Can there be cancer after removal of the uterus? Uterine cancer after surgery

Removal of the uterus (hysterectomy) is the second most common surgical procedure for women. Often this method of treatment is the only one that is extremely necessary, although patients are afraid that a hysterectomy is fraught with all sorts of negative consequences. After it is carried out in the initial stages of the disease, abdominal pain, breakthrough bleeding and other characteristic symptoms disappear.

Operation

Her method depends on the health and age of the patient, the degree of spread of the malignant process. Spinal anesthesia (an anesthetic is injected into the spinal canal) or anesthesia with controlled breathing is used. The volume is planned at the stage of its preparation, but may change during its implementation after examination of the abdominal organs.

Types of hysterectomy:

subtotal - supravaginal amputation of the uterus with preservation of the cervix;
total - removal of the body, cervix.

In most cases, after surgery, a treatment method such as radiotherapy is prescribed to prevent relapses.

Rehabilitation period after surgery for uterine cancer

After abdominal surgery - the most difficult. It lasts about a week, on the 6-7th day the staples are removed from the scar. With the help of abdominal hysterectomy, it is possible to more accurately assess the degree of cancer, however, the recovery period in this case is more complicated. The patient returns to normal life after a few weeks. The general recovery period takes about 1-2 months.

Complications

Possible complications after surgery for uterine cancer: infection, heavy bleeding, blood clots. It is very important to get plenty of rest after a hysterectomy and only do basic activities. The recovery period is often accompanied by an increase in body temperature. Very rarely, during surgery, damage to the abdominal organs and abdominal structure occurs. The risk of prolapse (loss) of the vaginal vault increases due to a decrease in supporting structures.

After surgery, at the initial stage, the following usually occur:

pain resulting from the formation of postoperative adhesions or poor healing of the scar;
discharge - if the functioning of the ovaries is not impaired (if they are not also removed), irritation of the cervix occurs with sex hormones;
minor bleeding from the vagina can last up to a month; if it intensifies, you should immediately consult a doctor.

The main signs of an infectious complication are swelling, redness, and pain in the postoperative wound. In some cases, purulent discharge from the wound may be disturbing and patients are prescribed a course of antibiotics.

To improve blood circulation and prevent the development of blood clots, you should try to get out of bed and walk around the ward. Blood clots are likely to form in the lungs and lower extremities.
You should not lift heavy objects for at least 6 months after surgery.
A balanced diet with iron replacement will speed up scar healing.
To avoid constipation, you should temporarily limit your fluid intake.
It is very important to do the exercises recommended by your doctor.
You should immediately consult a doctor if you experience heavy bleeding, nausea, pain, or signs of infection.

Some patients believe that they should forget about sexual activity after a hysterectomy. However, they are deeply mistaken. First of all, you need to deal with depression. Decreased libido and vaginal dryness can occur after radical surgery (with removal of the ovaries and tubes), but this issue can also be resolved, since most patients take special hormonal medications.

Surgery to remove a cancerous uterus is often supplemented with radiation therapy. Ionizing rays do not harm healthy structures. Radiation therapy after removal of the uterus and appendages is considered a gentle way to destroy remaining atypical structures and metastases. The procedure can be supplemented with chemotherapy and is prescribed at any stage of tumor development.

Collapse

Why is it used and how is it done?

Radiation therapy is indicated in the following cases:

to remove abnormal structures at the initial stages of the oncological process;
for the comprehensive fight against uterine cancer;
after removal of the uterus to prevent relapse of the disease;
in advanced stages of uterine cancer, when surgery does not bring results.

Irradiation leads to disruption of the functioning of the ovaries, which causes premature cessation of menstruation. Therefore, radiation treatment of patients is carried out with caution. In some cases, the ovaries are moved from the irradiated area to another location before the intervention. This reduces the risk of injury during the procedure.

The operation is performed sequentially:

The patient lies down on a medical table, which has the ability to move in different directions. It is important that the woman remains motionless during the session. Otherwise, the rays will not reach the tumor and can damage healthy tissue.
Women who cannot stay in one position for a long time are secured with special belts.
After the last radiation therapy session, the patient undergoes additional diagnostic tests.
The doctor advises the patient about the features of the recovery period and gives recommendations for correcting nutrition and lifestyle.

During the procedure, women do not feel pain or discomfort

Types of radiation therapy

After surgery, ionizing radiation is prescribed for distant metastases and residual cancer cells. Surgery may also be indicated if there is a high risk of recurrence of the pathology after a hysterectomy. The intervention is performed remotely, intracavitary, contact.

In the first case, the radiation appears at a certain distance from the lesion. In the contact type of procedure, the device is attached to the patient’s skin. With the intracavitary method, atypical cells are removed by introducing a special device to the lesion.

Before radiation therapy, diagnostic measures are necessary. They allow you to accurately calculate the required radiation dose. The doctor informs the patient about the consequences of the intervention and prescribes medications to be taken during the rehabilitation period.

A balanced diet and following all the specialist’s recommendations will help you recover faster after surgery.

Preparation for the procedure

The specialist describes the treatment plan in detail, calculating the radiation dose for the full course of therapy and separately for each session. The doctor determines the duration of the course of treatment and the duration of one procedure. Before starting radiation therapy, the following preparatory procedures are performed:

At the hospital, the patient is offered disposable clothing. If a woman wants to stay in her clothes, then she should take care of some nuances:

things should not fit the body or restrict movement;
the jacket must have an open collar.

If necessary, the patient is fixed to the table using belts, mattresses and other fasteners. These measures are necessary in order to completely limit the patient’s movements during the intervention.
Healthy tissues and organs are covered with special protective blocks to protect them from radiation exposure.
Before the procedure, the doctor can take a control photo to assess the correct positioning of the woman relative to the medical device.

The first radiation therapy session will be the longest. The duration of each subsequent procedure is gradually reduced.

Patients should adhere to several basic rules before treatment:

do not dry your hair with a hairdryer;

hide irradiated areas under clothing when leaving home;

stop using cosmetics and sunscreen for a while;

minimize physical activity;

try to go outside after sunset;

consume enough fluid.

10 days before treatment, the patient needs to adjust her diet. At this time, pickled foods, carbonated and alcoholic drinks, spices, and spicy dishes are completely excluded. A week before radiation therapy, doctors recommend that a woman do breathing exercises and increase rest time.

List of other preparatory activities

Necessary measures for carrying out RT What is it done for?
The presence of spacious clothing made of cotton material with a minimum number of seams. The products will contribute to less trauma to the skin after the session. It is recommended to wear such items throughout the entire treatment period.
Purchasing herbal infusions that have an antiseptic and astringent effect (chamomile, oak bark, sage). Rinsing the mouth with this medicine helps minimize the negative effects of radiotherapy on the body.
Replacement oral care products. After radiotherapy, increased bleeding of the gums and mucous membranes of the mouth is observed. To reduce the risk of tissue damage, it is necessary to use brushes with soft bristles and pastes with a neutral chemical composition.
Consequences of radiation

Radiation therapy provokes a number of negative consequences. These include:

Intoxication of the body, manifested by weakness and nausea.

Abnormal stool in the form of chronic diarrhea.

Skin irritation in the irradiation area and the appearance of red rashes on it.

Increased dryness of the vaginal mucous membranes.

Forecast

After removal of the reproductive organ, a woman will forever have to forget about reproductive function. But surgery performed in conjunction with radiation therapy provides a high probability of complete recovery. The success of treatment largely depends on the stage of the detected disease. The best results from treatment are achieved in the early stages of the development of the pathological process. Complete healing from cancer is possible after 5-6 sessions of radiation therapy.

Radiotherapy equipment

It will be difficult to stop the spread of abnormal cells at stage 3 of cancer development using complex therapy, but at stage 4 it will be impossible. Radiation therapy in advanced cases is necessary to minimize pain and slow down the division of cancer cells.

After treatment, the woman is advised to undergo physiotherapeutic measures:

balneotherapy;

radio wave baths;

acupuncture.

If radiation therapy provokes health problems, then the woman is given a disability group. Sexual activity is allowed only 2 months after the intervention.

Oncologists say that radiation therapy does not affect the psychological state and sexual desire of a woman. Sexual activity after surgery is not contraindicated, but before starting sexual relations it is advisable to consult a gynecologist.

Radiation therapy after a hysterectomy is one way to reduce the risk of problems recurring. The procedure can be carried out remotely, intracavitary and contact. The intervention method and duration of therapy are determined by the doctor based on the characteristics of the oncology course.

Content

Uterine cancer is considered one of the most common tumors in older women. However, deteriorating environmental conditions, unhealthy eating habits, and an increase in the number of hormonal and inflammatory pathologies have led to a significant rejuvenation of the malignant process.

Uterine cancer is often detected in young patients. Uterine cancer is the development of a malignant tumor in its inner layer.

The uterus is an organ related to the female reproductive system. It is known that the uterus performs a reproductive function and is a certain symbol of the feminine principle. The uterus has a relatively small volume. The size of the organ depends on whether the woman gave birth or not.

The proximity of the bladder and rectum often causes the appearance of characteristic symptoms in pathologies of the uterine body. In the upper part of the uterus on the right and left, the tubes through which the egg enters the ovary are identified.

In the lower part, the uterine body passes into the cervix. It is noteworthy that the cervical part is a kind of barrier between the vagina and the uterine body. Thanks to the cervix, protection against infection, conception and childbirth are ensured.

The uterine body consists of several layers.

On the outside, the organ is covered with a serous membrane, which is the outer layer or parametrium.
The middle layer is represented by the muscular layer or myometrium, which allows the uterus to stretch and contract.
The inner layer or mucosa is the endometrium, which grows and then is shed during each cycle.

In fact, only the functional layer of the endometrium grows under the influence of sex hormones. This is a kind of preparation of the uterine cavity for conception and implantation of the fertilized egg. Otherwise, under the influence of other sex steroids, the functional layer is rejected and excreted in the form of menstruation. Restoration of the mucosa is ensured by the basal layer, which is static.

Uterine cancer appears as a result of excessive growth and malignancy of endometrial areas.

The prognosis of cancer depends on the stage of the oncological process, histological structure, and direction of growth.

Cancer types are distinguished depending on the degree of cellular differentiation:

highly differentiated;
moderately differentiated;
low differentiated.

The higher the cellular differentiation, the better the prognosis. Such tumors are non-aggressive, grow slowly and rarely metastasize. Moderately differentiated variants are most often identified.

Depending on the direction of tumor growth, they can be:

endophytic;
exophytic;
mixed.

Stages of uterine cancer:

Damage to the uterine body.
Spread of the oncological process to the cervix.
The growth of a neoplasm outside the organ.
Involvement of the bladder, intestines and other organs.

From the third stage, the formation of metastases is possible, which is the spread of malignant cells throughout the body and the formation of new tumors.

Causes and symptoms

Uterine cancer can be either hormone-dependent or autonomous. In the hormone-dependent variant, the endometrium grows due to excessive production of estrogen with low levels of progesterone.

Hyperestrogenism is observed in diabetes mellitus, hypertension, obesity, liver pathologies, taking HRT, and tumors. Clinically, hyperestrogenism is manifested by the following symptoms:

cycle disruption;
hyperplasia in the ovarian region;
infertility;
late menopause.

The autonomous variant of cancer is less common. As a rule, the disease is typical for older women with low body weight. According to observations, autonomous cancer has a less favorable prognosis.

Cancer development factors:

heredity;
obesity;
diabetes;
hypertension;
late onset of menopause;
absence of pregnancy and childbirth;
tumors in the ovaries;
use of Tamoxifen;
the effect of pelvic irradiation;
liver diseases.

Cancer of the uterine body in the early stages has no symptoms. As a rule, the first signs appear in the second or third stage. Manifestations of cancer include:

uterine bleeding;
increase in the amount of menstrual flow;
leucorrhoea;
purulent, bloody, watery discharge;
pain syndrome;
disorders associated with the functioning of the bladder, intestines and kidneys;
swelling;
deterioration in general health;
noticeable weight loss.

A warning sign can be called spotting in women after menopause in any quantity.

Diagnostics before removal

The examination is necessary to develop a treatment plan, which often includes removal of the uterus. Diagnostics include:

establishing a direct diagnosis;
determining the location of the tumor;
assessment of the severity of the disease, which is expressed by stage, presence of metastases and damage to lymph nodes and other organs;
determining the degree of cell differentiation of the formation;
study of the condition of the female body, including identification of concomitant diseases and contraindications to hysterectomy.

Diagnosis begins with an analysis of the patient’s complaints. The doctor also evaluates the woman's medical history and determines risk factors for developing uterine cancer.

Gynecological examination

Inspection on the chair is carried out using mirrors. A gynecological examination allows you to exclude diseases and pathological conditions of the cervix. This is due to the fact that many pathologies of the uterus and its cervix have a similar clinical picture.

Palpation is used to determine an enlarged, painful uterus, compactions or infiltrates in the pelvis. Using this method, you can also judge the size of the ovaries and fallopian tubes. However, the palpation method cannot help the doctor identify gynecological pathology, in particular uterine cancer, at an early stage.

Aspiration biopsy

Uterine cancer can be detected on an outpatient basis through aspiration biopsy. For patients of reproductive age, this study is carried out at the end of the menstrual cycle, and for women after menopause - on any day. Aspiration biopsy is a gentle, painless procedure.

During the manipulation, a catheter is inserted into the uterine cavity, through which the contents of the uterus are sucked into the Brown syringe. However, aspiration biopsy is not indicative in the early stages of the oncological process, while in later stages the reliability of the method exceeds 90%.

Ultrasound

This is a leading diagnostic method that allows you to detect uterine cancer in the early stages. Ultrasound can detect and determine:

localization of uterine tumor;
growth pattern, such as endophytic or exophytic;
the depth of germination of malignant cells into the myometrium;
involvement of the cervix and serosa;
coverage of the oncological process of the appendages.

However, ultrasound does not always detect a malignant process in the lymph nodes, which often occurs in the initial stages. This is why ultrasound is usually complemented by CT and MRI.

Hysteroscopy

During hysteroscopy with targeted biopsy, the doctor can examine the uterine cavity and take a tissue sample for subsequent histological examination. Gynecologists emphasize that hysteroscopy is absolutely reliable in detecting uterine cancer.

Fluorescence study

This is a method for early diagnosis of uterine cancer, which is carried out through the use of tumor-tropic photosensitizers, as well as their metabolites. The study allows you to detect a tumor less than 1 mm in size.

Scraping

The procedure is performed after hysteroscopy. Curettage of the uterine cavity allows you to diagnose epithelial pathologies, and therefore has a certain diagnostic value.

General examination

Before prescribing a hysterectomy or other surgical intervention, radiation or chemotherapy, the doctor must have an understanding of the general condition of the woman’s body and identify contraindications to treatments. In particular, if the doctor suspects the presence of distant metastases, they conduct an examination of the kidneys, intestines, lungs and other organs.

Surgery

It is known that the elimination of uterine cancer is carried out on an individual basis. The doctor takes into account the patient’s age, reproductive plans, and somatic pathologies. The choice of treatment tactics depends on the characteristics of the progression of uterine cancer and the general condition of the female body.

Indications for intervention

Surgical tactics are the main ones for early stage uterine cancer. However, in gynecological practice there are cases when surgical intervention may be contraindicated. Of the total number of patients, 13% have contraindications to the intervention.

The volume of operations and the method of their implementation for uterine cancer is determined by the following factors:

stage;
degree of tumor cell differentiation;
woman's age;
associated diseases.

It is noteworthy that organ-preserving operations for cervical cancer are possible. However, they are performed infrequently due to the advanced age of most women.

For stage zero uterine cancer in young patients, endometrial ablation is performed. This manipulation can also be recommended for women with stage 1 A, which implies a tumor in the endometrium. Ablation is recommended for older women if there are contraindications to radical surgery.

During ablation, the doctor removes the endometrium, including its growth layer and adjacent myometrium at a depth of up to 4 mm. Manipulation is carried out using laser, electrical or thermal effects.

After removal of the mucous membrane, it does not recover. As a result, women experience amenorrhea and the inability to conceive.

For young women with uterine cancer, removal by extirpation may be recommended. As part of this removal, the uterus and tubes are amputated. Preserved ovaries prevent the early onset of menopause.

Uterine amputation

Supravaginal removal, subtotal hysterectomy, is the removal of the uterus with immediate preservation of the cervix. The advantages of such removal include:

good tolerance;
preservation of ligamentous material;
reducing the risk of complications and disorders, including sexual ones.

Removal of the uterine body is performed in the early stages of cancer when there is no risk of the malignant process spreading to the cervix.

Extirpation

This is a total hysterectomy, which involves removing the uterus and cervix. At the first stage, the uterus, appendages and cervix are removed. In the second stage, there is a risk of involvement of lymphatic vessels. That is why removal is accompanied by lymphadenectomy followed by a biopsy.

Methods of performing a hysterectomy

Abdominal removal is performed when the doctor gains access to the organ by opening the peritoneal cavity in the lower abdomen. Removal is performed under anesthesia. This intervention allows for removal of varying volumes. However, the operation is quite traumatic and is accompanied by the formation of a large scar.

A vaginal hysterectomy means removal through the vaginal wall from behind. This removal is recommended for patients who have given birth if the tumor is small. Removal is well tolerated, however, the surgeon acts blindly when performing it.

Laparoscopic removal is performed using innovative equipment. Gas is injected into the abdominal cavity to provide access to the organ. A specialist inserts equipment and a video camera through small incisions. The accuracy and safety of actions is ensured by visualization of the entire removal. In fact, laparoscopy allows you to perform any amount of removal. Laparoscopic hysterectomy is considered the optimal method of removal, which has a low risk of consequences and is well tolerated by patients.

2011-03-07 23:33:08

Elena asks:

Hello, please help me with advice or information. 4 months ago my mother was diagnosed with gall bladder cancer with metastases, she underwent 2 courses of chemotherapy, a month ago she had surgery - the uterus was removed, a complex cholecestomy was removed, the spleen and omentum were removed. A new diagnosis was made - ovarian cancer. After the operation, 2 days later, perforation of the small intestine and peritonitis occurred, respectively, they cleaned it, but after 2 days everything happened again, they washed it again. A week passed - my mother began to recover, then there was another perforation - this time it was the large intestine, and they put in an ostomy. And after that, for a whole week, perforations occurred in practically different places; in total, she underwent about 10 rinses under anesthesia (some of them were already planned). 8 days passed without perforation and on Saturday again - large intestine and a day later leakage again. At the same time, blood tests show positive dynamics and the peritonitis resolved before the beginning of this week. What to do? How to fight?

2016-02-28 00:02:27

Inna asks:

Hello! I am 48 years old. Please tell me what to do? In 2014, I had surgery to remove the uterus and appendages. A diagnosis was made: stage 3 a uterine cancer. T3a NxMO. After the operation, I underwent 6 courses of red chemotherapy, and DHT to the pelvis 42 Gy, HPHT to SOD 30 Gy. After treatment I felt good. In January 2015 she underwent examination before re-examination. The results of an ultrasound of the abdominal cavity and pelvis are normal, CA125 readings are 13.5. But in early February, aching, nagging pain began in the lower abdomen, in the lower back,
and at the end of February there was slight bleeding. I don’t understand what happened, what should I do? surgery again?

Answers Gerevich Yuri Iosifovich:

Good afternoon. You need to immediately undergo an examination, examination by an oncologist, MRI or CT scan of the pelvis and abdominal cavity. What treatment will be prescribed will depend on the results of the examination - maybe if this is a false alarm, then if there is a problem only in the vagina, then a minor operation and HPHT, if the problem is more pronounced, then chemotherapy. I hope this is just bloody discharge from the operated vagina that is not related to the disease, this also happens often. You need to get tested immediately.

2015-06-22 13:21:32

Anna asks:

Tell me, after abdominal surgery (everything was cut out) stage 1 cervical cancer, is it necessary to undergo radiation? 3 months have already passed since the operation.

Answers Medical consultant of the website portal:

Hello Anna! The treatment regimen for cervical cancer depends on the histological type of the tumor, the stage/substage of the disease, the woman's age and a number of other factors. Everything is decided individually, by the attending physician, in a personal meeting with the patient. Therefore, we advise you to contact your doctor with your question. Take care of your health!

2015-05-03 08:47:13

Irina asks:

Hello, I am 35 years old, I have never given birth, I had one abortion, I have been observing myoma for almost 3 years, and over the past six months it has grown from 5 cm to 8 cm, I visited doctors, at first they said that everything should be completely removed, I decided with the gynecologist to drink Esmiya for three months Before the operation, in February, an abdominal operation was performed without opening the uterine cavity, a large node and five small nodes up to 1.5 cm were removed. According to the histology results, it corresponds to leimioma with areas of myxomatosis in the large node. At the oncology clinic they said that in such cases the uterus is completely removed, that despite the fact that it is all benign, it can develop like cancer and metastasize to different organs, and that if it grows again, then the uterus is completely removed. What is your opinion on this matter? A year ago, a small nodule without a capsule was found on the thyroid gland, thyroid hormones were normal, after the operation I did another ultrasound, everything was clear, I haven’t taken any hormones yet. Now I’ve been taking Genistril as prescribed for three months, and then what? How to find out the reason for the growth? Are there really no options? Why do doctors mostly choose watchful waiting? What examinations are necessary? I read on the Internet that they are doing an MRI of the sella turcica, that there could be a cyst on the pituitary gland? I also have elevated testosterone and hair is growing on my neck and décolleté, I am fighting with all available means, but the result is still very weak, now I have been doing electrolysis for almost two years, Is this procedure not a contraindication? The cosmetologist says that it only acts locally on the skin, but when they do it on the left side of my neck, my leg twitches slightly, probably some nerve endings are affected? Then my bowel movements just can’t get better, I have flatulence, and every three days I have to push for long periods of time. I took laxatives after the operation, but didn’t get carried away, maybe dysbiosis from antibiotics? Regarding physical activity, sports, what is possible and when is it possible? After two months, sometimes I began to forget myself and I could lift something heavy up to 5-8 kg several times, I was worried, I scolded myself, but more than two months had already passed? The lower back sometimes hurts parallel to the place where the large knot was and at the same time it hurts in front. What could it be? Maybe the stitches are just pulling... Is it possible to get a massage or go to a chiropractor? How soon can you plan a pregnancy?

Answers Wild Nadezhda Ivanovna:

Irina, you need not to go to doctors, but to be seen by one, preferably a local obstetrician-gynecologist. Observation and inspection on the Internet in this case should not happen, because you will not tell everything, and not everything can be asked. Myoma, fibromyoma - occurs when the body has reduced cancer immunity and the presence of mutated cells. This occurs in women who drink large amounts of coffee, tea, fast food, smoke,... In addition, the presence of excess hair requires examination by a gynecologist, an endocrinologist, who can be found in an endocrine dispensary or center. There you can also get tested for hormone levels. Problems with the intestines need to be resolved with a gastrologist or immunologist. Your back may ache as a result of osteochondrosis - be examined by a neurologist. Get examined, undergo treatment, prepare for pregnancy, and then get pregnant. It is advisable to become pregnant at least a year after removal of fibromatous nodes.

2014-11-05 20:42:47

Ksyu asks:

Hello. Tell me, is this a complete answer after a biopsy of uterine tissue: “both materials are represented by indometrium with signs of adenocarcinoma growth with areas of necrosis and fragments of a crushed endometrial polyp”?

No differentiation is specified or anything at all.

Please tell me if I need to re-inspect the glass? What is the diagnosis, how is the stage determined and the presence of metastasis?

The gynecologist said that the cervix was not damaged and that’s all. She said that surgery was needed, but chemotherapy was often not performed.

And the surgeon at the oncology center (without examining the patient, only looking at the conclusion of the laboratory technicians after the biopsy) says that surgery and chemotherapy are mandatory. It’s just that my grandmother is 72 years old and even an operation can be difficult to endure, but chemistry gives complications and weakens an already sick body. There are no varicose veins, but everything still hurts a little. I only treated pyelonephritis, there are problems with the intestines. The pressure is slightly increased.

I don’t see anything written on the Internet about chemotherapy for uterine cancer. They write about operations and radiation, supposedly it has a more effective effect on uterine tissue (but chemistry does not).

What can you suggest? What's the smartest thing to do? Is it right to have surgery? Will cancer begin to progress after this?

Is chemotherapy required after surgery at this age and how much chance does it give for a complete recovery? and if it doesn’t, then maybe it’s better not to do the operation, but simply suppress the development of cancer with radiation or medications?... and is it worth reviewing the glasses to get a more detailed description. I want to prolong my life as much as possible with minimal risks.

Please tell me everything you can.

2014-08-01 15:56:45

Elena asks:

Hello, doctor. I underwent an operation to remove the uterus of the ovaries. Before the operation, cancer was not detected by histology, but after the operation and repeated histology, stage 3 cancer was detected. Now I am undergoing chemotherapy and then radiation. But I am worried about where I can get a diagnosis in Ukraine after all this and make sure that I am cured

2014-07-19 02:40:44

Natalya asks:

Hello! I am 42 years old, two years ago I had an operation to remove the cervix and uterus. Diagnosis of stage 1 cervical cancer. I would like to tighten my stomach, the muscles have become flabby. I started doing gymnastics, some kind of lump appeared at the top of my abdomen, I thought it was a hernia, I went to the surgeon, he said that there was no muscle after the operation, the walls of the peritoneum were weak. And if doing gymnastics can be worse, a hernia can appear, it is not recommended to do it. He only told me to wear shapewear. What do you advise?

Answers Serpeninova Irina Viktorovna:

I don’t agree with your surgeon. It is necessary to do gymnastics, only physical exercise will tighten the muscles, but do it in shapewear.

2013-09-17 08:31:49

Anna asks:

Hello, I am 24 years old, I was diagnosed with grade 1 cervical dysplasia caused by the human papilloma virus of a high oncogenic type, I am now undergoing treatment with immunostimulators, antibiotics and antivirals before cauterizing the dysplasia. Do I need ILBI and when, if any, should I do the procedure? Now to enhance the effect of drugs or after cauterization? I heard about the possibility of eliminating HPV at a young age. Will ILBI help? And what is the probability of cancer? How long after surgery can you plan a pregnancy?

2013-06-09 17:21:04

Natalya asks:

I had my cervix and ovaries removed due to cancer. 1A. After that, I began to observe an increase in urination, day and night, at first I thought it was from the bandage, but it turned out that it was the same without it. What is this from...and what should I do? Go to the oncologist on June 14. the operation took place on May 21

Answers Kirsenko Oleg Vladimirovich:

Natalya, you need to contact a urologist, perhaps this is a banal inflammation after inserting a catheter, perhaps the anatomy of the internal organs has changed and you need to get used to it.

News on the topic: uterine cancer after surgery

IUDs - intrauterine contraceptives have long and firmly gained popularity among women around the world as a reliable means of preventing unwanted pregnancy. But Italian scientists came up with an additional function for them - therapeutic. There is a paradox: contraceptive “spirals”, capable of releasing a special hormone, help not only stop the development of uterine cancer in the early stages, but also subsequently give young women with an already established diagnosis the opportunity to experience the joy of motherhood. Then, after childbirth, a radical operation follows, completely relieving the woman of cancer.

This tragic incident occurred in one of the clinics in New York. An incredible chain of accidents led to the death of a patient who had successfully received a kidney transplant from a posthumous donor. Only a few days after the operation it became known that the donor woman had uterine cancer. But the patient with her kidney became so accustomed to the new organ that, despite the doctors’ warnings, he refused to part with the dangerous “gift”... Alas, a few months later he died of a malignant tumor.

Doctors from the United States are testing an experimental method of treating one of the forms of breast cancer using local treatment - applying a gel containing an antitumor drug. If successful, the method will help avoid severe side effects.

Removal of the uterus with fibroids occurs more often in late reproductive age, but is also possible in young women 25-35 years old. This creates a state of artificial early menopause, which occurs with symptoms reminiscent of physiological menopause.

Fibromyoma, leiomyoma, myoma are names of the same disease, which is a benign tumor of the muscle tissue of the uterus. It can grow closer to the internal cavity and form nodes on the leg, located in the thickness of the muscles or closer to the outer surface of the uterus.

Benignity means that the cellular structure of the tumor does not differ from healthy tissue and is not capable of spreading metastases to other organs. Removal of the uterus with fibroids leads to relief from the disease, but creates another pathological condition.

Indications for surgery

For young women who want to have children, they try to carry out organ-preserving operations - remove the myomatous node itself or get rid of it by ligating the supplying vessels. Sometimes hysterectomy cannot be avoided. There are clear indications for this:

Uterine size over 14-16 weeks of pregnancy often accompanied by compression of neighboring organs and a significant increase in the abdomen. Also in large nodes the blood supply is disrupted and necrosis develops. To avoid such consequences, fibroids are disposed of within the specified time frame.
Rapid tumor growth. This is considered to be an increase in the size of the node by 4 weeks of pregnancy per year. In this case, the development of sarcoma is suspected - a tumor with malignant growth.
Growth of fibroids in postmenopause. This is an unfavorable symptom, because During this period, hormonal stimulation by estrogen normally stops and the tumor should undergo reverse development.
Cervical node growth. This tumor is accompanied by severe pain, difficulty urinating and defecating.
Node power failure– an acute condition in which cells die and disintegrate. This is accompanied by acute pain and requires emergency intervention.
Changes in the functioning of neighboring organs– bladder and intestines when compressed by a tumor.
Frequent heavy bleeding during menstruation and between them lead to the development of severe anemia and exhaust the woman.
Ineffectiveness of hormonal treatment, which did not lead to a reduction in lesions.

Peculiarities

At a young age, in nulliparous patients who plan to have children, they try to preserve the organ and remove only the nodes. If such women have to have their uterus removed, the consequences of the operation are more difficult to bear than those who are approaching natural menopause.

The operation is easier to tolerate at a young age, when the number of concomitant diseases is minimal.

Methods

Surgery to remove the uterus is called a hysterectomy.

You can approach the organ abdominally - through the opened abdominal wall, or vaginally, without leaving any incisions on the abdomen. In the first option, two methods of operation are used.

Laparotomy. It is performed under general anesthesia. This method is used for large fibroids and suspected tumors of poor quality. This access is convenient for the operating doctor and allows you to examine the ovaries. The operation itself is more difficult to tolerate; intervention in the abdominal cavity often leads to the development of adhesions.
Laparoscopy- This is an intervention using a video camera - a laparoscope. Several punctures are made in the skin of the abdomen, through which guide tubes for instruments and a video camera are inserted. The method is suitable for small tumors. Recovery time after surgery is reduced, complications develop less frequently.
Vaginal access used for small tumors. The entire operation takes place through the vagina, but with this method the cervix is always removed. This method is used in women who have given birth.

If the cervix is not changed, then they try to preserve it; it participates in the formation of the ligamentous apparatus of the small pelvis. Removing the cervix leads to a narrowing of the vagina, which can affect the quality of sexual life.

After a hysterectomy, the ovaries continue to function as before. But the risk of developing tumors in them increases. Therefore, one ovary is removed to reduce risks, but the second is left for women who have not reached menopause.

This helps ensure the necessary hormonal levels. Over time, due to decreased blood flow in the pelvis, the remaining ovary regresses, as during natural menopause.

How abdominal surgery is performed is shown in this video:

Rehabilitation

The length of hospital stay depends on the type of surgery. If a laparotomy was performed, you can be discharged in good condition after 7-10 days of stay. After laparoscopy, it is possible to go home on the 3rd day after the intervention.

To avoid thrombosis, the legs are bandaged with elastic bandages or compression stockings are worn. They continue to be worn after surgery for a week to a month. Getting out of bed early helps restore normal blood flow in the extremities and helps intestinal function.

In the first few hours after coming out of anesthesia, it is important to urinate. This will indicate that the functioning of the kidneys and bladder is not impaired. Defecation is expected on the 3rd day; if there is no defecation, a laxative (castor oil, lactulose) is given.

Prevention of thrombosis is carried out with low doses of aspirin. It is often recommended to take it for a month after returning home. Women with concomitant heart pathology, atherosclerosis, and varicose veins may need to take aspirin for life.

After surgery you cannot:

lift weights;
2 months of exercise;
sunbathe in the sun and in a solarium;
go to the sauna, bathhouse, take hot baths.

Rehabilitation is carried out using physiotherapy methods:

electrotherapy;
laser therapy;
hyperbaric oxygen therapy;
acupuncture;
hydrotherapy.

Sex life

You can return to sexual activity no earlier than after 1-1.5 months. During this period, the internal sutures will completely heal, and the organs will return to their usual location. Technically, a woman can have sex and experience pleasure, but artificial menopause can lead to decreased libido and vaginal dryness due to a lack of estrogen.

This can be eliminated by using lubricants and hormonal therapy prescribed by a doctor.

Further treatment

Hysterectomy with ovarian preservation leads to the development of symptoms that resemble menopause. They can develop immediately after surgery or in the late period - from 1 month to a year.

Treatment is hormone replacement therapy (HRT). The doctor selects the most suitable drug. Self-medication in this case is unacceptable.

Monopreparations containing only estrogens. Their use is permitted only in case of hysterectomy. They are not suitable for treating natural menopause because they promote the development of tumors.

Gynodian depot can be used immediately after surgery. The drug is administered intramuscularly, which quickly achieves the required concentration of estrogen. The effect lasts up to 4-6 weeks.
Klimara patch can be used after the previous drug. Glue it once every 7 days, each time in a new place. It ensures the gradual entry of estrogens through the skin, which maintains their concentration in the blood.
Divigel– a preparation for local use. Apply 1 g of gel once a day to clean, dry skin of the abdomen, shoulders, lower back, and buttocks. The application location changes daily. Then wait for it to dry. The skin should not be wetted for an hour so as not to wash off the active substance.

Combination drugs contain estrogens and gestagens. Their use is acceptable after eliminating the severe symptoms of posthysterectomy syndrome.

Femoston contains two hormonal components, the dosages of which are selected to simulate the natural hormonal cycle. 1 tablet is taken once a day at the same time. There is no break between cycles.
Klimonorm also contains two hormones and valerian extract. The package contains 21 tablets, which are taken at one time. After finishing, take a 7-day break and resume taking it.
Trisequence Prescribe 1 tablet per day continuously.
Livial contains additional androgens. Prevents the production of gonadotropins, which stimulate the synthesis of sex hormones, reduces bone loss, and increases libido. Take the drug strictly one tablet at a time, moving according to the arrows.

Treatment is continued for 3-6 months until the symptoms of hysterectomy disappear. After this, the ovary begins to work. In severe forms of hysterectomy syndrome, long-term HRT is required, which is stopped one year before the age of natural onset of menopause. This age is approximately after 50 years, the period is set individually by the doctor.

Additionally, osteoporosis is prevented by taking calcium supplements. To treat anemia, iron is used - Totema, Sorbifer, Maltofer, Ferronal.

Life without an organ

In the first time after surgery, pain is possible, which is eliminated by taking analgesics. In the future, persistence of pain may indicate the development of adhesions. Psychological trauma after organ removal, especially at a young age, leads to the development of neuroses, which is aggravated by hormonal imbalance. In such cases, the help of a psychotherapist is sometimes required.

If a woman did not plan to have more children, then a hysterectomy makes it possible not to worry about contraception. Sex life does not suffer.

But metabolic, neurovegetative and emotional disorders develop regardless of a woman’s desire.

How does this happen

Removal of the uterus entails a decrease in blood supply to the ovaries and their ischemia. Restoration of blood flow to an adequate level occurs within a year. Until this happens, atrophy develops, ovulation does not occur, and hormone production decreases.

Estrogen receptors are located in the vaginal mucosa, skin, bones, intestines and adipose tissue. Therefore, they are the ones who suffer from the lack of:

the skin becomes dry and flabby, wrinkles appear;
vaginal dryness;
osteoporosis develops in the bones;
the intestines are subject to the development of constipation;
the mass of adipose tissue increases.

Through a feedback mechanism, gonadotropic hormones continue to intensely stimulate the ovaries, but they are unable to produce the required amount of estrogen. At the same time, the production of neurotransmitters, which affect the function of blood vessels, the respiratory system, and the psycho-emotional background, decreases.

Mood instability and tearfulness appear. Vascular reactions manifest themselves in the form of hot flashes, redness of the facial skin, sweating, and chills. Sometimes I suffer from shortness of breath and palpitations.

Health problems

Arterial hypertension develops under the influence of a decrease in dopamine in the hypothalamus and impaired vascular reactions. For treatment, antihypertensive drugs are taken for life, which are selected individually. It is also important to follow a diet.
Hyperthermia occurs after spasm of blood vessels in the hypothalamic structures. Prevention - contrast shower.
Obesity develops due to a lack of estrogen. Treatment is HRT, a low-calorie diet and physical activity.
Neuropsychiatric disorders, depression, decreased mood as a consequence of impaired blood supply to the hypothalamic structures and the production of dopamine. It is corrected by psychotherapy methods, taking motherwort tincture, valerian extract, and in severe cases, antidepressants.

The solution to health problems depends on hormonal levels. Replacing the lack of your own estrogens eliminates most pathological disorders.

On the first day after surgery, follow a light diet so as not to burden the intestines. Cereal soups, liquid porridges, and omelettes are preferred. Give jelly, tea or compote to drink. For 2-3 days you can steamed lean meat and fish, vegetables. They eat small meals every 2-3 hours.

From 5-6 days they switch to a dietary diet that excludes hard-to-digest foods, smoked foods, and spicy foods. For bowel function, it is important to consume at least 1.5 liters of fluid.

Approximately 2 weeks after surgery, you return to your normal diet. But hormonal changes after removal of the uterus contribute to excess weight gain. Therefore, you need to carefully monitor the calorie content of your food and not overeat.

Products to be consumed:

vegetables and fruits;
lean meats and fish;
dairy products;
cereals;
wholemeal bread;
vegetable oil;
to loosen stools - beets and prunes;

Limit or completely eliminate:

salt;
sugar;
baked goods, flour products;
smoked, spicy;
sweet drinks.

Necessary measures for carrying out RT	What is it done for?
The presence of spacious clothing made of cotton material with a minimum number of seams.	The products will contribute to less trauma to the skin after the session. It is recommended to wear such items throughout the entire treatment period.
Purchasing herbal infusions that have an antiseptic and astringent effect (chamomile, oak bark, sage).	Rinsing the mouth with this medicine helps minimize the negative effects of radiotherapy on the body.
Replacement oral care products.	After radiotherapy, increased bleeding of the gums and mucous membranes of the mouth is observed. To reduce the risk of tissue damage, it is necessary to use brushes with soft bristles and pastes with a neutral chemical composition.