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WHAT IS A HYSTERECTOMY SURGERY?

 Surgical removal of the uterus (the womb) is called Hysterectomy. It is major gynecological surgery and the second most performed surgery across the world. As a woman ages and nears her menopause, the uterus tends to develop many uterine-related health issues such as extensive vaginal bleeding, severe abdominal pain, nausea, constant fatigue, blackouts, and weakness. Hysterectomy is most commonly done for reason of the development of uterine fibroids. 

 

In many cases, the uterus falls from its original place and obstructs urination and defecation along with repeated urinary tract infection, this condition is called uterine prolapse. Hysterectomy and removal of the uterus is the only option left to treat such conditions for immediate relief. 

WHO NEEDS A HYSTERECTOMY?

  • Heavy or painful vaginal bleeding even after 
  • Fibroids or Leiomyomas are non-cancerous and benign tumors present in the uterus.
  • Endometriosis leads to severe abdominal pain.     
  • Uterine prolapse - A shift of the uterus from its normal position
  • Chronic pelvic pain (persistent pain in the lower belly).
  • Cervical or uterine cancer or abnormalities that may lead to cancer 
  • Conditions with the lining of the uterus like hyperplasia, recurrent uterine polyps, or adenomyosis. 

TYPES OF HYSTERECTOMY 

  • Total Hysterectomy – Removal of uterus and cervix, leaving the ovaries
  • Supracervical Hysterectomy – Removing just the upper part of the uterus while leaving the cervix
  • Total hysterectomy with bilateral salpingo-oophorectomy – Removal of uterus, cervix, fallopian tubes (salpingectomy), and ovaries (oophorectomy) 
  • Radical hysterectomy with bilateral salpingo-oophorectomy – Procedure of removal of uterus, cervix, fallopian tube, ovaries, the upper portion of the vagina, and some surrounding tissue and lymph nodes. This type of hysterectomy is performed when cancer is involved. 

DIAGNOSIS AND LINE OF TREATMENT 

 

  • Pelvic ultrasound
  • CT scan
  • MRI scan
  • Blood and urine tests
  • Endometrial Biopsy 

SURGICAL OPTIONS

Most commonly performed in cases of uterine prolapse and other non-malignant conditions Your uterus is removed through an incision at the top of your vagina. There is no external incision. Dissolvable sutures are placed inside the vagina. Fewest complications and the fastest recovery (up to four weeks) and is considered the preferred approach. Patients often go home on the same day of surgery.

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The uterus is removed through a six- to the eight-inch-long incision in the abdomen. The incision is made either from your belly button to your pubic bone or across the top of your public hairline. The surgeon will use stitches or staples to close the incision. Most commonly used when cancer is involved, when the uterus is enlarged or when the disease spreads to other pelvic areas. It generally requires a longer hospital stay (two or three days) and a longer recovery time.

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A laparoscope (a thin tube with a video camera on the end) is inserted into the lower abdomen through a small incision in the abdomen. Surgical tools are inserted through several other small incisions. Your uterus can be removed in small pieces through the incisions in your abdomen or through your vagina. Full recovery is shorter and less painful than an abdominal hysterectomy.

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The surgeon performs the procedure with the help of a robotic machine. A laparoscope is inserted in the abdomen so the pelvic area can be viewed. Small, thin surgical tools are inserted through three to five incisions on the abdomen. Robotic arms and instruments are controlled by the surgeon. Shorter recovery time and less painful

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NON-SURGICAL OPTIONS

Uterine prolapse can be improved with Kegel exercises that strengthen pelvic floor muscles Maintaining weight, quitting smoking and chronic cough can help relieve pelvic muscle pressures. Hysteroscopic evaluation and management including polypectomy, myomectomy, and endometrial ablation are effective to avoid hysterectomy.

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BENEFITS OF HYSTERECTOMY

  • Stop abnormal heavy bleeding
  • Relives chronic pelvic pain
  • Restores pain-free sex
  • Prevents cancer & spread of cancer
  • Removes cancerous tissues
  • Improves quality life 

RISKS AND COMPLICATIONS

  • Urinary incontinence
  • Vaginal Prolapse
  • Vaginal fistula formation
  • Chronic pain 
  • Wound infections
  • Bleeding

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Frequently Asked Questions

  • Vaginal Hysterectomy is considered to be the best method of uterus removal surgery only in the cases of uterine prolapse.
  • For fibroids, heavy periods & endometriosis Total laparoscopic hysterectomy (TLH) is the most advanced and minimally invasive method.

The hospitalization for uterus removal surgery depends on the type of surgery performed. The patient may take discharge the next day in case of a Laparoscopic hysterectomy. 

The most common reasons for having a hysterectomy include Heavy periods - which can be caused by fibroids. Pelvic pain – This is caused by endometriosis, Pelvic inflammatory disease (PID) 

The alternatives to total abdominal hysterectomy include vaginal hysterectomy, laparoscopic-assisted vaginal hysterectomy, laparoscopic Supracervical hysterectomy, endometrial ablation, and myomectomy.

You may feel discomfort at the incision site for about four weeks, and any redness, bruising or swelling will disappear in four to six weeks. Feeling burning or itching around the incision is normal.

The anesthesia used during your hysterectomy also paralyzes your bowel movement. Your bowel movements become irregular due to your recovery from the anesthesia. Cramping, constipation, and irregular bowel movement are all common for women to experience after a hysterectomy. 

  • Hot flashes
  • Vaginal dryness
  • Loss of libido
  • Difficulty sleeping 

This depends on whether the ovaries were removed. If your ovaries remain after a hysterectomy, you will not enter menopause right away. If both of your ovaries were removed during the hysterectomy, you might enter menopause immediately.

Sexual life is not affected by the hysterectomy. If the ovaries are removed from the uterus, this could start menopause immediately. Low sex drive and vaginal dryness could be side effects of hysterectomy.

Many insurance companies provide coverage for hysterectomy surgeries after a period of few years. Our HospiOne Team can guide you perfectly in this scenario.

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