The use of laparoscopic technologies is now considered the "gold standard" in the treatment of many gynecological diseases. Small invasiveness, good tolerability and rapid recovery after such intervention are the main advantages of this method over others. Most often, laparoscopic surgery is performed with ovarian pathology, endometriosis and infertility. Sometimes the procedure can provoke some disorders, including the menstrual cycle. If a laparoscopy was performed, and the monthly ones did not start as usual, is it normal and pathological? What are the characteristics of recovery after surgery?
Restoration of the body after operation
Laparoscopic surgery is performed using modern equipment that allows to penetrate into internal organs through small incisions on the skin. Features of the conduct allow you to identify the characteristic features of the rehabilitation period. These include:
- Laparoscopy is performed under general endotracheal anesthesia. In view of this, for some time after the operation, but not more than a few days, a woman may be bothered by unpleasant sensations in the nasopharynx. This is due to the minor trauma of the mucosa during intubation.
- Gynecological operations using laparoscopic technique are conducted in the position with the lowered head end. Often after this, women notice some unpleasant sensations in the shoulders that go through a few days.
- Pain syndrome after laparoscopy is several times less pronounced compared with classical operations. This is due primarily to the fact that all incisions and tissue damage are minimal, there is no additional trauma by the hands of a doctor, for example, or with napkins, etc. In the postoperative period, it is rarely necessary to resort to strong painkillers, for example, narcotic. Usually, analgin or a similar preparation is sufficient.
- Already after 5 - 7 hours a woman can begin to actively move and get up. And, as is known, the earlier a person activates, the easier and faster they recover. After the usual operations, severe pain prevents such early movements.
- As with any such treatment, there are always limitations in physical activity. On average for a period of about a month.
- After a laparoscopic operation, a hernia is never formed.
- For prevention of infectious complications, sexual rest is prescribed for 2 - 3 weeks. In some cases, there is no such prohibition, for example, after performing a similar operation for polycystic ovaries. Laparoscopy is performed before menstruation, which should minimize cycle disturbances.
- Within a few days after the operation, bloating may occur. This is due to the fact that during the intervention it is filled with carbon dioxide to visualize the entire process. For two or three days, it resolves without additional prescriptions.
- Care should be taken for small stitches on the skin of the abdomen. Despite the size, if the processing rules are not respected, they can become inflamed. So, one should not bathe before the full healing of wounds( in a bath, bath, etc.).It is better to choose loose clothing to avoid friction and damage. To process and further to delete strings in seams should be strictly on purpose of the doctor.
- An important advantage of laparoscopy is the less likely adhesion process. And, consequently, the discomfort, unpleasant sensations, pains and other symptoms associated with this will be much less pronounced or nonexistent.
- During the laparoscopy, the total blood loss is not so great. Only in special cases and with the development of complications it is necessary to conduct a blood transfusion in the postoperative period or to take iron preparations to restore the hemoglobin level.
Features of the menstrual cycle after performing the operation
Often women will note that the monthly after laparoscopy of the ovaries does not arrive in time, and sometimes even significantly the cycle is broken. It can be connected with several aspects. These include:
- the reason for the laparoscopy;
- on what day of the cycle the manipulation was performed;
- whether there were additional interventions, such as hysteroscopy or conventional scraping of the uterine cavity;
- was prescribed hormone therapy immediately after laparoscopy;
- was the removal of ovarian tissue;
- age of the woman;
- features of the patient's body and some other factors.
Many women are interested in whether laparoscopy is done with menstruation. Generally, it is undesirable to perform any diagnostic or treatment procedures on critical days. This is due primarily to the increased bleeding of tissues in girls during this period. Even according to the results of a coagulogram, there may be some phenomena of hypocoagulation - a reduction in coagulation.
It should also be taken into account that often, along with laparoscopy, other diagnostic procedures are performed, for example, chromo-hydrotubation of the fallopian tubes or hysteroscopy. If this is done during periods, the risk of various infectious complications increases sharply, and the result of the study is of lesser diagnostic value. That is why all planned interventions, including laparoscopy, are carried out mainly in the first half of the menstrual cycle.
About polycystic disease
The goal of laparoscopy in case of polycystic disease is to remove the dense squamous cell membrane so that the follicle with the egg can ripen. In this case, almost always there is a removal of some part of the ovary. All this leads to a hormonal imbalance, as a result, a cycle violation may occur. If the operation is carried out for the purpose of further pregnancy, then hormone therapy is not prescribed. Exception - drugs to stimulate ovulation and the formation of the second phase. But their action is always aimed at normalizing the cycle.
About the ovarian cyst
We recommend reading the article on the postoperative period with laparoscopy of the ovarian cyst. From it you will learn about the features and duration of the operation, the rehabilitation period, recommendations for nutrition, the possibility of pregnancy after removal of the cyst.
About infertility
Diagnostic laparoscopy is most often used to diagnose infertility, during which tubal patency - chromohydrotubation - is also determined. In most cases this intervention ends, sometimes the dissection of adhesions is performed. Some gynecologists with a view to "stimulating" the ovaries sometimes make incisions on them. Violation of the cycle is a rarity in this case. After such a laparoscopy of the fallopian tubes is performed, and the monthly next cycle came on time, you can plan pregnancy.
About endometriosis
Endometriosis often has fairly common forms. Laparoscopy is considered the "gold standard" in the treatment and diagnosis of this pathology. There are several reasons for this. First, the foci of endometriosis often have very small dimensions, only a few millimeters. A special technique allows you to magnify the image dozens of times, which makes it possible to view even invisible usually affected areas. Secondly, using laparoscopic technologies, the traumatic nature of the operation and blood loss during it are significantly reduced.
If the foci of endometriosis are not located on the ovaries, then after surgery no significant disturbance of the menstrual cycle occurs. In the case where you have to remove or burn areas here, you may get bloody spotting on the day 2 - 3 after the operation.
Often after endometriosis laparoscopy, hormone therapy is prescribed. Usually from the first day of the cycle, which, of course, affects the nature and duration of menstruation, sometimes up to complete amenorrhea at the time.
About an ectopic pregnancy
Detection of atopic pregnancy occurs in most cases after a delay in menstruation or a few days before it. Therefore, after performing a surgical intervention, often a few days later, normal critical days come. If there were bleeding episodes of a temperate nature before the operation, then later they may not be.
As a prevention and normalization of the hormonal background after pregnancy, hormonal contraceptives are often prescribed from the first hours after the intervention. In this case, plentiful monthly after laparoscopy are very rare, often it is a minor daub.
Regarding removal of uterine fibroids
Modern laparoscopic technologies allow even to remove myomatous nodes with intramural and subserous growth. But if a woman subsequently plans a pregnancy, it is better to perform such operations in a classical way, since in this case the probability of rupture of the uterus decreases when the fetus is born.
The first months after laparoscopy, myomas are very often painful, even if before a woman did not notice such discomfort. This is due to the fact that during critical days, the myometrium decreases, and in the region of the remote site the wound does not have time to heal properly. This causes sharp and sometimes very severe bouts of pain.
As diagnostic procedure
In order to clarify the diagnosis, laparoscopy is used in many dubious states. Acute abdomen with an unidentified cause, suspicion of torsion of ovarian cysts and many other surgical pathologies is a direct indication for performing diagnostic laparoscopy. In 90% of cases, these manipulations should not lead to a cycle failure. The only thing that can provoke malfunctions is stress and emotions in such periods of life.
If additional procedures were performed
Often together with laparoscopy in gynecology, hysteroscopy, chromohydrobubation of the fallopian tubes, introduction of additional instruments into the uterus, etc. are performed simultaneously.
So, if there is diagnostic scraping of the uterine cavity or removal of the endometrial polyps, a woman should not be surprised whenafter manipulation and within a few days of the genital tract will be allocated blood. The day of surgery should be considered the first day of the new cycle - the next monthly will come in 28-30 days.
Look at the video about laparoscopic operations in gynecology:
Possible violations of
There will be irregularities in the menstrual cycle after a laparoscopy or not, depends on both the technique and amount of intervention, and the individual characteristics of the woman's body.
If the operation involves any intervention on the ovaries, then a malfunction is observed in almost all cases.
If hysteroscopy is performed together with laparoscopy or scraping of the uterine cavity is performed, then the day of surgery should be considered the first 24 hours a day, despite previous menstruation. During these procedures, the surface layer of the endometrium is removed. This is a kind of artificial "critical days", after which it begins to grow again.
The most common disorders of the menstrual cycle after laparoscopy are:
- Spotting off immediately after the operation, and also for the next few days.
- Delays for several days, usually no more than 14 days.
- Establish a new monthly schedule, when the first day of the cycle is the time when laparoscopy was performed.
- Pains with monthly after laparoscopy occur when performing any serious interventions, more often after removal of fibromatous nodes.
- Menstruation can be profuse only if there is a pathology of the uterine cavity, for example, hyperplasia or polyps, as well as adenomyosis.
It should also be taken into account that stress, feelings, as well as other causes can lead to disruption of the menstrual cycle, and the time coincides with the time of laparoscopy. The true cause can only be determined by a physician, who should be consulted in case of symptoms not reported by the operating surgeon.
Dabbling after laparoscopy - norm or deviation?
Spotting after laparoscopic surgery is the most frequent complaint that causes confusion among women. In fact, in most cases, it is not worth worrying if there was a gynecological intervention.
As a rule, a daub can periodically bother a woman during the entire cycle before the next menstruation begins. Also such secretions can appear and on a background of hormonal therapy, especially at the beginning of treatment.
Often, there may be any disturbances in the cycle, for example, delay in menstrual periods after laparoscopy. Particularly characteristic changes and the appearance of irregular bloody discharge with various manipulations on the ovaries. If you have any worries about which the attending physician has not warned, you should additionally seek medical help to avoid other complications.