Hysterectomy: All you need to know

Hysterectomy: All you need to know

What is Hysterectomy?

Hysterectomy means the surgical removal of the uterus. In some cases, other accompanying organs such as the fallopian tubes, ovaries and cervix are often removed too, depending on the type of hysterectomy being performed. The procedure terminates menstruation and the ability to have a pregnancy. 

Hysterectomy is one of the most common types of elective surgeries for women. It is essential for women to be educated about it. One must also bear in mind that a hysterectomy is not a minor surgery and, in most cases, leads to drastic changes physically, mentally and in terms of lifestyle. It should not inevitably be chosen as the only treatment and only option for heavy menstrual bleeding. A hysterectomy should be reserved for cases only when conservative treatment options have not worked.

Types of Hysterectomy

• Supracervical hysterectomy: Removal of the upper part of the uterus leaving the cervix behind.
• Total hysterectomy: Removal of the uterus and cervix.
• Total hysterectomy with bilateral salpingo-oophorectomy: Removal of the uterus, cervix, fallopian tubes (salpingo) and ovaries (oophor).
• Radical hysterectomy with bilateral salpingo-oophorectomy: Removal of the uterus, cervix, fallopian tubes, ovaries, the upper portion of the vagina and some surrounding tissue and lymph nodes. A radical hysterectomy may be performed to take care of cervical or uterine cancer.

In what cases is Hysterectomy performed?

The majority of hysterectomies are performed to take care of conditions such as fibroids (growths inside the uterus), heavy bleeding, endometriosis, adenomyosis, uterine prolapse and cancer.

Very few would disagree with the efficacy of removing the uterus for cervical, uterine, or ovarian cancer, where hysterectomy can be life-saving. However, loads of other women have symptoms that, while not life-threatening, do have an effect on their general physical and emotional health and their capability to perform normal activities.

Are there alternatives to hysterectomy?

Absolutely. A hysterectomy is only one option amongst several options to treat problems affecting the uterus. For certain conditions, however, hysterectomy may be the best choice. Do solicit your doctor to discuss what alternatives are available to take care of your precise situation.

What are the various hysterectomy methods?

Abdominal hysterectomy

An abdominal hysterectomy is done when widespread exploration is necessary such as in the case of cancer, an inflamed uterus, and obesity or if the patient has not had children. Having fibroids, extensive adhesions or endometriosis are other cases where this method is often favored.

An abdominal hysterectomy can be executed through a bikini line cut which is made horizontally, directly above the pubic hairline or by way of a vertical incision which entails a cut from the navel to the pubic hairline. The bikini line method is more commonly chosen because it leaves a lighter scar and results quicker recovery.

The benefit of an abdominal hysterectomy is the lower occurrence of injury to the urinary tract and blood vessels. The drawback is that this method is usually more painful.

Vaginal hysterectomy

A vaginal hysterectomy entails making an opening in the upper portion of the vagina and taking out the uterus via the vagina. The advantages of this are a lesser amount of pain, a shorter hospital stay and the lack of a noticeable scar.

Laparoscopic hysterectomy

Used to describe a hysterectomy in which any part of the operation is performed laparoscopic, which involves making three or four small incisions in the abdomen. A laparoscope is an apparatus that allows the inside of the abdomen to be viewed and is inserted through one of the incisions into the abdominal cavity. The surgeon can then observe the pelvic organs on a monitor and place in surgical instruments through the remaining incisions.

Laparoscopic procedures are recommended to patients due to a shorter hospital stay and sometimes recovery time compared to an abdominal hysterectomy. The doctor must be experienced in the procedure for these benefits to be achieved.

Shortcomings of a laparoscopic hysterectomy are the possibility of a longer surgery time depending on how much of the operation is performed laparoscopic, increased costs and an increased risk of damage to the urinary tract. Patients considering a laparoscopic hysterectomy are advised to ask detailed questions about the surgeon's training and know-how in this particular procedure.

It is essential for women to make sure that they make their own judgment about whether to have a hysterectomy. This decision can be a complicated and emotional route. It is imperative for women to be well informed about the procedure so they can self-assuredly talk about all existing options with their gynecologist.