Hysterectomy Important information about this type of surgery

Hysterectomy is the removal of the uterus in women. Sometimes, for the treatment of some diseases, there is no solution left for the doctor, except to remove the uterus and in some cases the ovary. In this article, we discuss hysterectomy, its methods, post-operative care, complications and risks of hysterectomy.

Reasons for performing hysterectomy surgery

1. Uterine fibroids, which are actually non-cancerous lumps in the uterine wall, can cause severe menstrual pain or bleeding in some women.
2. Heavy or unusual menstrual bleeding: Hormonal changes, infection, cancer or fibroids can lead to continuous and heavy bleeding (find out what causes fibroids).
3. Uterine prolapse: Uterine prolapse, which is actually the sliding of the uterus from its usual place into the vagina, is more common among women who have had several natural births, and may also occur after menopause or due to obesity.
4. Endometriosis: This disease occurs when the uterine tissue grows outside the uterus and on the ovaries and can cause severe pain and bleeding and spotting between periods.
5. Adenomyosis: In adenomyosis, uterine tissue starts to grow inside the uterine wall and can cause thickening of the uterine wall and severe pain and bleeding.
6. Cancer: uterine cancer, ovarian cancer or cervical cancer. If one of the areas of the ovary, uterus, endometrium or cervix has cancer, hysterectomy is usually the best treatment option.

Preparing for hysterectomy

Before performing a hysterectomy, the doctor should talk to the patient about its risks and complications and discuss any alternatives to hysterectomy. A complete physical examination including blood tests is essential before surgery. In some cases, imaging studies (such as ultrasound, CT scan, or MRI) will be performed before surgery. If necessary, an endometrial biopsy (removal of tissue inside the uterus) may be performed to diagnose cancer or precancerous conditions of the uterine tissue. Fasting before the operation may be necessary depending on the type of procedure chosen and the type of anesthesia. Be sure to consult your doctor about this.

 

Types of hysterectomy procedures

All hysterectomy procedures are performed in the operating room of the hospital under local anesthesia or anesthesia. Different methods are used in hysterectomy. Creating standard surgical incisions is necessary in some of these procedures. While other methods such as myomectomy surgery are mainly performed through laparoscopy with small abdominal incisions to insert the laparoscope and other surgical instruments.

1) Full abdominal hysterectomy

In this hysterectomy method, the main incision is made on the abdomen. In this procedure, the uterus and cervix are removed through a 6- to 8-inch abdominal incision.

2) Supra-cervical or sub-total hysterectomy

In this surgical procedure, the uterus is removed, but the cervix remains intact. This operation can be performed laparoscopically or through standard surgical incisions.

3) radical hysterectomy (wide)

As its name suggests, this method covers a wider area than similar methods. Radical hysterectomy is used in the treatment of cancer and during it, some tissues around the uterus are removed. This work is usually done through an abdominal incision, but it can also be done by laparoscopic or robot-assisted laparoscopic methods.

4) vaginal hysterectomy

In vaginal hysterectomy, the uterus and cervix are removed through an incision in the upper part of the vagina. In many cases, the tubes and ovaries can also be removed through the vagina.

5) Laparoscopic hysterectomy

During this operation, the uterus is removed with laparoscopic techniques. In this procedure, several very small incisions are made below the navel area to insert the laparoscope and surgical instruments. The abdominal cavity is filled with a gas (usually carbon dioxide) so that the surgeon can see the abdominal organs better and more clearly. Then the uterus is removed vaginally or through small abdominal incisions. Laparoscopic hysterectomy will have much less complications after the operation than other methods.

6) Laparoscopic vaginal hysterectomy

This method is the same as vaginal hysterectomy, this time it is performed with the help of laparoscopic techniques.

7) Oophorectomy

This is a surgical procedure to remove one or both ovaries in women. Oophorectomy is a surgical procedure that aims to remove the ovaries and fallopian tubes. This procedure may be performed at the same time as hysterectomy.

Complications of hysterectomy

1) Complications of abdominal hysterectomy

Abdominal hysterectomy is performed when there is adhesion or the uterus is very large. However, abdominal hysterectomy has more complications than vaginal hysterectomy or laparoscopic hysterectomy, which include infection, bleeding, blood clots, and damage to tissues and nerves. Abdominal hysterectomy usually requires more hospital stay and longer recovery time than vaginal hysterectomy or laparoscopic hysterectomy.

2) Complications of laparoscopic hysterectomy

Compared to abdominal hysterectomy, laparoscopic hysterectomy surgery has less pain, less risk of infection, and shorter hospital stay. You can return to your daily activities faster. Among the complications of laparoscopic hysterectomy, it can be mentioned that the duration of surgery is longer compared to abdominal hysterectomy or vaginal hysterectomy. There is also a possibility of damage to the urinary tract and other organs in this surgery.

3) Complications of vaginal hysterectomy

Vaginal hysterectomy has fewer complications than abdominal hysterectomy or laparoscopic hysterectomy. The recovery time is less compared to the abdominal hysterectomy method and it is the first choice for hysterectomy.

Care after hysterectomy

Post-hysterectomy care varies from person to person, primarily depending on which hysterectomy procedure was used to treat you. Also, how much of your internal organs need to be removed is important in post-operative care.

For example, a person who has a part of his uterus removed laparoscopically to treat chronic bleeding will surely recover sooner than patients who have used the conventional method of hysterectomy to treat ovarian cancer and uterine cancer. Because in the second case, it is more difficult to perform surgery and difficult conditions cause significant fatigue, pain and mental and physical stress.

Most hysterectomy patients return home within 48 hours after the surgery with pain relief medication prescribed. Patients who have undergone laparoscopic surgery are able to resume their activities within two weeks after surgery. In case of open surgery with larger incisions, patients need six to eight weeks to recover and face more restrictions due to larger incisions. These patients should not lift heavy objects for at least six weeks after the operation.

Regardless of the type of hysterectomy, patients should avoid baths and swimming for at least six weeks after surgery. In addition, some discharge is expected to pass during the recovery period, but heavy bleeding and unexplained purulent discharge should be reported to your doctor immediately.

Most women will be able to have pain-free intercourse after six to eight weeks. Of course, you should consult your surgeon about the most appropriate time to have sex.