Take good care of yourself!
Many women tremble when they learn that they may have their uterus removed due to illness.
Cut or not? How much to cut? How much risk does cutting have? Will there be a bad effect after cutting?
Today's article takes you through the things that are done with hysterectomy.
The uterus is the organ that gives birth to embryos, fetuses, and menstruation. It is suspended in the center of the pelvic cavity under the support of ligaments, muscles and fascia, with the bladder in front, the posterior rectum, the vagina in the lower part, and the fallopian tubes and ovaries on the left and right.
The uterus itself can be divided into two parts: the uterine body and the cervix.
Why do I have my uterus removed?
The importance of the womb to women need not be said, then it is doing a lot of sinful things to make women give up on it?
Hysterectomy may be performed when the following conditions occur:
Obstetric diseases
Those who have scar pregnancy, placental abruption, placenta previa, most of the placenta implantation, amniotic fluid embolism, postpartum haemorrhage, etc., and who cannot control bleeding after active treatment; uterine rupture, uterine varus, toxic infectious uterus.
Tumors of the genital organs
Severe treatment of uterine fibroid symptoms is ineffective or growing too fast suspect malignant, cervical cancer and cervical lesions, endometrial cancer, uterine sarcoma, ovarian cancer, fallopian tube cancer and other benign tumors and malignant tumors that cannot control the symptoms.
Uterine bleeding
Ineffective treatment for dysfunctional uterine bleeding, perimenopause or abnormal proliferative bleeding of the uterine lining after menopause.
Endometriosis
Those who do not require fertility or are older, have severe symptoms, and are ineffective with multiple treatments.
Adenomyosis
Those who have severe symptoms and are unable to live and work normally, who are ineffective in drug treatment, who are older, and who have no fertility requirements.
How many "parts" is to be discarded to remove the uterus?
According to the requirements of the scope of resection of different diseases, hysterectomy can be divided into total hysterectomy, sub-total hysterectomy, extensive hysterectomy, radical hysterectomy and so on.
Benign lesions are multi-resection of the uterine body and cervix, and unilateral or bilateral fallopian tubes and ovaries are removed as appropriate.
Malignant tumors are mostly removed on this basis on a larger scale, such as removing more ligaments, vaginas, and dissecting lymph nodes.
Can't keep the cervix?
For malignant lesions of the uterus/ovaries, the cervix is generally not retained, and cervical hypertrophy, severe erosions, and old lacerations are also removed.
If it is a benign lesion, there are also certain considerations whether to remove the cervix, and it is necessary to explain its advantages and disadvantages to the patient and discuss the decision.
If the cervix is retained, there is still a risk of stump cancer in the future, and when the operation is performed again, the adhesions caused by the previous operation will also bring certain difficulties and risks to this operation.
There are also studies that suggest that cervical preservation maintains pelvic floor integrity and normal dissection.
For women under 40 years of age, healthy cervical and physiological functions are retained, secretions can lubricate the vagina, facilitate sexual life, and may be involved in regulating ovarian function, but retainers should have regular physical examinations.
Can't keep the fallopian tubes?
The role of the fallopian tube is to transport eggs and provide a place for fertilization, and when there is no fertility requirement, it is a veritable "waste wood".
Studies have shown that after the removal of the uterus, the fallopian tubes are prone to complications such as hydropsine adhesions, and secondly, some ovarian cancer originates from the fallopian tubes, and retaining the fallopian tubes is likely to leave a time bomb.
Therefore, when the uterus is generally removed, the fallopian tubes will not be spared.
Can't keep the ovaries?
Ovarian preservation is generally benign uterine lesions, such as uterine fibroids, adenomyosis, etc.; early cervical cancer, young patients can also retain ovaries.
In patients with malignant lesions, it is more than one-time resection to prevent the residue of the lesion.
Of course, preserving the ovaries still avoids the risk of continued cancer in the future, but if retained, it can also provide hormone supplementation for young patients, with both pros and cons.
How much risk do I have to take to remove the uterus?
The surgery is no size, and hysterectomy can be performed through transarceloscopy, transvaginal, transabdominal, etc., all of which have corresponding risks.
As mentioned earlier, the uterus is located in the center of the pelvis, adjacent to the bladder and rectum; during intraoperative treatment, the separation of the ureter, large and small arteries and veins are at risk of damage to these tissue structures around the uterus.
Infection of the surgical site and infection of the vaginal stumps may still occur after surgery. Patients should be fully informed before surgery.
Removal of the uterus, but also removal of "sexual bliss"?
When I think of surgery in the genital organs, the first thing that comes to mind is what to do with my own sexual well-being, not only to ask several questions!
Vagina is short, affecting sexual life?
For benign diseases, hysterectomy will retain the basically complete vagina, the length after suture does not change much, it will not affect the progress of sexual life in the slightest, and men, you are not so long, aren't you!
For malignant tumors, the vagina will be removed from 1/2 to 3/4 to varying degrees, and the length of the vagina will be significantly shortened, but the incidence of these malignant tumors in young women is not as high as that of middle-aged and elderly women.
A puncture in the vagina, may be punctured?
After hysterectomy, vaginal sutures form a blind end.
First of all, you have to believe that the doctor's suture technique is excellent and will not give you a bad pocket.
Secondly, good anti-infection and recovery after surgery will speed up the healing of the wound.
Finally, sexual life is prohibited for 3 months after surgery. Wait until the vagina is fully grown and it's not too late to have sex, but don't try the overly intense way, you know.
No orgasm in the removal of the uterus and vagina?
The stimulation of orgasm comes from the vagina and clitoris, and the arousal of sexual desire originates from the sex hormones secreted by the ovaries, as long as the ovaries are retained, they are completely unaffected.
This doesn't seem to have anything to do with the womb.
Do you have sequelae after removing the uterus?
After all, the uterus is one of the major organs of the human body, and it is not something that can be cut off casually.
Affects ovarian function
The blood supply to the ovaries originates in part from the uterus, which may affect the blood supply to the ovaries after hysterectomy, and although ovarian failure does not occur immediately after surgery, the long-term risk of failure or premature menopause increases.
If one side of the ovaries is removed during surgery, the contralateral side still has a certain secretory function, and symptoms such as perimenopause will not appear immediately.
If both ovaries are removed together, there is no need to worry too much, and you can relieve your symptoms with exogenous supplementation.
Increased risk of associated diseases
The uterus plays an important role in the support of the pelvic cavity, and the support relationship between the pelvic organs after hysterectomy is destroyed, which may lead to vaginal prolapse, urinary incontinence and other conditions.
In addition, the removal of the uterus also has a certain test for women's psychology, and it is necessary to actively communicate and recover in the company of family.
Inability to have children
Of course, the uterus is the birthplace of life, and of course there is no way to conceive life after excision.
However, some women who retain their ovaries can still get their own babies through uterine transplantation, but at a huge cost.
Every woman experiences menstruation, pregnancy, perimenopausal and other physiological phenomena in her lifetime that men cannot experience.
When they face diseases also have more burdens, hysterectomy is also a great physical and mental damage for them, and companionship is the longest confession.
bibliography:
LIU Xinmin. Obstetrics and Gynecology Surgery. 3rd Edition. People's Medical Publishing House.2017.134-139
Xie Xing,Kong Beihua,Duan Tao. Obstetrics and Gynecology. 9th Edition. People's Medical Publishing House.2018.
This article was first published: Medical Sciences Obstetrics and Gynecology Channel
Author: Pudding
Editor-in-charge: Liu Fengling