Hysterectomy is a surgical method in which the uterus of a woman is removed. Sometimes, the ovaries and fallopian tubes are also removed.
The uterus also referred to as the womb, is where a baby grows inside their mother.
Once a woman has had a hysterectomy, she will no longer menstruate and cannot become pregnant.
Indications
Your doctor may suggest you undergo a hysterectomy if you have the following conditions:
- Uterine fibroids
- Endometriosis not cured by medicine or surgery
- Uterine prolapse - when the uterus descends into the vagina
- Cancer of the uterus, cervix, or ovaries
- Vaginal bleeding that continues despite treatment
- Chronic pelvic pain
Types of Hysterectomy
Types of Hysterectomies include Partial, Total or Radical Hysterectomy.
Partial or supracervical hysterectomy is where the upper part of the uterus is removed, but the cervix is left in place.
A total hysterectomy involves removal of both the uterus and cervix. Radical hysterectomy is usually done in cases of cancer and involves removal of the uterus, tissue on the sides of the uterus, the upper part of the vagina, and the cervix.
Salpingo-oophorectomy (removal of tubes and ovaries) may be performed along with hysterectomy in postmenopausal women, women with a strong family or personal history of gynecologic cancer, or cases of cancer or infection. The fallopian tubes alone may be removed in premenopausal women.
Bilateral oophorectomy is where the ovaries on both sides of the uterus are removed. This results in menopause right away from the sudden drop in hormone levels.
Procedure
There are various ways to perform a hysterectomy. The route of the procedure is based on individual clinical conditions which guide the surgeon in selecting the best approach. For example, a vaginal approach may be best for uterine prolapse, abdominal for large fibroids and laparoscopic for endometriosis.
Abdominal hysterectomy is where the incision is made through the skin and tissue in the lower abdomen to reach the uterus.
Laparoscopic hysterectomy uses a laparoscope to guide the surgery. A laparoscope is a thin, lighted tube that is inserted into the abdomen through a tiny incision in or around the umbilicus (belly button) which allows the surgeon to view the internal pelvic organs on a monitor.
Total laparoscopic hysterectomy is a method where the entire uterus is removed in small pieces either through tiny incisions or through the vagina.
Laparoscopic-assisted vaginal hysterectomy uses a laparoscope to guide the surgery and the uterus is removed through the vagina.
Robotic-assisted laparoscopic hysterectomy uses a robot attached to instruments to help perform the surgery through tiny incisions with a laparoscope.
Vaginal hysterectomy is a method where the uterus is removed through the vagina. As the incision is made inside the vagina, healing time may be less than with abdominal surgery
Post-operative Care
Your recovery depends on the type of surgery performed and the progress of your healing. You will be prescribed pain medications to keep you comfortable and antibiotics to prevent infection.
You will be instructed to get adequate rest and avoid heavy lifting after your surgery. You can continue normal activities once the pain, bleeding, and abdominal pressure has resolved. Sexual activity can be resumed after about six weeks following surgery. Exercises should be avoided until 3 weeks after surgery.
Recovery and return to activities of daily living are earlier in cases of women who have undergone vaginal hysterectomy when compared to women who have undergone an abdominal hysterectomy.
Dr. Davila is considered an expert in vaginal surgery, and the performance of vaginal hysterectomy..
Complications
Most women recover without any complications from the surgery. However, Risks and Complications associated with hysterectomy surgery can include the following:
- Infection
- Bleeding
- Blood clots
- Urinary incontinence: loss of bladder control
- Vaginal prolapse: a condition in which the vagina protrudes from the vaginal opening.
- Chronic pain
- Bladder or ureter injury
- Painful intercourse
- Early menopause if ovaries were removed
Call your doctor if you experience any of the following signs:
- Heavy vaginal bleeding
- Pain, redness, swelling, or discharge around the incisions
- Fever over 101° F
- Nausea and vomiting
- Shortness of breath
