A hysterectomy is a surgical procedure that involves the removal of all or part of the uterus. The uterus, also known as the womb, is the location where a baby would go when a woman is pregnant. After a hysterectomy has been performed on a woman, she will no longer be able to become pregnant, nor will she experience menstrual periods.
Why is a Hysterectomy Performed?
There are numerous reasons for a woman to undergo a hysterectomy. One of the main reasons is to treat or prevent certain diseases and medical conditions. For example, a hysterectomy can be performed to treat cancer of the uterus, ovaries or cervix. In an article by Time Magazine, it is estimated that 10 percent of patients who undergo hysterectomies do so for cancerous reasons. However, the other 90 percent are opting for this form of surgery for reasons other than cancer, most of which are not even life-threatening.
Some of these reasons for a hysterectomy that are not life-threatening include:
- Removing benign tumors in the uterus.
- Stop heavy bleeding during menstruation.
- Prevent chronic pain and bleeding between periods due to endometriosis.
- Stop pelvic pressure and issues with urination and bowel movements due to prolapse of the uterus.
- Alleviate pain caused by adenomyosis, which is a condition where tissues that are supposed to line the uterus grow within the walls of the uterus.
There are several variations of a hysterectomy procedure that depend on how much of the uterus is actually removed:
- Partial hysterectomy: A partial hysterectomy is when only the upper portion of the uterus is removed, while the cervix remains in the woman's body.
- Radical hysterectomy: A radical hysterectomy includes the removal of the upper portion of the vagina, the uterus and the tissue on both sides of the cervix. This is a common type of hysterectomy used for treatment and prevention of cancer.
- Total hysterectomy: Total hysterectomy is a procedure that consists of the entire removal of the uterus and the cervix.
A patient has several options when choosing a hysterectomy procedure. The surgeon will assist the patient in choosing the most appropriate procedure, where medical history and the purpose of the hysterectomy are factors that are taken into account. The different surgical techniques for a hysterectomy procedure include:
- Abdominal hysterectomy: For this procedure, the surgeon makes a 5-to-7 inch incision in the abdomen to access the uterus.
- Vaginal hysterectomy: This procedure consists of uterus removal through the vagina. This hysterectomy procedure is utilized when the uterus is not too large and/or the woman has a vaginal canal that is large enough for the procedure due to previous childbirth(s).
- Laparoscopic hysterectomy: A laparoscopic hysterectomy utilizes a thin tube with a camera at one end called laparoscope. The surgeon will make several small incisions on the patient's abdomen, and with the laparoscope and other small tools, will cut the uterus into small pieces to be removed through the incisions.
- Laparoscopy-assisted vaginal hysterectomy: This procedure is a combination of a vaginal and laparoscopic hysterectomy. The surgeon removes the uterus through a cut made inside the vagina, using a laparoscope for guidance.
- Robot-assisted laparoscopic hysterectomy: Similar to a laparoscopic hysterectomy, this procedure uses a special machine, or robot, in conjunction with a laparoscope to access the uterus. This hysterectomy procedure is typically used for patients who are obese or have cancer, where vaginal surgery is not considered safe.
A hysterectomy is generally considered a low-risk surgical procedure. However, just like any other form of surgery, there is the risk of complications that accompany a hysterectomy procedure. Such complications can include:
- Damage to other organs and body parts near the operated area
- Blood clots
- Urinary incontinence
- Vaginal prolapse
- Chronic pain
- Allergic reaction to medication
- Early menopause, which can be a result of ovary removal or if the woman being operated on is drawing close to menopause
- Lack of a sexual drive; disinterest in sex
Many of these risks are uncommon with only a small portion of women experience any complications at all from a hysterectomy. Those who undergo an abdominal hysterectomy tend to be at a higher risk for infection after surgery and experience more pain than women who undergo a vaginal hysterectomy.
What to Expect Post-Op
Once a hysterectomy procedure has been completed, pain medication will be prescribed to alleviate any discomfort. Patients may also need to urinate through a catheter that is inserted into the bladder for up to several days after the procedure. Recovery time varies depending on the type of hysterectomy procedure that was performed. A hysterectomy that includes the ovaries being removed will cause a woman to go into menopause. If the ovaries were not removed, the woman can expect to enter menopause at an earlier age.