What is Hysterectomy?

Hysterectomy is the surgical removal of the uterus, together with either the cervix or ovaries if required. Hysterectomy is one of the most commonly performed surgical operations done on women.

A hysterectomy is a surgery that removes a woman’s uterus and sometimes her ovaries and cervix. This procedure is often performed as a result of uterine problems like abnormal bleeding not responding to medication. This surgery can also be used as an treatment for cancer in the uterus, ovaries or cervix, or as treatment for uterine prolapse, fibroids or endometriosis.

If you have been advised to undergo a hysterectomy operation then it's important that you discuss the risks and benefits of this surgery and other possible alternative treatment options.

Why is a hysterectomy performed?

It is usually performed as a treatment for:
  • A condition called uterine myoma or fibroid (a noncancerous tumor of the uterus)
  • Endometrial or other gynaecological cancer
  • Pelvic organ prolapse (when uterus, bladder or rectum protrude outside the vagina)
  • Severe endometriosis (abnormal growth of the endometrial lining tissue outside of the uterus into the pelvis causing heavy painful periods)

What are the different kinds of hysterectomy?

The medical term hysterectomy is derived from “hyster” which means uterus. The removal of the uterus can be done in different ways depending on what condition is being treated or the desired effect. The types of hysterectomy are classified into four categories:

1. Supracervical Hysterectomy

This may be done if your doctor believes that your cervix may be left intact, but the uterus only needs to be removed, like in benign conditions of abnormal bleeding or fibroids.

2. Total Hysterectomy

This comprises of removing the cervix, uterus and parts of other surrounding structures. This type is the most commonly performed hysterectomy.

3. Radical Hysterectomy

This is a surgical procedure that includes removal of the cervix, uterus, tubes, ovaries anc parametrium. This is usually done to treat gynaecological cancers.

Surgical Techniques for Hysterectomy

Hysterectomy or removal of the uterus can be done in many ways, either by cutting the abdomen or removing through keyhole or laparoscopic assistance or Vaginally.These are some of the surgical techniques for a Hysterectomy:

Total abdominal hysterectomy (TAH)

An abdominal hysterectomy is done by removing the uterus through an incision in the abdomen.

The method of abdominal hysterectomy is used when the uterus is either too large or adhered to other organs to be removed through the vaginal approach.

This procedure releases tension on the bladder and colon, which means that there is less chance of them being pulled or damaged during surgery. It is also the preferred method in ovarian cancer or other suspicious gynaecological cancers.

Total laparoscopic hysterectomy (TLH)

The laparoscopic hysterectomy is a surgical procedure which removes the uterus through small incision.It is the preferred method as it leads to early recovery. It can be used to treat benign conditions like bleeding problems, conditions of the cervix, or to remove fibroids that are in the wall or outside the uterus.

It can also be used to treat cancers in the uterus, because it offers better control of bleeding and can reduce the amount of pain medication required after the surgery.

Laparoscopic assisted Vaginal hysterectomy ( LAVH)

Total vaginal hysterectomy (TVH)

A vaginal hysterectomy is used for removing the uterus through the vagina, generally because of Prolapse. It is the preferred method when the uterus is bulging into the vagina. It may also be used in cases of fibroids, endometriosis, or other benign conditions if there is adequate access from below.

Non descent Vaginal hysterectomy ( NDVH)

Depending on what type of procedure is done, there are different risks that may come with it like bleeding, infection and damage to other organs near the area being operated on.

What happens after a hysterectomy?

After a hysterectomy, women need to take care of their health by following certain precautions. The doctor will provide them with a personalised set of instructions after they decide on the type of surgery that they want. It will take time to heal, but it's important to maintain a healthy lifestyle. After the surgery, patients are usually able to do basic things like daily chores, light exercises, stretches, walking in 2-3 days but are asked to avoid lifting heavy objects, and strenuous exercise for a couple of months.

The doctor will advise that patients not return to work or school until they are fully healed.

How long does it take to recover from a hysterectomy?

Patients may have different times to recovery after their surgery depending on the type of surgery they had, how old the woman is, her weight, any other medical conditions, any complications during or after surgery and how much time has passed since the surgery took place.

Total recovery can take up to six weeks for patients who have had an abdominal hysterectomy.This time is much less- about 2 weeks, if surgery is done through laparoscopic or Vaginal approach.

Dr. Astha Dayal one of the most experienced Gynecologist and Obstetrician in Gurgaon Haryana specialised in Management & Treatment of High Risk Pregnancies

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