Hysterectomy-removal of the uterus

What is a hysterectomy?

Hysterectomy means removal of the uterus (womb). A hysterectomy can be combined or not with the removal of the fallopian tubes and one or both ovaries. The removal of a tube and ovary is called salpingo-oophorectomy, and the two tubes and ovaries is called bilateral salpingo-oophorectomy.

There are different types of hysterectomy described as the organs are removed.

• A total hysterectomy is the most common operation and indicates the removal of the uterus and cervix (this is the lower part of the uterus, and contact with the bottom of the vagina).
• A partial hysterectomy (subtotal) indicates the removal of the body of the uterus, leaving the cervix.
• A radical hysterectomy involves removing the uterus, cervix, a small portion of the top of the vagina and some connective tissue (tissue that serves as a union between organs) of the pelvis. A radical hysterectomy is only performed in cases of cervical cancer and gynecologists who have received special training.

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When hysterectomy is necessary?

Hysterectomy is one of the most common gynecological procedures. A hysterectomy is almost always necessary if cancer is diagnosed cervical or uterine cancer and is usually recommended if there is ovarian cancer .

However, most of hysterectomies are performed on women who do not have cancer, but in which uterine bleeding or pain they cause so many difficulties that they want to operate. In such cases, a hysterectomy is only appropriate for women who do not want children in the future.

A hysterectomy is usually a valid option for women with fibroids, endometriosis, pelvic inflammatory disease or heavy periods with no explanation. If a woman has uterine prolapse (descent and partial or full exit the uterus through the vagina) you can perform a hysterectomy as part of the prolapse repair operation. A special case is that urgent hysterectomy performed after a normal delivery or cesarean section because of complications, usually bleeding, which sometimes arise.

The most common indication for hysterectomy is uterine myomas (fibroid).

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How is hysterectomy done?

Hysterectomy is a major surgical procedure and is performed under general anesthesia. Besides the different types of hysterectomy, there are different ways in which the gynecologist can perform the operation. This may be influenced by the reason to hysterectomy first uterine size and the experience and preference of the individual gynecologist.

The differences between them are specified in terms of time of hospitalization, economic costs and time needed for a full recovery. Thus, the abdominal hysterectomy requires more days in hospital after the operation, its costs are greater and the recovery is slower. Vaginal hysterectomy along with laparoscopic assisted vaginal hysterectomy are those that require less hospitalization time, recovery is faster and generally have fewer complications.

• Abdominal hysterectomy is the most common method and is performed by a scar of about fifteen centimeters in the lower abdomen.
• A vaginal hysterectomy is performed through the vagina and leave no visible external signs that the woman has undergone an operation.
• In a vaginal hysterectomy assisted by laparoscopy (LAVH), endoscopic surgery gynecologist used in combination with surgery through the vagina to complete the operation.

How did you feel after a hysterectomy?

Strong painkillers for the first days after the operation was prescribed. women are encouraged to move in the first 24 hours after surgery and usually also eat and drink during this time. Most women stay in the hospital three to five days after routine hysterectomy.

It is advisable to plan four to six weeks of convalescence after hysterectomy, although the recovery time can vary from one woman to another. The recovery time is often shorter if there has been a vaginal hysterectomy or LAVH compared with abdominal hysterectomy. The recovery time is longer after radical hysterectomy. The emotional response after a hysterectomy vary greatly from one woman to another, often depending on the reason for the intervention. Usually there will be sense of relief that the menstrual pain and discomfort of periods a thing of the past with the impression that they can continue their lives in a more positive way. Women diagnosed with cancer are often very restless, rightly, on the success of the surgery, and may be concerned about the need for other forms of treatment designed to prevent relapse.

For some women there is a sense of loss, since the place where their children were born and developed it is gone forever. Whatever the emotional response it is advisable that women express their anxieties and feelings to someone you can trust, whether a relative, a friend or more properly your gynecologist who will provide accurate and necessary support information that enable it to adapt to the new situation by avoiding the tendency to depression in some patients arises.

What are the risks of a hysterectomy?

No surgery is without risk. A hysterectomy is a major operation, but most women who suffer not suffer complications. If a woman is overweight, weight loss before hysterectomy may facilitate operation and reduce the risk of postoperative complications. Complications arise from time to time and these include:

• Severe bleeding at the time of the intervention.
• Surgical damage to the bladder or ureters (the tubes that carry urine from the kidneys to the bladder) or other organs in the vicinity of the uterus.
• After surgery, infection involving the surgical wound or bladder ( cystitis ). It may require treatment with antibiotics.
• A serious but rare complication is the development of clots in the veins of the legs (venous thrombosis) or the pelvis with the risk of their migration to pulmonary or cerebral territory causing serious injury or death.

Will it affect hysterectomy sex life?

Most women do not experience adverse effects on their enjoyment of sex . Often the opposite is true, with improving your sex life, especially if bleeding was prolonged and the uterus causing pain during intercourse . Most women can have sex after six weeks of hysterectomy relations.

Will you need to start hormone replacement therapy after a hysterectomy?

If a woman has not gone through menopause ( menopause ) and have their ovaries removed at the time of hysterectomy, usually this hormonal treatment will be recommended to avoid hot flashes, the rest of the wide range of symptoms suffered by women and even Most importantly in their health, the prevention of osteoporosis (softening of bones) and cardiovascular problems .

If the ovaries are not removed, they will continue producing the female hormone (estrogen) and this hormone replacement therapy is not necessary.

Will you need to get a cervical cytology (Papapanicolau) after a hysterectomy?

If there was no cancer before hysterectomy and the cervix has been removed, there is no need for further smears . If there has been a partial hysterectomy (subtotal) and remains part of the cervix, it is necessary to continue the review program of cervical cytology.

Are there alternatives to hysterectomy?

In the presence of certain cancers, there is rarely a realistic alternative to hysterectomy. Non-cancerous conditions, hysterectomy is usually offered when treatment with pills or other surgical procedures have been tried and have failed.

For women with heavy periods with no explanation, surgical techniques that attempt to remove or destroy the lining of the uterus (endometrial ablation) can provide relief of symptoms without resorting to more serious surgery. It should be remembered that a hysterectomy or endometrial ablation procedure is only suitable for a woman who does not want to become pregnant in the future.

When there is a more or less severe vaginal bleeding and the cause of this is the presence of fibroids in the uterus may opt for the conservative attitude as is the removal of such preserving the uterus. This is especially important in young women who want to have children.