Hysterectomy

Hysterectomy refers to partial or complete removal of uterus via surgical procedure. On an annual basis, nearly 6,000,000 women in United States undergo this procedure for various indications. In some cases, ovaries, fallopian tubes and cervix are also removed as part of the extended surgical process to restrict the spread of disease. Hysterectomy is a major surgery that is performed under general anesthesia and depending upon primary indications, the risk of complications also increases a great deal.

What Are The Indications Of Hysterectomy Procedure?

There are numerous indications for which this procedure is performed in women. Based on the results of a new survey, most common indications for undergoing hysterectomy procedure in the United States are:

• Cancer

• Uterine fibroids, a non-cancerous growth along the uterine walls
• Uncontrolled, abnormal uterine bleeding
• Chronic pain
• Slipping of uterus into the vagina (uterine prolapse)
• Endometriosis – tissues starts to grow outside the uterine wall and ovaries instead of endometrium
• Adenomyosis - tissues that make lining of uterus, grows inside the uterus walls

Are There Any Alternatives To This Procedure?

There are other options also available to address the symptoms of above mentioned conditions for example, uterine prolapse can be managed via special products like vaginal pessary that holds the uterus in place. Excessive pain and abnormal bleeding can be controlled with the help of birth control pills. Usually uterine fibroids resolve on their own after the menopause; however, some cases especially cancerous growths may require hysterectomy and there is no other choice.

Depending upon the severity of symptoms, sometimes smaller surgical procedures can also be performed. These procedures are less invasive compared to this procedure.

Types Of Hysterectomy

Depending upon the extent of tissue manipulation, this procedure can be divided into two major categories:

• Partial

This surgical procedure is also known as supracervical or subtotal hysterectomy. During this surgical process, only the upper portion of uterus is removed without excising the cervix. Sometimes ovaries are also removed as part of partial hysterectomy procedure.

• Total

As the name indicates, entire uterus along with the cervix is removed. Depending upon the physical condition of patient, ovaries and fallopian tubes are also removed.

• Radical

Radical hysterectomy involves removal of whole uterus and cervical tissues present on both sides. This type of procedure is performed when there is a cancerous growth. Fallopian tubes and ovaries are also removed.

How It Is Performed?

As discussed previously, it is a major surgical procedure that requires general anesthesia. There are different ways of performing hysterectomy, including:

• Lower abdominal surgical approach
• Per-vaginal approach (in which instruments are passed all the way up through the vagina)
• Laparoscopic approach (in which numerous small incisions are made in the abdomen and a scope (or instruments) are inserted through these holes)

Hysterectomy And Recovery

Usually it takes 6 weeks to get fully recovered from hysterectomy. Following are the symptoms that may be experienced:

• Increased risks for heart diseases and bone loss
• Urinary incontinence, more commonly experienced when both ovaries are removed.
• No more periods due to removal of uterus. A woman can experience symptoms of menopause if her ovaries are removed
• Loss of libido or sex drive
• Depression is expected especially if woman is young due to hormonal imbalance.

Some females also opt for hormone replacement options after this procedure. Speak to your healthcare provider if you are considering hysterectomy.

References

• Aarts, J. W., Nieboer, T. E., Johnson, N., Tavender, E., Garry, R., Mol, B. W. J., & Kluivers, K. B. (2015). Surgical approach to hysterectomy for benign gynaecological disease. The Cochrane Library.
• Corona, L. E., Swenson, C. W., Sheetz, K. H., Shelby, G., Berger, M. B., Pearlman, M. D., ... & Morgan, D. M. (2015). Use of other treatments before hysterectomy for benign conditions in a statewide hospital collaborative. American journal of obstetrics and gynecology, 212(3), 304-e1.
• Vijay, N. S. (2014): Indications, Route of Surgery & Techniques: An Overview. EC Gynaecology, 1, 1-2.