Hysterectomy is the surgical removal of the uterus, or womb. Depending upon the type of procedure that is performed and the reason for the surgery, hysterectomy may also include removal of the adjacent Fallopian tubes and ovaries.
Hysterectomy is the most common major surgical procedure (unrelated to pregnancy) performed on women. Approximately 300 out of every 100,000 women will undergo a hysterectomy. The most common reason hysterectomy is performed is for uterine fibroids. The other reasons include abnormal vaginal bleeding, endometriosis and uterine prolapse. The choice of types of surgical procedures depends upon the reason for the procedure and the underlying medical condition of the patient. A hysterectomy is a major decision that patient should take after careful consultation with doctor. Patient should understand the reason for the operation, the benefits and risks and the alternatives to a hysterectomy.
Prior to the decision of a hysterectomy, the pelvic examination and Pap smear tests are must. For pelvic pain laparoscopy procedures are commonly undertaken. Removal of uterus is major decision and extensive evaluations are necessary before finalizing this procedure.
There are 4 different methods for removal of the uterus. These include:
1.Total abdominal hysterectomy
The doctor removes the uterus, including the cervix though incision from the abdomen. The scar may be horizontal or vertical, depending on the reason the procedure is performed, and the size of the area being treated.
The uterus is removed through the vagina. It is an appropriate hysterectomy procedure for uterine prolapse, endometrial hyperplasia, or cervical dysplasia.
3.Laparoscopy-assisted vaginal hysterectomy
Laparoscopy-assisted vaginal hysterectomy (LAVH) is similar to the vaginal hysterectomy procedure conducted with the use of a laparoscope. A supra-cervical hysterectomy is used to remove the uterus; the cervix is maintained. It is a simpler procedure and requires less time to perform.
All these procedures are conducted under spinal or general anaesthesia and taken usually 2- 4 hours depending in the type of procedure, size of the uterus and other related issues.
Hysterectomy is a treatment option in the treatment of uterine cancer, cervical cancer as well as for some benign conditions such as fibroids and endometriosis which results in abnormal bleeding, pelvic pain and discomfort to the patient.
Like any surgery, patient must discuss all the health concerns with the doctor prior to the procedure. Young women must recognize that after hysterectomy, they can bear children and must evaluate all the pros and cons prior to the surgery. Patient’s diagnosis with uterine cancer needs follow up treatment for cancer. All the physiological parameters of the patient must be stable at the time of surgery. Post-surgery patient must take sufficient rest and should not lift heavy weights, join strenuous exercise programmes. Patient should join back normal activities only after the advice from clinician.