Hysterectomy

Overview

In cases of fibroids, endometriosis, prolapsed uterus, and some gynaecological cancers, the doctors recommend hysterectomy as a viable treatment option. This procedure can involve the total removal of the uterus and cervix or partial removal where the cervix remains intact while the uterus is removed. A radical hysterectomy is performed to remove tissues around the uterus for cancer control.

Through a direct abdominal operation or a vaginal one, or using a minimally invasive laparoscopic technique, hysterectomy is carried out. The recovery duration also depends on the type of surgery, but normally it takes 2-8 weeks to get better. Removal of the ovaries will affect fertility and lead to hysterectomy if they have been removed.

What is Hysterectomy?

Hysterectomy also known as removing the uterus is a surgical operation for treating many female genitourinary system diseases. It is employed for women's health conditions like uterine fibroids, endometriosis, ovarian cysts, prolapsed uterus, chronic pelvic pain or gynaecological cancers. This procedure can be done by open abdominal or vaginal, or by using minimally invasive surgical procedures such as laparoscopy. The patient should consult a doctor about undergoing a hysterectomy as it results in the cessation of menstruation and childbearing.

Types of Hysterectomy

There are different types of hysterectomy which are discussed below:

Total Hysterectomy

The total hysterectomy involves the removal of both the uterus and cervix. This is common and carried out for conditions like uterine cancer, fibroids or severe endometriosis. Cervix removal means that the patient will not have menstruation again in their lifetime.

Subtotal (or Supracervical) Hysterectomy

In subtotal hysterectomy, the uterus is removed but the cervix is not removed. They can do this for some conditions that may require a change in the uterus but not the cervix like fibroids, or abnormal bleeding. Some women opt for it to maintain pelvic support and certain functions of the cervix.

Radical Hysterectomy

It is the removal of the cervix, uterus, and parts of the vagina, and also the fallopian tubes, ovaries, and lymph nodes if needed. This is usually done when there is cervical or uterine cancer. It is an even more complicated process and may take longer to heal.

Laparoscopic (Minimally Invasive) Hysterectomy

In a laparoscopic or minimally invasive hysterectomy, a small camera system is inserted through three or four small incisions. This type usually leaves smaller scars, causes less pain, and heals faster than other conventional abdominal surgery.

Symptoms of Hysterectomy

Some of the symptoms that women are likely to develop after a hysterectomy depend on the type of surgery undergone and their health status. The common side effects seen shortly after surgery include pain, bruising and swelling in the lower abdomen or the vaginal area. These symptoms are not acute instead they gradually improve with time. Some women may also develop a discharge from the vagina for a few weeks while the uterus is being healed.

After the hysterectomy, if the ovaries are taken out, a woman can face menopausal symptoms such as hot flushes, mood swings and vaginal dryness. However, even if the ovaries are left intact, hormonal fluctuations may manifest, including abnormal periods, or early menopause. Some women may feel the change in their emotions and even exhibit mood swings or feel helpless if the hysterectomy affects the issue of childbearing. Some individuals may have issues with body image or they develop depression during the time of the recovery period.

Causes of Hysterectomy

A hysterectomy can be performed because of several medical indications. However, the most common indication is when standard treatment methods cannot be formulated or fail to provide a solution. Uterine fibroids or benign tumours in the uterus are one of the prime reasons for hysterectomy including heavy bleeding, pain and pressure in the pelvic area. If the fibroids grow and cause problems then surgical intervention may be required. Endometriosis is a health condition where endometrial-like tissue forms out of the uterus resulting in severe pain and ministration of fertility. This is another cause of performing a hysterectomy.

Hysterectomy Diagnosis and Tests

The first tests conducted in cases of a hysterectomy involve a pelvic exam. While doing the exam the doctor may palpate for lumps or pain in the uterus the cervix and the vaginal area. Moreover, it is applied to define such conditions as uterine fibroids, ovarian cysts or any other change in the uterus and ovaries. A doctor may also call for an MRI to get better insight into the conditions such as endometriosis or pelvic organ prolapse.

In case of cancer suspicion, the tissue samples from the uterus, cervix or other areas are collected for diagnosis. A pap smear can enable a woman to know when she is affected by cervical cancer. Furthermore, blood tests may be useful for determining the hormonal balance and checking anaemia, a characteristic condition leading to a hysterectomy. It helps the doctor to know the best action to take including whether the patient should go ahead with the hysterectomy or not.

Hysterectomy Management and Treatment

Management and treatment of hysterectomy require following a patient-centred and appropriate cumulative treatment planning. Patients also need to do numerous tests including imaging and blood work to determine whether the patient is a candidate for a hysterectomy. This is because counselling and discussions of fertility issues, hormone treatments and all the psychosocial aspects surrounding the surgery are crucial.

Hysterectomy can be done in three methods; abdominal, vaginal or laparoscopic. Consequently, patients are observed for infection or complications after the surgery. It is necessary to take painkiller drugs, stay in bed, and follow a healthy diet. Furthermore, counselling plays an important role in patient care to allow them to come to terms especially if they are not able to bear a child.

Preventive Measures of Hysterectomy

Some of the interventions that can be taken to avoid hysterectomy include screening, diagnosis and control of diseases that affect fertility. Pap smears and pelvic exams in healthy and sexually active women are conducted to identify cervical cancer or fibroids. Incorporation of a proper diet, a good exercise regime and a healthy body weight will effectively help you avoid associated diseases such as fibrosis, or pelvic organ prolapse, which are major reasons for hysterectomy.

Underlying health conditions also need to be managed such as diabetes or hormonal disorders. Girls who had an earlier family history of gynaecological cancer or those with high risk can undergo genetic counselling and early check-ups to identify signs of such diseases.

Myths and Facts Related to Hysterectomy

Some of the most common myths and facts related to hysterectomy include the following:

Myth 1: Gynaecological Problems Can Only Be Solved by Hysterectomy
Fact: Hysterectomy is a treatment that is needed when a woman has been diagnosed with a disease such as uterine cancer, fibroid or endometriosis. Most of the ailments can be controlled and treated by using medications, hormones, or minimally invasive surgeries.

Myth 2: A Hysterectomy Will Cause Menopause Right Away
Fact: Menopause is possible only when the ovaries are removed during the procedure. If the ovaries remain in the body, the patient may not experience a menopausal period right away. They may have certain hormonal alterations.

Myth 3: Hysterectomy is Uncomfortable with Long Recovery Times and Most of the Time, It Has Very Dangerous Consequences
Fact: Of course any surgery is risky. However, it has been proven that hysterectomy is not a very risky surgery anymore. It needs to be done in a hospital that uses modern technology. Techniques such as laparoscopic hysterectomy are preferred for patients since they lead to shorter rehabilitation periods than open surgery procedures.