Why do you need to remove the uterus and how it threatens

Why can the uterus be removed?

The operation - called hysterectomy - is done only when indicated. Removal of the uterus may be necessary in the following cases Hysterectomy / U. S. National Library of Medicine:

With a large myoma. When benign nodes grow in the thickness of the uterus, they stretch and deform it. In fact, it turns into a solid fibroid. In addition, hormonal changes appear, due to which heavy bleeding occurs during or between periods.
With severe endometriosis, which is accompanied by massive bleeding and chronic pelvic pain. Surgery is prescribed if medications or other surgical methods do not help.
With prolapse of the uterus. This often leads to urinary incontinence, fecal incontinence, pelvic pain, and a foreign body sensation in the vagina. Some women find it painful to walk and sit. It is pointless to return the uterus to its place on its own or with the help of a doctor - it will fall out again while walking or when a woman goes to the toilet, sneezes, picks up something heavy. Reduction not only does not solve the problem, but also increases the risk of infection and inflammation. In some cases, bedsores appear on the organ.
With cancer of the uterus or its cervix, as well as with malignant tumors of the ovaries, as due to the general lymphatic network in the uterus there can be metastases.
With massive uterine bleeding that cannot be stopped. It can occur due to complications of fibroids, endometriosis, or during childbirth.
For chronic pelvic pain, if all else fails. This gynecological symptom usually occurs due to complications of endometriosis, varicose veins of the small pelvis or adhesions.

What complications can the removal of the uterus lead to?

The consequences of a hysterectomy, like any other operation, can be quite severe. Some of them occur during or shortly after surgery, while others much later. Doctors point out the following possible complications of Hysterectomy / NHS:

Allergy to anesthesia. It is extremely rare, since anesthesiologists always ask patients if they have drug intolerance.
Nerve damage. Can occur during anesthesia that is injected into the spinal cord.
Bleeding. The risk exists as with any other operation.
Injury to the ureter. The fact is that it is very thin and is located next to the internal genital organs, therefore, occasionally, when the uterus is removed, it is injured.
Damage to the bladder. It is located in front of the uterus and can be accidentally injured. This leads to bleeding and urinary incontinence. Therefore, the wound is sutured, and a catheter is temporarily inserted into the bladder.
Bowel damage. During the operation, there is a risk of injury to the organ located behind the uterus. As a result, bleeding will occur. The damage will be sutured, and in some cases, a colostomy will be made - a temporary hole in the side for collecting feces in a special bag.
Infectious diseases. In some cases, after surgery, pathogenic bacteria begin to multiply in the wound or urinary tract. This is usually treated with antibiotics.
Thrombosis. During surgery, the body increases blood clotting to stop bleeding. Therefore, after the end of the surgical intervention, blood clots can form in the veins of the legs or other places, which can break off and clog a vital artery.
Pelvic organ prolapse. It develops in some women. Due to the lack of supporting ligaments, the bladder, rectum and sigmoid colon sag along with the walls of the vagina. This leads to incontinence of urine, feces, problems in sex life.
Insufficiency of the ovaries. Many people experience this problem after about 5 years, if only the uterus is removed. Pathology is associated with the fact that part of the blood was received by the appendages from the uterine arteries. After they are removed, the nutrition of the ovaries deteriorates and they produce less hormones. Therefore, there are signs of menopause.
Early menopause. If a woman's uterus is removed along with the appendages, the body abruptly stops synthesizing estrogens. As a result, hot flashes, sweating and vaginal dryness appear quite soon, and later there is osteoporosis Primary Ovarian Insufficiency Linked to Osteoporosis / Medscape.

How to prepare for the removal of the uterus

Sometimes, for example, with massive bleeding, the operation is done urgently, without serious preparation. This is necessary to save a woman's life. In other cases, surgery is carefully planned to reduce the risk of complications during and after surgery. To do this, do the following Abdominal hysterectomy / Mayo Clinic:

Survey is carried out. They take blood and urine for a general analysis and biochemical study, do an ultrasound of the pelvis and an ECG. A cytological smear from the cervix is also needed, and in some cases, an endometrial biopsy.
Reconsider the regimen of taking medications if a woman drinks them. Sometimes the doctor advises you to change the dosage of the drugs a few days before the removal of the uterus.
Anesthesia is selected. For a hysterectomy, anesthesia is needed so that the woman does not feel anything. But each drug has its own contraindications, which the doctor takes into account.
They are planning to stay in the hospital. After the operation, you will need several days of observation by the medical staff.

How is the uterus removed?

In some women, the body of the uterus is removed, but the cervix is retained. In others, the entire uterus is excised. And still others are deprived of even fallopian tubes with ovaries. Sometimes they act quite radically and remove the surrounding tissues, lymph nodes and the upper part of the vagina. The gynecologist chooses the type of surgery depending on the diagnosis and the individual characteristics of the woman.

There are two main ways to remove the uterus.

Through the vagina

This is the least traumatic method, as Vaginal hysterectomy / Mayo Clinic incisions on the abdomen will not be made. Therefore, they are discharged from the hospital faster. This method of hysterectomy can be used in all cases, except for cancer.

All manipulations are performed with surgical instruments inserted through the vagina. Sometimes, in addition, small punctures are made on the abdomen, into which tubes with a video camera are inserted in order to better see the pelvic organs.

Through the belly

Abdominal hysterectomy / Mayo Clinic is the choice for abdominal hysterectomy if the woman has a very large uterus with fibroids that is difficult to remove through the vagina, if the doctor wants to check the rest of the pelvic organs for signs of cancer and other problems, or if the surgeon thinks this is more appropriate.

Option two: abdominal surgery and laparoscopy.

In the first case, to remove the uterus, the doctor makes a vertical or horizontal incision in the abdomen below the navel. Moreover, the vertical one is chosen for cancerous tumors, myoma or endometriosis, in order to provide the surgeon with better access to the internal organs. Next, a hysterectomy is performed, the abdomen is washed with a sterile solution and sutured. Sometimes tubes are left in the wound, through which inflammatory fluid flows out within 1-2 days.

In the second case, gynecologists perform the operation using a laparoscope. To do this, several punctures are made in the abdomen, into which a tube with a video camera and a surgical instrument is inserted.

How is recovery after removal of the uterus

To prevent the wound from hurting too much, the woman is given powerful pain relievers after surgery with Hysterectomy / NHS. In addition, droppers with medications are made to restore the volume of circulating blood and prevent complications. Antibiotics are also administered to prevent infectious complications. And in the bladder there is a catheter for some time, which helps to remove urine.

If the uterus was removed through the vagina, a gauze pad is inserted into the vagina for 24 hours to help reduce the risk of bleeding.

You will be asked to get out of bed the next day after the operation. It will be painful and difficult, but it will help reduce the chances of blood clots forming.

If the uterus is removed vaginally or by laparoscopy, it is discharged from the hospital after 1–4 days. After surgery through an incision in the abdomen, it will take 5 days of hospitalization. And the sutures from the wounds in both cases are removed on the 5-7th day.

Then, after 4-6 weeks, the woman should visit her doctor to check the condition. It will take up to 8 weeks to fully recover. To work, if it is not associated with manual labor and weight lifting, you can return after 4 weeks: sick leave is usually given just for such a period.

Until the wounds heal, you will need to come to terms with Hysterectomy / NHS restrictions:

Do not drive for 3–8 weeks. Some pain relievers can alter reflexes and reaction rates, and driving can be uncomfortable because braking uses your abdominal muscles.
Do not lift heavy objects or swim. You can walk, do light physical exercises recommended by your doctor.
Don't have sex for 4-6 weeks. It is necessary to wait until the wounds are completely healed and the discharge in the form of an ichor from the vagina stops. Even after that, do not forget about contraception, because you cannot get pregnant, but you can get infected with sexually transmitted infections.