Hysterectomy Procedure | Why & How?

Hysterectomy Procedure | Why & How?

Hysterectomy is a surgical procedure that is ideal for the removal of the uterus. However, you may need a hysterectomy procedure for many other reasons too. The surgery also targets a number of chronic pain conditions as well as certain types of cancer and infections that are treatable using minor surgical procedures. The most frequent reason for hysterectomy in women is removal of fibroid tumors. Fibroid tumors are non-cancerous (benign) growths in the uterus that can cause pelvic, low back pain, and heavy or lengthy menstrual periods. Treatment of endometriosis is also one of the other common reasons for a hysterectomy. When a woman has heavy or abnormal vaginal bleeding with no specific cause and is uncontrollable by other means, hysterectomies prove to be useful to diagnose and treat such conditions.

The scope of a hysterectomy varies depending on the reason for the surgery. The doctor may also remove the ovaries and the fallopian tubes during the procedure. The ovaries are the organs that produce estrogen and other hormones. The fallopian tubes are the structures that transport the egg from the ovary to the uterus.

Patients with mild uterine prolapse normally do not require surgical treatment since they are usually asymptomatic. However, when symptoms occur, many patients initially opt for conservative treatment. Considering your age and whether you wish to have children in the future, certain surgeries can repair the uterus or remove it. When indicated, and in severe cases, your uterus can be removed using hysterectomy. Once you’ve had a hysterectomy, you’ll stop having menstrual periods. You’ll also be unable to get pregnant.

Why is hysterectomy done?

Hysterectomy is useful in treating many health conditions related to women. Some of these conditions include the following:

  • Uterine fibroids (the most common reason for hysterectomy)
  • Endometriosis
  • Pelvic support problems (such as uterine prolapse)
  • Abnormal uterine bleeding
  • Chronic pelvic pain
  • Gynaecologic cancer

Are there alternatives to hysterectomy?

In case you have the option to avoid going through a hysterectomy, there are many alternate options to explore that will take care of heavy bleeding, endometriosis, polyps and fibroids.

Current treatment options include:

  • Medical/hormonal management
  • D&C and hysteroscopy
  • Endometrial ablation
  • MRI–guided focused ultrasound (MRgFUS)
  • Laparoscopy and endometriosis excision
  • Myomectomy
  • Uterine artery embolization (UAE)

What structures are removed during a hysterectomy?

Total hysterectomy deals with the removal of the uterus and cervix. However, in certain cases when the procedure involves removing the Fallopian tubes and ovaries along with the uterus, it is known as a hysterectomy with bilateral salpingo-oophorectomy. On the other hand, a subtotal hysterectomy deals with removing only the uterus. A radical hysterectomy facilitates the removal of the uterus, cervix, ovaries, oviducts, lymph nodes and lymph channels. The type of hysterectomy performed depends on the reason for the procedure. The most significant effect of a hysterectomy is that menstruation permanently stops and the woman is no longer able to bear children.

How is a Hysterectomy Performed?

Abdominal Hysterectomy

During an abdominal hysterectomy, your doctor removes the uterus through a large cut in your abdomen. The incision may be vertical or horizontal. Both types of incisions tend to heal well and leave little scaring.

Vaginal Hysterectomy

During a vaginal hysterectomy, the surgeon makes a small incision inside the vagina for uterus removal. There are no external cuts, so there won’t be any visible scars.

Laparoscopic Hysterectomy

During a laparoscopic hysterectomy, your doctor uses a tiny instrument called a laparoscope. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The surgeon inserts this instrument through small incisions made in the abdomen. Three or four small incisions are made instead of one large incision. Once the surgeon can see your uterus, they’ll cut the uterus into small pieces and remove one piece at a time.

Laparoscopic-assisted vaginal hysterectomy

LAVH allows surgeons to perform a vaginal hysterectomy that might otherwise be too difficult to perform vaginally. The hospital stay is usually only one day and recovery time is about two weeks. Because of the short hospital stay and minimally invasive nature of the surgery this technique is really gaining in popularity.

Hysterectomy is a relatively safe operation, although like all major surgery it carries risks. Although there are some concerns that go with any major surgery, there are many conditions for which the operation generally improves a woman’s quality of life, corrects moderate or severe painful symptoms ensuring that they feel better mentally, physically, and sexually after the operation.

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