A hysterectomy is a surgical procedure to remove a woman’s uterus. The uterus, also known as the womb, is where a baby grows when a woman is pregnant. The uterine lining is the source of menstrual blood.
You may need a hysterectomy for many reasons. The surgery can be used to treat a number of chronic pain conditions as well as certain types of cancer and infections.
The extent of a hysterectomy varies depending on the reason for the surgery. In most cases, the entire uterus is removed. The doctor may also remove the ovaries and the fallopian tubes during the procedure. The ovaries are the organs that produce oestrogen and other hormones. The fallopian tubes are the structures that transport the egg from the ovary to the uterus.
Once you have had a hysterectomy, you will stop having menstrual periods. You will also be unable to get pregnant.
There are several types of hysterectomy.
- Partial Hysterectomy
During a partial hysterectomy, your doctor removes only a portion of your uterus. They may leave your cervix intact.
- Total Hysterectomy
During a total hysterectomy, your doctor removes the entire uterus, including the cervix. You will no longer need to get an annual Pap test if your cervix is removed. However, you should continue to have regular pelvic examinations.
- Hysterectomy and Salpingo-Oophorectomy
During a hysterectomy and salpingo-oophorectomy, your doctor removes the uterus along with one or both of your ovaries and fallopian tubes. You may need hormone replacement therapy if both of your ovaries are removed.
Why it is done
Your doctor may suggest a hysterectomy if you have any of the following:
- chronic pelvic pain
- uncontrollable vaginal bleeding
- cancer of the uterus, cervix, or ovaries
- fibroids, which are benign tumors that grow in the uterus
- pelvic inflammatory disease, which is a serious infection of the reproductive organs
- uterine prolapse, which occurs when the uterus drops through the cervix and protrudes from the vagina
- endometriosis, which is a disorder in which the inner lining of the uterus grows outside of the uterine cavity, causing pain and bleeding
- adenomyosis, which is a condition in which the inner lining of the uterus grows into the muscles of the uterus
Risks
A hysterectomy is considered to be a fairly safe procedure. As with all major surgeries, however, there are associated risks. Some people may have an adverse reaction to the anaesthetic. There is also the risk of heavy bleeding and infection around the incision site.
Other risks include injury to surrounding tissues or organs, including the:
- bladder
- intestines
- blood vessels
These risks are rare. However, if they occur, you may need a second surgery to correct them.
Procedure
A hysterectomy can be performed in several ways. All methods require a general or local anaesthetic. A general anaesthetic will put you to sleep throughout the procedure so that you do not feel any pain. A local anaesthetic will numb your body below the waistline, but you will remain awake during the surgery. This type of anaesthetic will sometimes be combined with a sedative, which will help you feel sleepy and relaxed during the procedure.
Abdominal Hysterectomy
During an abdominal hysterectomy, your doctor removes your uterus through a large cut in your abdomen. The incision may be vertical or horizontal. Both types of incisions tend to heal well and leave little scaring.
Vaginal Hysterectomy
During a vaginal hysterectomy, your uterus is removed through a small incision made inside the vagina. There are no external cuts, so there will not be any visible scars.
Laparoscopic Hysterectomy
During a laparoscopic hysterectomy, your doctor uses a tiny instrument called a laparoscope. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through incisions in the abdomen. Three or four small incisions are made instead of one large incision. Once the surgeon can see your uterus, they will cut the uterus into small pieces and remove it one piece at a time.
Results
After your hysterectomy, you will need to spend two to five days in the hospital. Your doctor will give you medication for the pain and monitor your vital signs, such as your breathing and heart rate. You will also be encouraged to walk around the hospital as soon as possible. Walking helps prevent blood clots from forming in the legs.
If you have had a vaginal hysterectomy, your vagina will be packed with gauze to control the bleeding. The doctors will remove the gauze within a few days after the surgery. However, you may experience bloody or brownish drainage from your vagina for about 10 days. Wearing a menstrual pad can help protect your clothing from getting stained.
When you return home from the hospital, it is important to continue walking. You can walk around inside your house or around your neighbourhood. However, you should avoid performing certain activities during recovery. These include:
- pushing and pulling objects, such as a vacuum cleaner
- lifting heavy items
- bending
- sexual intercourse
If you have had a vaginal or laparoscopic hysterectomy, you will probably be able to return to most of your regular activities within three to four weeks. Recovery time will be a little longer if you have had an abdominal hysterectomy. You should be completely healed in about four to six weeks.