Hysterectomy is the surgical removal of the uterus. It ends menstruation
and the ability to become pregnant. Depending on the reason for the surgery, a
hysterectomy may also involve the removal of other organs and tissues, such as
the ovaries and/or fallopian tubes.
Your health care provider might recommend
a hysterectomy if you have
·
Fibroids. Many
hysterectomies are done to permanently treat these benign tumors in your uterus
that can cause persistent bleeding, anemia, pelvic pain, and pain during
intercourse and bladder pressure. For large fibroids, you might need surgery
that removes your uterus through an incision in your lower abdomen (abdominal
hysterectomy).
·
Endometriosis. This
occurs when the tissue lining your uterus (endometrium) grows outside the
uterus, involving the ovaries, fallopian tubes or other organs. Most women with
endometriosis have a laparoscopic or robotic hysterectomy or abdominal
hysterectomy, but sometimes a vaginal hysterectomy is possible.
·
Adenomyosis. This
occurs when the tissue that normally lines the uterus grows into the uterine
wall. An enlarged uterus and painful, heavy periods result.
·
Gynecological cancer. If
you have cancer of the uterus, cervix, endometrium or ovaries, or precancerous
changes, your doctor might recommend a hysterectomy. Most often, treatment for
ovarian cancer involves an abdominal hysterectomy, but sometimes vaginal
hysterectomy is appropriate for women with cervical or endometrial cancer.
·
Uterine prolapse. When
pelvic supporting tissues and ligaments weaken or stretch out, the uterus can
sag into the vagina, causing urine leakage, pelvic pressure or difficulty with
bowel movements. Removing the uterus and repairing supportive tissues might
relieve those symptoms.
·
Abnormal uterine bleeding. When
medication or a less invasive surgical procedure doesn't control irregular,
heavy or very long periods, hysterectomy may be needed.
·
Chronic pelvic pain. If
your pain is clearly caused by a uterine condition, hysterectomy might help,
but only as a last resort. Chronic pelvic pain can have several causes, so an
accurate diagnosis of the cause is critical before having a hysterectomy.
Types of Hysterectomy
- Partial Hysterectomy – removes the body of
the uterus while the cervix is left in place.
- Total or Simple Hysterectomy – removes the
entire uterus and cervix.
- Hysterectomy with Bilateral Salpingo-Oophorectomy
– removes the uterus, cervix, and fallopian tubes.
- Radical Hysterectomy – removes the uterus,
cervix, ovaries, fallopian tubes and possible upper portions of the vagina
and affected lymph glands.
Are there alternatives to hysterectomy?
Depending on your condition,
you may want to try other options first that do not involve surgery or to
“watch and wait” to see if your condition improves on its own (American
College of Obstetricians and
Gynecologists, 2018). Some women wait to have a hysterectomy until after they
have completed their families. If you choose another option besides
hysterectomy, keep in mind that you may need additional treatment later.
Risks
Although vaginal hysterectomy is generally safe, any
surgery has risks. Risks of vaginal hysterectomy include:
- ·
Heavy bleeding
- ·
Blood clots in the legs or lungs
- ·
Infection
- ·
Damage to surrounding organs
- ·
Adverse reaction to anesthetic
Severe endometriosis or scar tissue (pelvic adhesions)
might force your surgeon to switch from vaginal hysterectomy to laparoscopic or
abdominal hysterectomy during the surgery.
Except in cases of suspected
uterine cancer, the surgeon might cut an enlarged uterus into smaller pieces
and remove it in sections (morcellation).
What
should I expect after having a hysterectomy?
According
to the American College of Obstetricians and Gynecologists, 2018, you
can expect to have some pain for the first few days after the surgery. You will
be given medication to relieve pain. You will have bleeding and discharge from
your vagina for several weeks. Sanitary pads can be used after the surgery.
Constipation is common after most hysterectomies.
Some women have
temporary problems with emptying the bladder after a hysterectomy. Other
effects may be emotional. It is not uncommon to have an emotional response to
hysterectomy. You may feel depressed that you are no longer able to bear
children, or you may be relieved that your former symptoms are gone
What are some important things I should know about recovery?
Follow your health care
professional's instructions. Be sure to get plenty of rest, but you also
need to move around as often as you can.
- ·
Take short walks and gradually
increase the distance you walk every day.
- ·
You should not lift heavy objects
until your doctor says you can.
- ·
Do not put anything in your vagina
during the first 6 weeks. That includes douching, having sex, and using tampons
After you recover,
you should continue to see your health care professional for routine
gynecologic exams and general health care. Depending on the reason for your
hysterectomy, you still may need pelvic exams and cervical cancer.
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