WHAT IS HYSTERECTOMY?

A hysterectomy is an operation to remove the uterus. This surgery may be done for different reasons, including:

  • Uterine fibroids that cause pain, bleeding, or other problems
  • Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal
  • Cancer of the uterus, cervix, or ovaries
  • Endometriosis
  • Abnormal vaginal bleeding
  • Chronic pelvic pain
  • Adenomyosis, or a thickening of the uterus
 

Hysterectomy for noncancerous reasons is usually considered only after all other treatment approaches have been tried without success.

Types of Hysterectomy

Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is important to clarify if the cervix and/or ovaries are removed:

  • A supracervical or subtotal hysterectomy removes only the upper part of the uterus, keeping the cervix in place.
  • A total hysterectomy removes the whole uterus and cervix.
  • A radical hysterectomy removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. Radical hysterectomy is generally only done when cancer is present.

The surgeon may remove the ovaries — a procedure called oophorectomy — or may leave them in place. When the tubes are removed that procedure is called salpingectomy. When the entire uterus, both tubes, and both ovaries are removed, the entire procedure is called a hysterectomy and bilateral salpingectomy-oophorectomy.

What is Hysterectomy done for?

A hysterectomy is a surgical procedure that removes the uterus. You lose the ability to become pregnant and no longer menstruate. Reasons for this surgery include abnormal bleeding, uterine prolapse, fibroids and cancer. Recovery usually takes four to six weeks, depending on the type of surgery you have.

There are two approaches to surgery: a traditional or open surgery and surgery using a minimally invasive procedure or MIP.

Surgical Techniques for Hysterectomy

Surgeons use different approaches for hysterectomy, depending on the surgeon’s experience, the reason for the hysterectomy, and the patient’s overall health. The hysterectomy technique will partly determine healing time and the kind of scar, if any, that remains after the operation.

There are two approaches to surgery: a traditional or open surgery and surgery using a minimally invasive procedure or MIP.

Open Surgery Hysterectomy

An abdominal hysterectomy is an open surgery. This is the most common approach to hysterectomy, accounting for about 54% for all benign disease.

To perform an abdominal hysterectomy, a surgeon makes a 5- to 7-inch incision, either up-and-down or side-to-side, across the belly. The surgeon then removes the uterus through this incision.

Following an abdominal hysterectomy, a person will usually spend 2-3 days in the hospital. There is also, after healing, a visible scar at the location of the incision.

 

Risks of Hysterectomy

Most people who get a hysterectomy have no serious problems or complications from the surgery. Still, a hysterectomy is major surgery and is not without risks. Those complications include:

  • Urinary incontinence
  • Vaginal prolapse (part of the vagina coming out of the body)
  • Vaginal fistula formation (an abnormal connection that forms between the vagina and bladder or rectum)
  • Chronic pain

Other risks from hysterectomy include wound infections, blood clots, hemorrhage, and injury to surrounding organs, although these are uncommon.

Hysterectomy Side Effects.

  • Blood loss and the risk of blood transfusion.
  • Damage to surrounding areas, like the bladder, urethra, blood vessels, and nerves.
  • Blood clots in the legs or lungs.
  • Infection.
  • Side effects related to anesthesia.
  • The need to change to an abdominal hysterectomy from one of the other techniques.