Hysterectomy: indications, types, what awaits a woman after surgery

Common causes of anxiety are fear of anesthesia, the belief that removal of the uterus leads to hormonal imbalance, and decreased libido. However, as they say, fear has big eyes: the achievements of modern medicine allow a woman to safely undergo surgery and lead an absolutely normal, fulfilling life after it.

In this article we will answer the most common questions that women have before surgery. Let's figure out what a hysterectomy is, how it is performed, what awaits the patient after surgical treatment.

What is uterine hysterectomy and what types of hysterectomy are there?

Hysterectomy is a surgical procedure aimed at removing the uterus. The operation is performed for severe pathologies when conservative treatment does not help or is inappropriate.

Depending on the extent of the surgical intervention, hysterectomy is:

1. Subtotal - the uterus is removed, but the cervix remains in place.
2. Total - removal of the uterus and cervix.
3. Radical - the uterus, cervix, ovaries, and fallopian tubes are removed.

Types of massage

Manual massage is carried out in two main ways:

• external - using pressure on the perineum in the area behind the scrotum and in front of the anus;
• internal, which involves inserting a gloved finger into the anus, groping the prostate and pressing on it with different amplitudes and frequencies.

There are also special devices for prostate massage and hydromassage, but you must first consult with a specialist about the possibility of using such techniques.

When is a hysterectomy indicated for a woman?

The final decision about whether a woman is indicated for surgery to remove the uterus is made in the hospital when the patient is admitted and has a number of problems. Doctors work according to the ICD, that is, according to certain standards that clearly define the indications for removal of the uterus.

Indications for surgical intervention are:

• fast-growing fibroids (hormone-dependent benign tumor);
• multiple fibroids;
• combination of uterine fibroids and endometriosis;
• symptomatic fibroids. For example, when a woman has very severe pain during menstruation or in the intermenstrual period due to fibroids;
• compression syndrome of neighboring organs. Occurs if a large fibroid compresses neighboring organs (intestines, bladder);
• hemorrhagic syndrome, when a woman’s hemoglobin constantly drops;
• malignant formations.

In addition to the availability of indications, the patient’s age, hormonal status and reproductive plans must be taken into account.

Frequently asked questions from our patients

There are many types of enemas; we offer installation of the most popular among them - hypertonic, siphon and cleansing.

No, our center’s specialists will arrive at the address you specified with all the equipment, including disposable diapers and other equipment necessary for the enema.

An enema, despite its apparent simplicity, has some contraindications that only a specialist can recognize. Therefore, we recommend using the services of our medical staff, who will take into account all the features of your medical history and perform the cleansing procedure correctly.

We work for you around the clock, you can call a specialist at a convenient time, even late in the evening or early in the morning.

How do you prepare for the operation?

One of the important aspects of preparing for surgery is a positive attitude, which largely determines how the operation and recovery period will go. For a favorable psychological state, it is important to trust doctors and be sure that after surgical treatment you will return to a full life and your body will function the same as before the operation.

Before a hysterectomy, any woman undergoes a comprehensive examination, which allows not only to assess her physical condition, but also to identify disorders that can be corrected before surgery. For example, hormonal imbalance, vitamin deficiency, and mineral deficiency are much easier to eliminate before surgery than after it.

A comprehensive examination must include an ultrasound of the ovaries with Doppler. The anatomical structure of all women is different. In some women, the ovaries have vasculature that extends from the uterus. In this case, after amputation of the uterus, the blood supply to the ovaries is disrupted, and the woman can quickly enter the menopause phase. Ultrasound of the ovaries allows you to assess the likelihood of such a consequence and take timely measures after surgery in the form of hormone therapy.

When a woman is admitted to a hospital, a consultation is held and, based on the data provided by the patient and a subjective examination, the question is resolved: how to ensure that the woman continues to live and work fruitfully with minimal intervention. If possible, preference is always given to surgery without removing appendages, which allows preserving the woman’s hormonal status.

Before the operation, the patient signs consent for surgical treatment. In this case, it is necessary to stipulate that intraoperatively (during the operation) it is possible to change the scope of surgical intervention. This can happen if during the operation the surgeon discovers complications (for example, signs of cancer) that were not previously recorded on ultrasound or MRI.

During the operation, it is impossible to obtain the patient’s consent for additional surgical procedures, since it is performed under general anesthesia. Therefore, all the details of a hysterectomy are discussed in advance and written down in the medical document. If a woman does not consent to additional surgical procedures, then the operation is carried out to the extent that the woman knows about.

On the eve of surgery, premedication is carried out - drug preparation of the patient for surgical treatment and anesthesia. Premedication allows:

• soften the effect of anesthesia on blood vessels;
• reduce the patient's anxiety level;
• reduce the secretion of glands;
• stabilize the functioning of the gastrointestinal tract.

Medications are prescribed depending on the individual characteristics of the woman. For example, probiotics, sedatives, and anticholinergic agents can be used.

The relevance of enema at home

There are many types of enemas, but the most commonly prescribed are cleansing, siphon and hypertonic. What are they needed for?

Loosening feces with the injected solution is very effective: in one procedure you can both get rid of delayed bowel movements and thoroughly cleanse the intestines before the upcoming examination.

Our medical staff will provide assistance to any patient, because the service has significant advantages:

1. The optimal cost of performing an enema. The prices are not inflated and are affordable for most.
2. Complete anonymity for the patient. The specifics of any manipulation will remain between the doctor and the client - we keep confidential information strictly confidential.
3. High quality result. An enema of any kind will have the desired effect, and the visiting nurse will monitor the entire process.
4. Specialist punctuality. We will arrive exactly at the time specified during registration, and not a minute later!
5. Availability of the necessary materials and disposable products: combination heating pads (Esmarch mugs), diapers, etc.
6. Maximum patient comfort during home treatment. A comfortable position, appropriate recommendations from a specialist and a painless procedure will please any patient.

In order to order a nurse at home for an enema in Moscow, call the specified phone number. The dispatcher will accept the call and dispatch the team as soon as possible!

Specify the type of research

I need an enema

Didn't go much

What access is used to remove the uterus?

Hysterectomy of the uterus can be performed using:

• laparoscopic (endoscopic) access. Endoscopic access is good because the operation is performed through small incisions, and after it there are practically no scars left on the body. The surgeon's main instrument is a laparoscope (telescoping tube) attached to a video camera. The video camera displays an image of the operated area on the monitor, which allows the surgeon to perform the operation with pinpoint precision;
• laparotomy access - an incision in the abdominal wall. The incision can be suprapubic, inferomedian (incision along the white line of the abdomen, from the navel to the pubic symphysis);
• vaginal access. It is used for prolapse of the internal genital organs.

Hysterectomy can be combined with other surgical procedures, including aesthetic ones. For example, with vaginal plastic surgery, which may be required after a difficult birth or when the bladder prolapses. Thus, in one surgical intervention (once completed training, anesthesia, rehabilitation) several problems of different nature can be solved at once - modern medicine makes it possible to do this.

Advantages of the procedure

Prostate massage has a therapeutic effect and reduces the inflammatory process by improving the outflow of urine and increasing blood supply to the prostate. The procedure has a number of advantages:

• congestion is removed, lymph and blood begin to circulate better in the prostate area, and there is a good flow of oxygen;
• prevention of oncology - bacteria and their waste products, eliminated by massage, increase the risk of malignant tumors;
• normalization of urination by reducing the pressure of the prostate on the urethra;
• the seminal fluid accumulated in the gland is released, which reduces the risk of inflammation and enlargement of the prostate;
• potency increases, as blood flow to the sexual organ increases, and the prostate is responsible for the release of seminal fluid;
• the tone of the perineal muscles increases, and tension disappears from them;
• return of the organ to normal size;
• pain and discomfort characteristic of chronic prostatitis disappear;
• during the massage, the doctor can identify oncological or infectious diseases, which, if diagnosed in a timely manner, can be treated, and the procedures will be stopped;
• improving the penetration of drugs into the prostate tissue by improving blood circulation;
• the patency of the prostate ducts is normalized, which provides a good outflow of secretions.

Massage is effective when problems already exist and when serious pathologies have not yet been discovered. It is indicated for men as a preventive measure, but any decisions about prescribing the procedure must be made by a doctor.

How long does it take and how is rehabilitation after hysterectomy?

The duration of the rehabilitation period after a hysterectomy depends on the access used to perform the operation. Recovery after endoscopic and vaginal access is smoother: the next day after the operation, it is allowed to sit down and stand up, and after 3-6 days the woman is discharged from the hospital. Physical activity is limited for 2-3 weeks.

After laparotomy, the patient is usually discharged after 7-10 days, physical activity is limited for 3 months.

To make recovery faster, it is important for a woman to eat properly and include in her diet:

• foods rich in iron: veal, beef, sea fish, seafood, legumes, spinach, broccoli, pomegranates, apples. Iron-containing foods help prevent the development of anemia;
• foods containing fiber, which are necessary to prevent constipation. There is a lot of fiber in whole grain cereals, vegetables, and fruits.

It is better to exclude smoked, spicy, fatty foods in the first month after surgery. You cannot drink carbonated drinks or drink alcohol.

Also, after surgery, wearing compression garments is recommended, which helps to avoid thromboembolic complications.

External prostate massage

Many men do not decide to have a finger massage of the prostate due to psychological barriers and other reasons. The external method consists of easier steps.

The hands are placed above the pubis, gentle pressure is applied with the pads of the fingers, after which the fingers are moved directly with the skin. The movements are repeated in all directions. The massage is done within a minute. Then the fingers are raised a little higher and the pressure is repeated. Thus, the hands reach the navel and go back down.

All movements should be light and neat. The final stage is a lateral massage, after which you need to visit the toilet to remove the secretions accumulated in the urethra. Massage should not cause discomfort or pain. When they appear, the procedure stops.

Does a woman's hormonal levels change after surgery?

The ovaries are an important organ that produces female sex hormones. Therefore, many patients are concerned with the question: what happens to the female body after removal of the uterus and ovaries, what happens to hormones after removal of the uterus?

In fact, nothing terrible happens: immediately after the operation, the woman is prescribed hormone replacement therapy, which imitates the functioning of the ovaries. If hormonal therapy is chosen correctly, then the woman does not change either visually or physically.

If the operation is performed without removing the appendages, then the ovaries continue to produce hormones, and after 40-45 years the woman goes through all stages of menopause:

• premenopause;
• menopause;
• postmenopause.

During menopause, for certain indications, replacement therapy is necessary, which allows the woman to remain in excellent physical shape and relieves her of “hot flashes”. Hormone therapy must be prescribed on time, so women with preserved ovaries need to take a hormone test every six months so as not to miss the moment of a sharp decrease in estrogen levels.

After the age of 40, a woman must have her own trusted gynecologist who can tell her when to take hormone tests, what medications are suitable for replacement therapy, and whether herbal remedies can be used.

Progress of the procedure

Before starting prostate massage, the medical professional advises the patient about the progress of the procedure. This is necessary to eliminate misunderstandings on the part of the patient. You can proceed to the procedure only when all its details have been clarified.

The patient takes a position on his knees and elbows or standing with his torso bent at an angle of 90 degrees, it is also possible to lie on the couch on his right side (or left side if the doctor is left-handed) and press his legs to his stomach. A doctor wearing sterile gloves inserts a finger into the anus to a depth of about four centimeters. To ensure greater comfort, the specialist will use a water-based lubricant or petroleum jelly.

The massage begins on the right side of the prostate and then moves to the left. The specialist moves in the direction from the periphery to the center. First there are stroking movements, individual areas are massaged more thoroughly. There are several types of finger movements: in the form of a figure “8”, from the sides to the central groove and funnel-shaped. At the end of the massage, the urologist rubs the midline of the prostate gland with his finger, squeezing out its contents.

With a long-term inflammatory process, the ducts of the prostate gland can be clogged with viscous secretion and will not empty during the first massage. The outflow of secretions will be restored only after several massage sessions.

A prostate massage by a urologist may cause the patient slight discomfort and the urge to urinate, but there should be no pain during the procedure. Pain can only be a diagnostic sign.

At the end of the massage session, you must visit the toilet to remove the secretion, or collect the secretions in a sterile vessel for analysis. The doctor will perform each subsequent procedure more energetically. The force of pressure depends on the density of the gland: intense pressure is suitable for rough tissues, but for soft tissues the force should be reduced. The aggressiveness of the massage and its quantity are determined by the doctor depending on the situation.

The average duration of exposure is 1-2 minutes. Repeat the massage every other day, that is, two to three times a week. The course consists of fifteen procedures, and it can be repeated after a few weeks. It is worth understanding that one therapeutic session will not solve the problem, even if some of the symptoms disappeared after the massage, they may return after a few hours. It is necessary to complete the full course of treatment.

Prostate massage in the clinic is combined with general and local treatment. The patient is prescribed anti-inflammatory, restorative, antibacterial and other drugs, as well as physiotherapy, therapeutic enemas and more.

Hardware massage

In medical practice, there are also specialized devices that can replace finger massage. They are:

• mechanical to improve blood circulation;
• thermal to relax the prostate muscles;
• magnetic to prevent inflammation;
• vibration to stimulate blood and lymph flow;
• electrical stimulation to tone prostate tissue.

Experts do not recommend using this type of massage, as it is more traumatic and the process cannot be accurately controlled.