Hysterectomy (Abdominal/Vaginal)

Hysterectomy is the surgical removal of the uterus; it may involve the removal of the cervix, ovaries and fallopian tubes, too. After hysterectomy, the woman will no longer get menstrual periods and won’t be able to conceive.

Need for Hysterectomy

The doctor will suggest alternative methods to treat the following conditions before going for hysterectomy:

  • Severe pelvic pain
  • Severe endometriosis
  • Cervical, ovarian and uterine cancer
  • Uterine fibroids and other noncancerous tumors
  • Abnormal or heavy vaginal bleeding
  • Uterine prolapse that can lead to uncontrolled bowel and bladder movements
  • Complications of childbirth, such as uterine rupture
  • Adenomyosis in which tissue grows into the uterine wall, causing it to thicken
  • Hyperplasia in which the lining of the uterus thickens

Kinds of Hysterectomy

The different types of hysterectomies are as follows:

  • Total Hysterectomy: Removal of the uterus and cervix, leaving ovaries behind. Since ovaries are still present, the woman won’t enter menopause immediately after this surgery.
  • Total Hysterectomy with Bilateral Salpingo-Oophorectomy: Removal of the uterus, fallopian tubes, cervix and ovaries. This will start the menopause immediately after the surgery.
  • Supracervical Hysterectomy: The upper part of the uterus is removed while leaving the cervix. The fallopian tubes and ovaries are removed. Since the cervix is still present, Pap smears to test cervical cancer will be needed.
  • Radical Hysterectomy with Bilateral Salpingo-Oophorectomy: Generally performed in people with cancer, this surgery involves the removal of the cervix, uterus, fallopian tubes, upper portion of the vagina, surrounding tissue and lymph nodes. Since ovaries have been removed, the women’s menstrual cycles will stop immediately.

Prepare for Hysterectomy

The doctor may collect blood and urine samples to confirm that the person is healthy to undergo surgery.

During Hysterectomy

Depending on the medical condition, the doctor will determine the type of hysterectomy and the best surgical method for it. A nurse will place an intravenous (IV) line to give medications and fluids. The anesthetist may give general anesthesia or local anesthesia to the spine to reduce pain.

Steps in Abdominal Hysterectomy

  • The surgeon makes a 6-8-inch-long incision either from the belly button to the pubic bone or across the top of the pubic hairline.
  • The uterus is removed, and surgeons opt for this method when cancer is involved, which has led to an enlarged uterus or disease that has spread to other pelvic areas.
  • The surgeon uses stitches or staples to close the incision.
  • This needs a longer hospital stay for about two or three days and a longer recovery time.

Steps in Vaginal Hysterectomy

  • The surgeon removes the uterus through an incision on the top of the vagina. No incisions are made on the abdomen.
  • The surgeon opts for dissolvable stitches inside the vagina.
  • Characterized by fewer complications and faster recovery of up to four weeks.
  • People can go home on the day of surgery.

Duration of Hysterectomy

Hysterectomy can last from one to four hours, and this time depends on:

  • Presence of scar tissue from past surgeries
  • Size of uterus
  • If the surgeon wants to remove endometriosis, fallopian tubes or ovaries

After the surgery

The nurse will suggest the woman who underwent a hysterectomy walk as soon as possible after the surgery to avoid blood clots in the legs. A woman undergoing an abdominal hysterectomy will have to stay at the hospital for a few days when compared to a woman undergoing a vaginal hysterectomy that would require an overnight stay.

Common Side Effects of Hysterectomy

The common side effects of hysterectomy are as follows:

  • Irritation at the incision site
  • Difficulty in bowel and bladder movements
  • Vaginal bleeding and drainage that can last up to six weeks
  • Fatigue from surgery

When ovaries are removed in a hysterectomy, the woman who hasn't entered menopause may feel below symptoms:

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

Complications of Hysterectomy

As with any surgery, a hysterectomy can come with a few complications, such as:

  • Bleeding
  • Severe infection
  • Injury to the urinary tract, bowel or nearby organs
  • Blood clots
  • Urinary incontinence
  • Vaginal prolapse in which part of vagina comes out of the body
  • Vaginal fistula formation where an abnormal connection forms between the vagina and bladder or rectum
  • Hemorrhage

Pain in the pelvic region can be an underlying cause of severe gynecological issues. Take prompt treatment from expert gynecologists at Matrix Hospital Mehdipatnam.

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