What is Uterine Removal Surgery (Hysterectomy)?

The uterus; It is an inverted pear-shaped female reproductive system organ, which has a cavity lined with a small amount of tissue that is renewed every month, and is located in the pelvic region in females. It is where the fetus develops and grows. It is also known as the uterus.

What is a hysterectomy?

Hysterectomy is surgery to remove the uterus. Hysterectomy surgery is the second most common surgery for women of reproductive age. After the removal of the uterus, the patient cannot become pregnant and does not menstruate. The type of surgery to be performed is determined according to which part or parts of the uterus will be removed, why the surgery is performed, and whether other reproductive organs will be removed. There are 4 types of hysterectomy:

• Total Hysterectomy: It is the most common type of hysterectomy. The entire uterus and cervix are removed. The ovaries (ovaries) are not removed.
• Subtotal (Supracervical) Hysterectomy: In this type of hysterectomy, the uterus is removed, the cervix is ​​not removed.
• Radical Hysterectomy: It is the type of hysterectomy that is mostly preferred in some cancer cases. The uterus, the cervix, the upper part of the vagina, the tissues around the cervix in the pelvic region and, if necessary, the pelvic lymph nodes are removed. If the patient is not in reproductive age, it is the preferred type of hysterectomy.

Uterine removal surgery can be performed open or closed (laparoscopically). The incisions made in closed surgery are much smaller than in open surgery. It is preferred because it is more advantageous than aesthetic surgery, but some situations are restrictive for closed surgery. Open surgery can be done in two ways. The uterus can be removed through an incision made in the abdomen, or it can be removed from the vagina. When the vaginal route is preferred, no incision is made in the abdomen. In cases such as cancer, chocolate cyst, it is preferable to remove the uterus with an incision made from the abdomen, and today, due to the development of laparoscopic methods, an operation can be performed as a door. In case of uterine prolapse, it may be preferred to remove the uterus by removing it from the vagina and adding procedures to prevent sagging of other abdominal organs if necessary. There are many diseases and conditions that add to it. These can be listed as follows:

• Chronic pelvic pain
• Uncontrolled vaginal bleeding
• Uterine cancer
• Cervical cancer (Cervical cancer)
• Ovarian cancer (Ovarian cancer)
• Fibroids (Fibroids are benign tumors that form in the uterus.)
• Pelvic inflammatory disease (A serious infection of the reproductive organs.)
• Uterine prolapse (Uterine prolapse)
• Chocolate cyst (Endometriosis)
• Uterine thickening

The most common causes of uterine removal; fibroid tumors, chocolate cyst (endometriosis) and uterine prolapse.

How Many Hours Does Uterine Removal Surgery Take?

Uterine removal surgery takes approximately 1 to 3 hours. This period may vary depending on the size of the uterus, whether the patient has had surgery before and whether other reproductive organs will be removed along with the uterus. discharge and bleeding and pain at the surgical incision site are uncomfortable feelings. Vaginal discharge and bleeding are not as much as bleeding during menstrual periods. It may take up to 6 weeks for improvement. If the discharge or bleeding is excessive, accompanied by a strong foul odor and blood clots, a doctor should be consulted. (decreased sexual desire), difficulty sleeping (insomnia), anxiety and sweating. “Hormone Replacement Therapy (HRT)” can be given if menopause-like symptoms make daily life difficult. Hormone Replacement Therapy begins to show its effect after a week. In order to reduce these complaints in patients who do not want to use HRT, it should be noted that low-fat herbal diet and consumption of soybean (and its products) may reduce complaints. Exercise after the recovery period is also very useful in controlling menopausal complaints. Changes in the patient's bowel habits after the operation there may be changes. Some women may experience urinary tract infection or constipation after surgery. Both conditions are easily treatable. After the operation, the patient may leak urine. Women who have had a hysterectomy face a 60% increased risk of urinary incontinence during their lifetime compared to women who have not had surgery. This cannot always be prevented, however, pre-operative examination detects existing leaks that can be treated with surgery, and if necessary procedures are added during hysterectomy, this rate can be reduced a little more. It is repaired during surgery. In most cases, it does not cause a long-term problem.

How Long Does the Pain Last After Uterine Surgery?

This period may vary depending on the age of the person and the operation performed, but in general, after hysterectomy 3 Simple aches and discomforts up to a month are considered normal. After the operation, the patient is given painkillers. If the patient's pain lasts longer than 3 months and has severe pain, he should consult a doctor.

Nutrition after Uterine Surgery

Bladder and bowel habits may change after uterus surgery. It is recommended that the patient consume plenty of water and fibrous food. The risk of encountering problems such as constipation has increased in the post-operative period. If the person includes fibrous foods in his diet, he will reduce the possibility of experiencing constipation.

What Happens After Uterus Removal?

The duration of hospital stay after surgery varies according to the type of surgery performed. If the uterus is removed with an incision made in the abdomen (abdominal hysterectomy), the patient stays in the hospital longer. It is normal to have pain and feel tired after the hysterectomy operation. It is aimed to reduce the patient's pain by giving painkillers.

It is recommended that the patient take small walks the day after the surgery. Thus, the blood flow returns to normal and the patient is protected against complications such as clots in the legs (deep vein thrombosis). If there is burning, severe pain, redness or discharge at the incision site, the patient should definitely consult a doctor. It is not recommended to have sexual intercourse until it stops. This can take about 4 to 6 weeks. If the ovaries are removed together with the uterus, the patient may have vaginal dryness. Due to vaginal dryness, water-based lubricants can be used or hormone replacement therapy can be given to the patient. A decrease in sexual desire can be seen immediately after the operation. Loss of libido will disappear with recovery. Apart from that, the patient's sexual life will not be affected by the surgery after full recovery.

Is There Any Swelling in the Abdomen After Uterine Surgery?

Swelling and gas in the patient after hysterectomy surgery is normal. It may take several weeks for the bloating in the abdomen to go away. Some exercises may be recommended to reduce swelling. By applying warm compressions and paying attention to nutrition, swelling can be reduced. Disruption of the intestinal flora due to the antibiotics used during the surgery can also increase this swelling, and a high-fiber diet accelerates the recovery in this area as well.

Is Weight Gained After Uterine Surgery?

Studies have shown that women have an increased risk of weight gain after hysterectomy. However, there are many factors that affect this and it is not valid for every woman. It has been shown that women who are overweight before the surgery, women whose ovaries are removed along with the uterus, women who have a longer recovery period and who are not active during this period are more likely to gain weight.

What to Consider After Uterine Removal Should?

There are some situations that the patient should pay attention to after uterine removal surgery:

• The patient may have vaginal discharge up to 6 weeks. It is recommended to use only sanitary pads for vaginal discharge.
• Nothing should be inserted into the vagina and attention should be paid to genital hygiene.
• Heavy items should not be lifted for at least 4 to 6 weeks. It is especially recommended not to lift objects heavier than 5 kg.
• Have sexual intercourse up to 6 weeks. It is recommended not to take a bath.
• A bath is possible. The scar should be washed with soap and water. Stitches will dissolve on their own within 6 weeks. Therefore, the patient should not open the sutures.
• The patient can return to his exercise routine within 4-6 weeks. Exercise is recommended for recovery. However, the exercises should not be compelling.
• If the uterus is removed through an incision made in the abdomen and narcotic painkillers are not taken, the patient can drive within 2 weeks. If the uterus was removed from the vagina or closed surgery was performed, the patient can drive within a few days.

The post-operative period is as important as the uterus removal surgery. The patient should take due care. Follow the recommendations after hysterectomy, do not forget to go to the doctor's controls when necessary, do not neglect your health!

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