A hysterectomy could be required for a number of reasons, including:
- Uterine prolapse which is when uterus has slipped from its normal position into the vaginal canal.
- Uterine fibroids that cause a variety of problems, including pain and bleeding.
- Endometriosis which is the development of uterine-lining tissue outside the uterus.
- Adenomyosis which is a thickening of the uterus.
- Abnormal bleeding.
- Chronic pain in the pelvis.
- Cancer of the ovaries, cervix or uterus.
A hysterectomy for problems other than cancer is usually performed only if other treatments have been ineffective.
Types of Hysterectomies
There are 3 basic types of hysterectomies:
- When the surgeon removes only the top section of the uterus, leaving the cervix in place, it is called a Supracervial or Subtotal Hysterectomy.
- When the cervix and uterus are completely removed, it is a Total Hysterectomy.
- When the whole uterus along with the tissue on the sides, the top section of the vagina and the cervix are removed, it is called Radical Hysterectomy. This s normally done when cancer has been detected.
There are two ways of performing the operation – The more common open surgery which is the traditional method and the minimally invasive procedure (MIP).
In the case of open surgery, a 5- to 7-inch long incision is made across the belly through which the organs are removed. The patient typically spends 3 days in the hospital after the procedure and a visible scar will remain.
In the case of an MIP hysterectomy, a number of approaches are available:
- Vaginal hysterectomy
- Laparoscopic hysterectomy
- Laparoscopic-assisted vaginal hysterectomy
- Robot-assisted laparoscopic hysterectomy
Your doctor will tell you about the way each is done and why a particular option may be chosen.
In general, the MIP approach results in a faster recovery, a shorter hospital stay, a lower chance of infection and less pain and scarring as compared to open surgery. Typically after a minimally invasive procedure, a woman can return to normal activities after 3 or 4 weeks. While after an open surgery the time to return to normal activities, could be 4 to 6 weeks. Not all women are good candidates for the MIP approach. Your doctor will decide which is right for you.
Life after a Hysterectomy
If the ovaries are removed along with the uterus, menopause will begin. If the ovaries are left in place, menopause will occur naturally. Sex is to be avoided for 6 weeks after the surgery. In almost all cases patients report that the procedure was successful in curing the problems they were facing such as heavy periods or extreme pain.
A hysterectomy, although it is a major procedure, is not something that you should dread. It is today a common and safe operation. Your gynecologist will be able to tell you, after studying your medical history and examining you, if you need one, or if an alternative treatment is better. She will walk you through the procedure, the recovery and answer all your questions. As with all surgery, the more confidence and trusts you have in your doctor, the easier everything is.