What Is a Hysterectomy? Why Is a Hysterectomy Performed?

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Hysterectomy is a surgical procedure done by Gynaecologist to remove uterus or womb. Guessed correctly! Once a woman has gone under a knife for this surgery, she cannot become pregnant nor will she have menstruation. It is natural for a woman advised hysterectomy to ask ‘Why me?’  This blog will enlighten you with types of hysterectomy, risks, indications, alternatives and life afterwards.

The extent of a hysterectomy depends on its indication.

Total Hysterectomy

In most cases, entire uterus, including cervix is removed. It can be performed abdominally or vaginally. Vaginal hysterectomy is associated with fewer complications than abdominal or laparoscopic hysterectomy, has shorter healing time than with abdominal surgery. Hence it is recommended as first choice for hysterectomy whenever possible.  Annual PAP test recommended for screening out cervical cancer is no longer needed after total hysterectomy. However regular pelvic examination is required.

Partial Hysterectomy

During a partial hysterectomy upper part of the uterus is removed, but the cervix is left in place. It can only be performed laparoscopically or abdominally. Laparoscopic surgery requires only 2-3 small incisions in your abdomen. Laparoscopic surgery is associated with less pain, lower infection rate, shorter hospital stay and early return to normal activities.

Hysterectomy and Salpingo-Oophorectomy

For prevention of ovarian or breast cancer, ovaries and Fallopian tubes may be concurrently removed in a hysterectomy. Ovaries produce oestrogen, a female sex hormone and hence its removal will lead to immediate menopause. Hormone replacement therapy may be recommended if a woman wishes to delay signs and symptoms of menopause.

Risks of a Hysterectomy?

If it is the only option, you should know the risks of hysterectomy. Though it is considered to be one of the safest surgery, a fraction of patients may face some rare risks as in any other major surgery.

  • Adverse reaction to the anaesthetic drug
  • Bleeding and infection around the incision site
  • Injury to bladder or intestine
  • Unintended removal of ovaries and Fallopian tubes

Why Is a Hysterectomy Performed?

  • Uterine fibroid, a benign tumor of uterus, is most common indication
  • Chronic pelvic pain refractory to medications
  • Uncontrollable uterine bleeding
  • Cancer of uterus, cervix, or ovaries
  • Serious infection of reproductive organs, called PID (Pelvic Inflammatory Disease)
  • Uterine prolapse
  • Endometriosis, in which inner uterine lining grows outside of the uterine cavity, causing pain and bleeding

Alternatives to a Hysterectomy

Hysterectomy is the second most common surgical procedure performed on women in the United States. It is considered to be a safe, low-risk surgery. However, a hysterectomy may not be the best option for all women, especially for those who still want to have children.

Endometriosis can be managed with hormones and fibroids with hormonal Intra Uterine Device (IUD), uterine artery embolization or partial hysterectomy, giving an option for woman to carry her pregnancy. Prolapse can also be corrected if uterus is desired. In cervical or uterine cancer, however, a hysterectomy is the best choice. You can discuss with your Gynaecologist to decide which type of hysterectomy and whether abdominal, vaginal or laparoscopic is suitable for you.

Life after Hysterectomy

You will be encouraged to walk around, during 2-5 days you spend in the hospital. When you return home, it is important to continue walking inside your house or around your neighbourhood, to prevent clots in leg veins. However, you should avoid straining activities like bending, lifting, pushing and pulling heavy objects. Following vaginal or laparoscopic hysterectomy you should recover completely within three to four weeks and six weeks after abdominal hysterectomy.

After hysterectomy for benign indications majority of women report improvement in sexual life and pelvic pain.

Hysterectomy is a major decision, since it deprives a woman of something only a female has. It not only needs surgical skills and well equipped hospital to manage all emergencies, but also counselling by the Gynaecologistand emotional support by family and doctor.

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