I. The uterus, a breeding ground for life
The uterus is a thick-walled, small-cavity, predominantly muscular organ, consisting of the cervix and the uterine body. It is an important part of the female reproductive endocrine system, and its most important function is reproductive function.
The mucous membrane covering the uterine cavity is the endometrium, which is affected by sex hormones after puberty and undergoes cyclic changes and produces menstruation. After sexual intercourse, the uterus is the passage for sperm to reach the fallopian tubes. During pregnancy, the uterus provides a superior environment for the fertilized egg to be laid, and for the fetus to develop and grow. In October, the uterus is again the channel for delivery, by which a complete fertility process is completed. Liu Fuzhong, Department of Interventional Medicine, Huaian Maternal and Child Health Hospital
However, does the uterus become a redundant organ after childbirth? Does the removal of the uterus prevent diseases? Our answer is no, because the uterus has other pivotal functions.
Second, the removal of the uterus, human endocrine disruption
From the anatomical structure of the uterus, the uterus has a close connection with the surrounding organs. The uterine artery supplies blood and nutrition to the uterus, while its blood is supplied to the surrounding organs such as ovaries, fallopian tubes, vagina, etc. through branch vessels. The branch vessels supplying the ovaries are worth mentioning. At a distance of two centimeters from the level of the endocervix, the uterine artery is divided into two branches, upper and lower, and the upper branch divides into an ovarian branch to supply the ovaries with nutrients.
When total hysterectomy is performed, the uterine artery is blocked, which inevitably results in the blockage of the ovarian branches and leads to partial ischemia of the ovaries. The ovary is one of the most important organs in female reproductive endocrine regulation, synthesizing and secreting two main female hormones, estrogen and progesterone. Mild ovarian ischemia has little effect, but severe ischemia can lead to endocrine disorders and even menopausal symptoms, such as dizziness, palpitations, anxiety, forgetfulness, lack of concentration, vaginal dryness, and decreased sexual function.
As a receptor organ, the uterus is also involved in female reproductive endocrine regulation. The uterus contains mainly estrogen receptors and progesterone-supporting receptors, which bind to estrogen or progesterone and become necessary for estrogen and progesterone to exert their physiological effects.
After removal of the uterus, although the most obvious external sign reflecting female endocrine – menstruation – no longer appears, endocrine disorders can still manifest themselves, such as in the cardiovascular system, flushing, palpitations, unstable blood pressure, dizziness, tinnitus and peripheral vascular dysfunction; in the nervous system, neuroticism, irritability, depression, insomnia, In the skeletal system, it manifests as joint pain and osteoporosis; in the genitourinary system, it manifests as atrophic vaginitis, etc.
In addition, the uterus is located in the pelvic floor and is surrounded by four ligaments, namely the round ligament, broad ligament, main ligament and uterosacral ligament, which together play a scaffolding role for the pelvic floor.
What will happen in the future if a woman loses her uterus?
After the removal of the uterus, is it possible to rest easy and relaxed? One scholar who did a psychological study found that the vast majority of women see menstruation as a necessary and valuable function for a variety of reasons. There were many women who were concerned that a hysterectomy would affect sexual response, suggesting that the uterus is quite closely related to women’s sexuality. One researcher studied 100 married women aged 20 – 47 years with non-malignant disease who had undergone hysterectomy, with face-to-face visits on days 7 and 12 after surgery, and a control group of patients with cholecystectomy. After 13 months, it was concluded from the questionnaire study of 85% of the study subjects that more psychiatric depression occurred with hysterectomy than with the control group. This suggests that gynecological surgery causes a unique kind of mental stress for women. The mental stress of having a hysterectomy is particularly significant when it causes both the loss of menstruation, a monthly marker, and the loss of a woman’s ability to bear children.
Fourth, the main manifestations of total hysterectomy syndrome are.
1. constipation, urinary retention, and urinary incontinence. This is a symptom of the absence of the uterus such as the pelvic cavity in the empty space, rectum, bladder and urethra to the middle of the displacement.
2, wasting and weakness, unable to hold weight. This is caused by the pelvic floor ligament rupture pelvic floor support decreased.
3.Sex life is not harmonious and there is no orgasm. Since the nerves of the clitoris are connected to the uterus, the removal of this clitoris will no longer receive stimulation, and this is compounded by the loss of the cervix. Secondly, painful intercourse, which is caused by the shortening of the vagina.
4. Premature ovarian failure. This is because half of the blood supply to the ovaries comes from the uterus.
5. Amenorrhea and infertility. It is jokingly referred to as castrated woman.
6. Heavy hanging sensation or occasional pain in the lower abdomen. This is a kind of leakage phenomenon because the uterus is located between the bladder and rectum in the pelvic floor and is the support for the internal organs, bladder and rectum, and after removal, it is like pulling a tooth and leaving a “gap”, and the surrounding organs fill in the defect.
7, if the transabdominal resection will also lead to a large scar on the abdominal wall affect the aesthetics.
8, under pressure, distorted heart. After total excision, many women’s personalities change and always feel that they are no longer a complete woman, even pretending to buy toilet paper, pretending to take time off for menstrual cramps, etc.
The uterus is often considered to be the second life of a woman. Therefore, there is no doubt about the importance of preserving the uterus for premenopausal women, and the decision to remove the uterus must be carefully considered by both physicians and patients before making the decision. Total hysterectomy with medical indications is the right thing to do. These indications include benign and malignant tumors of the uterus, dysfunctional uterine bleeding, and adnexal pathology that prevents preservation of the uterus. However, hysterectomy without medical indications can do more harm than good, and removal of the uterus to prevent malignant tumors is even less desirable. For example, the incidence of cervical cancer is only 10 to 20 per 100,000 population per year, while the incidence of uterine body cancer is even less, at 5 to 10. As long as regular checkups are conducted, the current medical conditions allow early detection and early treatment to ensure life safety.