According to medical statistics, ovarian cyst is one of the most common gynecological diseases among women of reproductive age. The pathology is treated by medical and surgical means. The choice of treatment method depends on the type of cyst, its size, and concomitant diseases. In the presence of indications, the operation is carried out mainly laparoscopic access. This solution allows you to radically get rid of the problem and minimize the risk of possible complications.
Recovery after removal of an ovarian cyst lasts 2-4 weeks and depends largely on the selected access and the amount of surgery. Other factors affect the course of the rehabilitation period: somatic and gynecological diseases, age of the woman. It is important to know how the postoperative period is normal, in order to notice the pathology in time and to avoid the development of complications.
Rehabilitation after laparoscopic and abdominal surgery: is there any difference?
Ovarian cyst removal is performed in one of two ways:
- Laparoscopic surgery is performed through small incisions in the anterior wall of the abdomen. All manipulations are carried out with a special endoscopic instrument. The surgeon sees his actions on a monitor located in the operating room. Information on the monitor comes from the sensor attached to the endoscope;
- Laparotomy involves incision of the skin and underlying tissues. During abdominal surgery, the doctor visually examines the wound and performs all the manipulations with familiar instruments.
Types of surgical treatment of ovarian cysts.
The difference between abdominal and laparoscopic surgery is not only external aesthetics. Much more importance is attached to the state of the internal organs after the intervention. The recovery period largely depends on how the operation went. The chosen access also affects the reproductive health of the woman, and thus determines the possibility of motherhood in the future.
Features abdominal surgery:
- After cutting and suturing the tissue, the woman remains immobilized for some time. She can not get out of bed on the first day due to the pronounced pain syndrome and the risk of seam divergence. Forced immobilization increases the risk of thromboembolic complications, increases the likelihood of exacerbation of chronic pathology of the heart, lungs, kidneys and other organs;
- With an open surgery, the doctor does not just make a large incision, but also stretches the tissues in different directions in order to gain access to the pelvic organs. This is an additional injury that increases pain and extends the time of rehabilitation;
- During laparotomy, the internal organs come into contact with the hands of the surgeon and the instrument. The uterus, appendages and peritoneum quickly dry out when exposed to air. All this provokes the formation of adhesions, which in the future can lead to infertility.
It is estimated that 95% of abdominal operations lead to the development of adhesions. Its expression will be different and is determined by the individual reaction of the female body.
One of the negative consequences of laparotomic surgery may be adhesions.
Features of laparoscopic surgery:
- Minimal tissue damage. The doctor does not make a large incision and does not stretch the muscles to access the ovary. All manipulations are carried out with a special tool with virtually no damage to healthy organs;
- There is no risk of drying fabrics, contact with the hands of the surgeon and surgical material. Reduced risk of adhesions;
- After laparoscopy, the patient can get out of bed and walk around the ward after 6 hours. Early activation of the patient is the best prevention of thromboembolic complications and other disorders of the internal organs.
Recovery time after abdominal and endoscopic surgery will be different. Rehabilitation after laparoscopy takes an average of 2-3 weeks. Recovery from classic open surgery lasts 5-6 weeks.
On the timing of rehabilitation is largely influenced by the behavior of women after surgery. You need to follow all the recommendations of the doctor and know how to behave after surgical treatment in order to quickly return to active life.
Stages of recovery after surgery on the uterine appendages
In surgery, it is customary to distinguish several stages of rehabilitation:
Early postoperative period
Duration – 3-5 days.
In the first hours after removal of the ovarian cyst, the woman is in the postoperative ward. At this time, she usually sleeps and recovers after anesthesia. You may experience mild dizziness, headache. There is chills and a slight increase in body temperature (up to 37.5 degrees) – the body’s natural reaction to the stress experienced.
After removal of the cyst, the woman is in the postoperative ward, where she gradually moves away from anesthesia and stress.
After the operation, according to reviews, many women complain of nausea and vomiting. This is a common phenomenon after anesthesia, which does not require special treatment. The appearance of complaints and pain in the postoperative suture area is also characteristic. Pain syndrome is well stopped by analgesics.
The operation on the pelvic organs is usually performed under intubation anesthesia. On the first day after cyst removal, soreness and sore throat are noted. It is not dangerous, and in the next two days the discomfort will go away.
After completion of the operation, a drainage tube may be left in the wound to facilitate the outflow of discharge. Drainage is removed on the 2nd day in the absence of complications.
6 hours after laparoscopic surgery, the woman is allowed to get out of bed. She begins to move around the ward, can independently walk to the toilet room. It is important not to overstrain, general weakness and dizziness will accompany the patient for at least another day. If your condition worsens, you should inform your doctor. After laparotomy, getting out of bed is allowed not earlier than in a day.
Treatment of sutures is carried out in the hospital every day. For the prevention of inflammatory processes used antiseptic. The stitches are removed on the 7th day. It is not painful, but unpleasant. If absorbable material was used, the sutures should not be removed.
A distinctive feature of laparoscopic removal of ovarian cysts is the absence of coarse scars. After the operation, there are almost imperceptible traces on the abdomen.
Traces of punctures after laparoscopy are small, and with proper subsequent care, wounds heal quickly.
In case of abdominal intervention, a scar remains on the skin. The photo is presented below:
After removal of an ovarian cyst, it is recommended to wear elastic stockings for at least 5 days. Compression underwear is worn during surgery. This tactic reduces the risk of thromboembolic complications (including fatal).
Monitoring in the hospital after laparoscopy lasts up to 3-5 days. In some cases, a woman may be allowed to go home on the day of surgery. After abdominal intervention discharged home after 7-10 days. With the development of complications to lie in the hospital will have a little longer.
Before planned hospitalization, it is important to find out what you can take with you to the hospital. The list is available at the reception. Be sure to need personal care products, replacement clothing, second shoes.
Late postoperative period
Duration – up to 3 weeks.
After discharge from the hospital, the woman remains in the hospital for up to 7 days or more. The duration of the sick-list is determined by the volume of the surgical intervention, the presence of complications and other factors.
General recommendations in the late postoperative period:
- Dieting. It is recommended to adhere to a gentle diet for at least 2 weeks after surgery;
- Sexual rest. In the first 2 weeks after laparoscopic surgery to have sex is not recommended. After laparotomy, sex life is banned for a month. You can resume intimate relationships after a specified period, but it is better to first get to the consultation with a gynecologist and make sure there are no complications;
- Physical rest. After the operation for 3-4 weeks you can not lift weights (more than 3 kg), play sports, overstrain. Physical activity threatens the development of bleeding and seam divergence;
- After the operation, it is not recommended to sunbathe for a month, to visit a solarium, a bath, a sauna. You should not swim in the pool and take a bath;
Within a month after the removal of an ovarian cyst, one should not be in the open sun, take other thermal procedures, swim in the pool.
- Special attention is paid to hygiene procedures. It is recommended to take a shower every day and wash yourself with intimate hygiene products. Do not use soap – it dries the mucous membrane of the vagina and disrupts the microbial landscape, which leads to the development of thrush and bacterial vaginosis;
- Wearing an elastic bandage. Properly chosen bandage accelerates the healing of stitches, reduces pain and contributes to the restoration of the muscular system. Wear a bandage should be 1-2 weeks.
All these recommendations will allow the woman to quickly recover from the operation and return to the usual way of life.
Long-term postoperative period
Duration – after 3 weeks.
At this time, the woman returns to the usual rhythm of life without significant restrictions. Exercise is allowed, but with a gradual increase in the intensity of exercise. Recommended are yoga, therapeutic gymnastics. In the late postoperative period, the issue of pregnancy planning is also resolved or highly effective contraceptives are prescribed.
The main complaints of women after surgical treatment
After surgery, the appearance of such problems:
- Pain syndrome. Pain is the natural companion of the operation. Injured tissue will hurt for 3-7 days. Discomfort is localized in the lower abdomen, less frequently in the perineum, lower back, and lateral regions. The intensity of sensations will gradually subside. For pain relief in the first days, analgesics are prescribed. After discharge from the hospital, the possibility of using painkillers should be agreed with the attending physician;
- Fever. An increase in body temperature to subfebrile numbers is observed on the first day after surgery. Further, the woman’s condition returns to normal, chills and other symptoms of fever go away;
- Delayed chair. Any intervention on the pelvic organs threatens the development of intestinal paresis and violation of the passage of fecal masses. After abdominal surgery, the likelihood of such an outcome is higher. Constipation is accompanied by pain in the side and lower abdomen, nausea. Improvement occurs on the 2nd-5th day;
Sometimes after surgery, a woman may experience difficulty in emptying the bowel.
- Flatulence. The discharge of gases is a common consequence of pelvic surgery. Accompanied by bloating. It passes on its own within two weeks;
- Highlight. After surgery, the appearance of bloody (scarlet, brown) discharge from the genital tract. They persist for 5-10 days, after which they disappear. It is recommended to use absorbent pads.
Restoration of the menstrual cycle and pregnancy planning
The first periods after surgery come in time or with some delay – in 25-35 days. They may differ from normal menstruation – to be scanty or plentiful, painful. On the background of hormonal failure, menstruation may come irregularly. The recovery cycle occurs within 3-6 months.
- Lack of menstruation. If your period does not start 30-35 days after surgery, you need to consult a doctor;
- Very heavy and prolonged periods;
- Severe pain during menstruation;
- Intermenstrual bleeding.
If these symptoms appear, you should be examined by a gynecologist.
The menstrual cycle can be restored already in the first month, and then ovulation will happen 2 weeks after the operation. Theoretically, a woman can conceive a child at this moment, but you should not hurry. You can plan a pregnancy 3-6 months after laparoscopy and 6-12 months after laparotomy. With the development of complications, the conception of a child is postponed for a longer period.
Before planning a pregnancy is recommended:
- To undergo an examination by a gynecologist, including making a pelvic ultrasound;
- Start taking folic acid (3 months before the intended conception of the child);
After surgery on the ovary before planning pregnancy, a woman should start a course of folic acid intake (vitamin B9).
- In case of detection of deviations in the state of health, to be treated by a specialist.
The favorable course of the rehabilitation period is a guarantee of a safe pregnancy in the future.
If the operation on the ovary was performed for endometriosis, do not delay with conceiving a child. Endometriotic cysts are prone to relapse, and further surgery may be required in the future.
Nutrition after removal of ovarian cysts
On the first day after the operation, only liquid broth is allowed. On the second day, when the intestine is stable, pureed food is allowed. From the third day the menu expands due to cereals, pureed vegetables, steam cutlets.
In the first month after surgery, it is recommended:
- Limit eating fried, spicy and spicy foods. You can not eat spicy dishes, add a large amount of salt;
- Add steamed dishes to the menu;
- Eat often – 6 times a day, correctly distributing the amount of food during the day. The first breakfast and lunch can be dense, the second breakfast and afternoon tea can be light. Dinner should be 2 hours before bedtime;
- After the operation, you can eat boiled meat and fish, cereals, dairy products, vegetables, fruits and herbs with good portability. It is not recommended to eat meat and fish of fatty varieties, semi-finished products, smoked meats, pastries, sweets, coffee and alcohol.
After removing an ovarian cyst, you should refrain from coffee, alcoholic beverages, smoked meats, fatty and fried foods, and confectionery.
After 4-6 weeks after surgery, you can return to the usual diet.
Complications in the postoperative period
Negative effects of ovarian cyst removal:
- Thromboembolic complications;
- Bleeding during surgery or in the early postoperative period;
- Wound infection and the development of the inflammatory process;
- Divergence and suppuration of the seams;
- Formation of a hypodermic hematoma;
- Paresis of the intestine and violation of its patency;
- Adhesions leading to chronic pelvic pain and infertility.
About the development of complications say these symptoms:
- Severe abdominal pain;
- Urinary retention;
- Lack of stools and gases;
- Bleeding from the genital tract;
- Drop in blood pressure;
- The appearance of unusual vaginal discharge;
- Shortness of breath or severe coughing;
- Nausea and repeated vomiting;
- Increased body temperature over 38 degrees.
If a woman’s body temperature rises strongly, this is a signal indicating the development of complications after surgery.
If any of these symptoms occur, consult a doctor as soon as possible.
Particular attention should be paid to the effects of anesthesia during the operation. Many women fear that after the administration of drugs, irreversible complications will arise from the brain and the entire nervous system. There are fears that anesthesia will lead to memory loss, reduced intelligence, a decrease in efficiency. In modern gynecology, such complications are extremely rare. The use of high-quality means for anesthesia and a thorough examination of the patient before the operation can reduce the likelihood of such consequences to a minimum.
Normally, a woman comes out of anesthesia soon after the operation is completed. In the first hours there is weakness, drowsiness, dizziness – a natural reaction of the body to the drugs used. Perhaps the appearance of nausea, vomiting, headache. All unpleasant symptoms subside during the first day. The severity of the effects depends on the drugs used and the individual response of the body.
Drug treatment after surgery
To speed up the rehabilitation and prevention of the development of complications, the following drugs are prescribed:
- Antibiotics to reduce the risk of infection;
- Painkillers for relieving pain;
- Nonsteroidal anti-inflammatory drugs at high body temperature;
- Enzymes for the prevention of the appearance of adhesions. For the same purpose, physiotherapy;
- Other remedies for symptomatic therapy.
After discharge from the hospital, hormone therapy is recommended for a course of 3 months. Combined oral contraceptives with ethinyl estradiol 30 mcg (Yarin, Regulon, Lindinet 30 and others) are prescribed. Acceptance of hormones can not only restore the menstrual cycle, but also protects against unwanted pregnancy during this period. If a woman does not plan to conceive a child, she can continue taking birth control pills after 3 months.
After discharge, the woman is recommended to continue her treatment with combined oral contraceptives containing ethinyl estradiol.
After the removal of an endometrioid ovarian cyst, another hormone therapy may be prescribed to eliminate the remaining foci and prevent the recurrence of the disease. The course of treatment is 3-6 months.
Surgical treatment of ovarian cyst does not guarantee that it will not reappear. If growth factors are not eliminated, the tumor may grow in the same place or in another ovary. It is important to be monitored regularly by a gynecologist and undergo an ultrasound at least once a year. Such tactics will allow you to notice the reappearance of ovarian cysts and take the necessary measures.