Hysterectomy

Hysterectomy is a surgical procedure to remove the uterus after which you lose the ability to become pregnant and no longer menstruate.

Some facts about Hysterectomy:

• Hysterectomies are performed to treat health problems affecting the female reproductive system including heavy periods, long-term pelvic pain, fibroids or non-cancerous tumours, ovarian cancer, uterine cancer, cervical cancer or cancer of the fallopian tubes.
• A hysterectomy is only considered after less invasive treatments have been tried as it a major operation with a long recovery time.
• A hysterectomy may involve removing surrounding organs and tissues, such as the fallopian tubes and ovaries depending on the reason for the surgery.
• You will not get your period after a hysterectomy and will lose the ability to get pregnant.
• You may experience menopausal symptoms such as Hot flashes, Vaginal dryness, Loss of libido and insomnia if your ovaries were removed at the time of your hysterectomy.
• Heavy bleeding and infection around the incision site can be a risk of Hysterectomy.
• Injury to surrounding tissues or organs, including the bladder, intestines and blood vessels are the some of the other risks of a Hysterectomy.

Types of Hysterectomy:

The types of hysterectomy to be performed will depend on the reason for operation and how much of your womb and surrounding reproductive system can safely be left in place.

Total hysterectomy:

Total hysterectomy involves the removal of entire uterus and cervix, but leaving the ovaries. You should continue to have regular pelvic examinations if your cervix is removed. An annual Pap test is no longer needed.

Supracervical hysterectomy:

Supracervical hysterectomy involves the removal of just the upper part of the uterus while leaving the cervix.

Total hysterectomy with bilateral salpingo-oophorectomy:

Total hysterectomy with bilateral salpingo-oophorectomy involves the removal of the uterus, cervix, fallopian tubes (salpingectomy) and ovaries (oophorectomy). Removing the ovaries will start menopausal symptoms if you haven't experienced menopause. Hormone replacement therapy may be needed if both of your ovaries are removed.

Radical hysterectomy with bilateral salpingo-oophorectomy:

Radical hysterectomy with bilateral salpingo-oophorectomy involves the removal of the uterus, cervix, fallopian tubes, ovaries, the upper portion of the vagina and some surrounding tissue and lymph nodes.
 

Preparation for Hysterectomy:

• The procedure in detail, including possible complications and side effects will be explained by your healthcare provider before the surgery.
• The type of hysterectomy you need and the best surgical method will be determined to perform that procedure.
• A general or local anesthetic will be given before starting the procedure to put you to sleep throughout the procedure so that you don't feel any pain.

Procedure for Hysterectomy:

Several different surgical approaches can be used by your healthcare provider to perform a hysterectomy. These include:

Abdominal Hysterectomy:

Your uterus will be removed through a large cut in your abdomen during an abdominal hysterectomy. The incision is made either across the top of your public hairline or from your belly button to your pubic bone. Stitches or staples will be used to close the incision. Abdominal hysterectomy is commonly used when cancer is involves, when the uterus is enlarged or when disease spreads to other pelvic areas.
A longer hospital stay and a longer recovery time is required for this type of Hysterectomy.

Vaginal hysterectomy:

Vaginal hysterectomy involves the removal of uterus through an incision at the top of your vagina. There is no need of external incision. Dissolvable stitches are placed inside the vagina in this type of hysterectomy. Vaginal hysterectomy is most commonly used in cases of uterine prolapse and other non-malignant or noncancerous conditions. It is considered the preferred approach among all type of hysterectomy because of fewest complications and fastest recovery. You can go home the same day of surgery.

Laparoscopic hysterectomy:

A laparoscope is a thin tube with a high-resolution video camera on the end, will be inserted in the lower abdomen through a small incision in the belly button in case of Laparoscopic hysterectomy. The surgical tools are inserted through several other small incisions in the abdomen. Generally, three or four small incisions are made instead of one large incision. Your uterus will be removed in small pieces through the incisions in your abdomen or through your vagina after cutting the uterus into small pieces. One piece will be removed at a time. Full recovery of Laparoscopic hysterectomy is shorter and less painful than an abdominal hysterectomy.

Robotic-assisted laparoscopic hysterectomy:

Robotic-assisted laparoscopic hysterectomy will be performed with the help of a robotic machine. The pelvic area can be viewed with the help of a laparoscope that is inserted in the abdomen. Small surgical tools are inserted through several tiny incisions around the belly button. Robotic arms and the surgical instruments are controlled by the surgeon. The recovery is same as a laparoscopic hysterectomy.

Recovery from a Hysterectomy:

• You will need to spend two to five days in the hospital after your hysterectomy. The recovery time varies depending on the type of surgery you had.
• Medication will be given by your doctor for the pain and your vital signs, such as your breathing and heart rate will be monitored.
• You will be encouraged to walk around the hospital as soon as possible as walking helps prevent blood clots from forming in the legs.
• Your vagina will be packed with gauze to control the bleeding if you have had a vaginal hysterectomy.
• You can probably return to most of your regular activities within three to four weeks if you have had a vaginal or laparoscopic hysterectomy. However, recovery time will be a little longer if you have had an abdominal hysterectomy.
• It will take about four to six weeks or complete recovery.