantly monitored by a gynecologist.
Laprotomy myomectomy is an operation in which the tumor is removed through an incision made in the abdominal wall. Reviews of women who have undergone such an operation suggest that the only disadvantage of this type of surgical intervention is the long-term recovery of the female body. When using laparotomic access to the uterine cavity in the postoperative period, the woman is in the hospital for 5-8 days. In addition, after such an operation, the rehabilitation period averages one month.
Hysteroscopic myomectomy is a type of surgical intervention in which the removal of a benign neoplasm takes place using a special instrument inserted into the uterine cavity through the vagina. Most often, treatment with this method is used when a woman needs to remove a submucosal node in the uterine cavity. More often you can find positive reviews about this method of treatment, and this is due to the fact that this type of operation is considered the most gentle for the female body, and after it is carried out, there is subsequently a chance of self-delivery.

Embolization

One of the ways to remove fibroids is embolization, in which the blood supply to the myomatous node is eliminated and the result is its shrinkage.

Most often, positive feedback from patients about such a surgical intervention prevails, because treatment by this method is the least traumatic and complications after it are minimal.

Many women are concerned about the question of how long the operation and rehabilitation itself will last.

It turns out that embolization lasts only a few hours and the woman will only have to stay in the hospital for one day.

After the operation in the abdominal cavity, the woman has two small punctures, which are subsequently well tightened and leave no traces behind. The postoperative period is largely determined by two factors: when the operation was performed, and how many myoma nodes were removed.

radical surgery

Most often, abdominal surgery is performed in cases where:

in the uterine cavity there is a large number of myomatous catches of impressive size;
a woman was diagnosed with malignant neoplasms in the uterine cavity.

An abdominal operation requires careful preparation, and it is for this reason that the patient is prescribed a series of tests and a complete examination by her attending physician. Most often, women's reviews of this method of treatment are not entirely joyful, since with this type of surgical intervention, specialists perform an open incision in the abdominal cavity and remove the entire body of the uterus.

However, despite this, in the future, most women experience various hormonal disorders.

Recovery after removal of fibroids

Any type of surgery is a real test for the female body, so after it is recommended:

limit physical activity;
at least temporarily protect yourself from household chores;
do not push, as this can provoke rupture of the seams;
avoid visiting baths and saunas, as well as limit the time spent in the sun.

Many patients are concerned about how long after the operation it is necessary to limit themselves, and when it will be possible to return to their usual way of life. It turns out that after the operation, you can do your usual things in 3-4 months. After abdominal surgery, a woman is given a sick leave for two weeks.

Not every specialist will be able to answer a woman's question about how long her rehabilitation period will last. The recovery of a woman's body is determined by several factors, for example, with open surgery, a longer recovery period is required, since the healing process is slower. Most often, it is difficult for a woman to overcome the psychological barrier, since many believe that life ends after the removal of the uterus.

The rehabilitation period will depend only on the woman herself, because it is the desire of the patient herself to recover that significantly speeds up the recovery process.