Hysterectomy is a surgical procedure done for the removal of the uterus to treat many medical problems of women. This is done to treat non-cancerous, pre-cancerous, and cancerous diseases that can damage the female reproductive system. During the operation, your surgeon may also remove other parts of the reproductive system, such as the cervix, ovaries, or fallopian tubes, depending on the reason for the hysterectomy. After the surgery, you will no longer have menstrual periods and you will not be able to get pregnant.
What is a Hysterectomy?
A hysterectomy is a surgical operation that removes the uterus from a woman to treat various chronic pain conditions, as well as certain types of cancer and infections. Uterus, also known as the womb, is where the baby grows when a woman is pregnant. The lining of the uterus is the source of menstrual blood. The extent of a hysterectomy varies depending on the reason for the surgery. The doctor may also remove the ovaries and fallopian tubes during the procedure. The glands that contain estrogen and other hormones are the ovaries. The fallopian tubes are the structures that carry the egg from the ovary to the uterus. Once you have had a hysterectomy, you will stop having menstrual periods.
Types of Hysterectomy
During a partial hysterectomy, your doctor removes only a part of your uterus. They can leave your cervix intact.
Your doctor will remove the entire uterus, including the cervix, during a complete hysterectomy. When your cervix is cut, you will no longer need an annual Pap exam. You can, however, expect to get pelvic tests done.
Hysterectomy and Salpingo-Oophorectomy
During a hysterectomy and salpingo-oophorectomy, your doctor removes the uterus along with one or both ovaries and fallopian tubes. If both ovaries are removed, hormone replacement therapy may be needed.
Why is a Hysterectomy Performed?
If you have any of the following symptoms, your doctor might recommend a hysterectomy:
- Chronic pelvic pain
- Uncontrollable vaginal bleeding
- Cancer in uterus, cervix, or ovaries
- Fibroids, which mean tumors that grow in the uterus.
- Pelvic inflammatory disease (PID) which is inflammation of the genital organs that can be fatal.
- Uterine prolapse, which occurs when the uterus falls through the cervix and protrudes from the vagina.
- Endometriosis, which is a disorder in which the lining of the uterus grows outside the uterine cavity and causes pain and bleeding.
- Adenomyosis which is a disease in which the endometrial tissue expands into the muscles of the uterus.
Surgeons use different approaches for hysterectomy, depending on the surgeon's experience, the reason for the hysterectomy, and the overall health of the patient. The hysterectomy technique will determine the amount of time it takes to recover and the kind of wound that remains following the procedure.
There are two approaches to surgery: a traditional or open surgery and a surgery that uses a minimally invasive or MIP procedure.
Open Surgery for Hysterectomy
An abdominal hysterectomy is an open surgery. This is the most common approach to hysterectomy and accounts for about 54% of all benign conditions. To perform an abdominal hysterectomy, a surgeon makes a 5 to 7-inch incision, either up and down or side-to-side, through the abdomen. The uterus is then removed from this incision by the surgeon. After an abdominal hysterectomy, a person will generally spend 2 to 3 days in the hospital. There is also a visible scar at the incision site.
Several approaches can be used for a MIP hysterectomy:
- Vaginal Hysterectomy: The surgeon cuts the vagina and removes the uterus through this incision. The incision is closed without leaving a visible scar.
- Laparoscopic Hysterectomy:This surgery is performed using a laparoscope, which is a tube with a lighted camera, and surgical tools which are inserted through several small cuts made in the abdomen. In the case of a single site laparoscopic procedure, a small cut is made in the belly button. The surgeon performs the hysterectomy from outside the body and views the operation on a video screen.
- Laparoscopic-Assisted Vaginal Hysterectomy:The surgeon uses laparoscopic tools in the abdomen to help remove the uterus through an incision in the vagina.
- Robot-Assisted Laparoscopic Hysterectomy:This procedure is similar to a laparoscopic hysterectomy, but the surgeon controls a sophisticated robotic system of surgical tools from outside the body. The surgeon will use normal wrist motions when viewing the hysterectomy on a three-dimensional screen. Thanks to these advanced technologies!
What to Expect After a Hysterectomy?
After a hysterectomy, if your ovaries were also removed, you will be in menopause. If your ovaries were not removed, you may enter menopause at a younger age than you would otherwise. Most people are told to abstain from sex and avoid heavy lifting for six weeks after a hysterectomy. Most people who underwent the procedure say that the operation has improved or cured their primary problem (for example, pain or heavy periods).
Risks of a Hysterectomy
A hysterectomy is considered a fairly safe procedure. However, as with all major surgeries, there are some associated risks. An allergic reaction to anesthesia is possible in certain people. There is also a risk of heavy bleeding and infection around the incision site. Other risks include injury to surrounding tissues or organs, including:
- Severe blood loss
- Damage to the bladder, urethra, blood vessels, and nerves in the underlying tissues.
- Blood clots
- Side effects of anesthesia
- Intestinal blockage
Bleeding, discharge, and constipation are some of the short-term hysterectomy side effects. A person may also temporarily experience menopausal-like symptoms such as hot flashes. These will resolve as the person recovers. In the long term, a person may feel a sense of loss or sadness, or possibly relief after the procedure. People who have also had their ovaries removed will experience menopause and can benefit from HRT. Hysterectomies have some risks and it also means that a woman might not be able to conceive. Before having surgery, the patient should discuss all the doubts and choices in hand with their doctor.