HYSTERECTOMY
Hysterectomy is a surgery to remove a woman's womb. The uterus is where a baby grows when a woman is pregnant. During the surgery the whole uterus is usually removed. Your doctor may also remove your fallopian tubes and ovaries. After a hysterectomy, you no longer have menstrual periods and cannot become pregnant
Why would you need a hysterectomy?
You may need a hysterectomy if you have one of the following:
- Uterine fibroids.
Heavy or unusual vaginal bleeding.
Uterine prolapse.
Endometriosis.
Adenomyosis.
Cancer (or pre-cancer) of the uterus, ovary, cervix, or endometrium
Can hysterectomy be avoided
Keep in mind that there may be alternative ways to treat your health problem without having a hysterectomy. Hysterectomy is a major surgery. Talk with your doctor about all of your treatment options.
Hysterectomy is major surgery. Sometimes a hysterectomy may be medically necessary, such as with prolonged heavy bleeding or certain types of cancer. But sometimes you can try other treatments first.
These include:
- Watchful waiting. for uterine fibroids, which tend to shrink after menopause.
Exercises. For uterine prolapse,
Medicine. to help with endometriosis.
Vaginal pessary (for uterine prolapse).
Surgery. You and your doctor may choose to preserve the uterus depending on your symptoms, these options may include: - Surgery to treat endometriosis.
Surgery to help stop heavy or long-term vaginal bleeding.
Dilation and curettage (D&C)
Hysteroscopy .
Endometrial ablation
Surgery to remove uterine fibroids without removing the uterus called a myomectomy.
Surgery to shrink fibroids without removing the uterus. - uterine artery embolisation (UAE) and
- magnetic resonance (MR)-guided focused ultrasound (MR[f]US).
Types of Hysterectomy
- Total Hysterectomy . For non-cancer conditions
- Radical Hysterectomy. For cancer
Ways by which hysterectomy is done
Laparoscopic . Usually can be done in most gynaecological problems
Vaginal. Mainly for prolapse
Abdominal. Most often for early stage cancers
What are the benefits and risks of laparoscopic hysterectomy?
Compared with abdominal hysterectomy, laparoscopic surgery results in less pain, has a lower risk of infection, and requires a shorter hospital stay. You may be able to return to your normal activities sooner.
There also are risks with laparoscopic surgery. It can take longer to perform compared with abdominal or vaginal surgery. Surgeons skills and experience are of importance in avoiding risks
How is laparoscopic hysterectomy done?
Laparoscopic surgery requires only a few small (about one cm long) incisions on your abdomen. A laparoscope inserted through one of these incisions allows the surgeon to see the pelvic organs. Other surgical instruments are used to perform the surgery through separate small incisions. A total of 3 or 4 incisions are used. Your uterus can be removed through your vagina
Points to remember
- Uterus is removed only when strongly indicated
ovaries may or may not be removed
When both ovaries are removed, you may go into menopause
laparoscopic route of hysterectomy is better in most gynaecological problems - Abdominal surgery can take from four to six weeks to recover.
Vaginal and laparoscopic hysterectomy can take from three to four weeks to recover