DIAGNOSTIC AND OPERATIVE HYSTERECTOMY

What is a Hysterectomy?

           Hysterectomy is a surgery in which a woman’s uterus or womb is removed. Uterus is the place where a baby grows when a woman is pregnant. In some cases, ovaries and fallopian tubes are also removed along with the uterus. After a hysterectomy, a woman no longer has menstrual periods and cannot become pregnant.

Why one would need a Hysterectomy?

The most common reason behind hysterectomy is large uterine fibroids. Other reasons may include:

  • Severe pelvic pain
  • Abnormal vaginal bleeding
  • Uterine prolapse
  • Endometriosis
  • Adenomyosis
  • Severe, recurrent pelvic infection
  • Cancer of uterus, ovaries or cervix
  • Heavy, painful periods

What are the different types of Hysterectomy?

           All hysterectomy procedures include removal of the uterus, but the type of procedure often depends on the condition being treated. There are four different types of hysterectomy, which are explained in detail, are as follows:

Partial Hysterectomy:   During a partial hysterectomy, the doctor removes only the portion of the uterus and may leave the cervix intact.

Total Hysterectomy:   Total hysterectomy is the most common hysterectomy performed. It involves the removal of both the uterus and cervix.

Hysterectomy with bilateral Salpingo-Oophorectomy:   During this type of hysterectomy; uterus, fallopian tubes, cervix and one or both the ovaries, are removed. One may need hormone replacement therapy if both the ovaries are removed.

Radical Hysterectomy:    Radical hysterectomy is generally performed when cancer is present. In this procedure, the whole uterus, the cervix, some surrounding tissues of uterus, ovaries, fallopian tubes and upper vagina are removed.

How Hysterectomy is performed?

           A hysterectomy can be performed in several ways. Traditionally, hysterectomy has been performed using a technique known as total abdominal hysterectomy. But in recent years, two invasive procedures have been introduced namely; vaginal hysterectomy and laparoscopic hysterectomy.

Total Abdominal Hysterectomy:    Total abdominal hysterectomy is the most common type of hysterectomy. During this procedure, the uterus and cervix are removed by making a horizontal or vertical incision on the abdominal wall, cutting through the skin and connective tissue to reach the uterus. The incision may be either vertical or horizontal depending on the reason the procedure is performed and the size of the area being treated.

Vaginal Hysterectomy:   During a vaginal hysterectomy, the uterus is removed through the vagina by making a small incision inside the vagina without any external cuts. Usually, vaginal hysterectomy is done in the cases of uterus prolapse and when the uterus is not too large.

Laparoscopic Hysterectomy:    Laparoscopic hysterectomy is similar to the procedure of vaginal hysterectomy, but laparoscopic hysterectomy adds the use of laparoscopy. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The laparoscope is inserted in the abdominal wall through a small incision. As it moves along, the camera sends images to a video monitor that helps the doctor to look directly at the outside of the uterus, ovaries and nearby organs. During a laparoscopic hysterectomy, the uterus is removed through the small cuts made in either the abdomen or vagina.

What changes one should expect after hysterectomy?

           Hysterectomy is major surgery and the biggest change is getting relief from the reasons and symptoms which made the surgery necessary. Other changes that most of the woman may experience after a hysterectomy include:

Menopause:    During a hysterectomy, if a woman’s ovaries are removed then she will enter menopause and if the ovaries were not removed then she might enter menopause at an earlier age than she would have otherwise.

Other Health problems:   If both the ovaries are removed during hysterectomy, there may be an increased risk for other health problems such as bone loss, urinary incontinence, and heart disease.

Sense of loss:   After a hysterectomy, some women may feel depressed due to loss of fertility, or other changes in their bodies. Symptoms of depression, loss of interest in food, loss of energy, may be seen after a few weeks of surgery.

How long does it take to recover from a Hysterectomy?

           Since hysterectomy is a major surgery, it takes a long time to recover and resume normal activities. The recovery time depends on the type of surgery and health before the surgery.

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