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 About Hysterectomy

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A hysterectomy is the surgical removal of the uterus, and most likely, the cervix. Depending on the reason for the surgery, a hysterectomy may involve removing surrounding organs and tissues, such as the fallopian tubes and ovaries. The uterus is where a baby grows during pregnancy. It's lining is the blood you shed during your menstrual period. 

What is a Hysterectomy?

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Hysterectomy, in the simplest sense, is the surgery to remove the uterus from a woman’s body. It is performed as a final and definite solution for multiple pathological uterine conditions, such as-

  • Symptomatic Uterine Fibroids (Leiomyomas)

  • Endometriosis

  • Irregular, excessive, or painful menstrual bleeding (Dysmenorrhea)

  • Uterine Prolapse

A hysterectomy is a surgical procedure that removes the uterus. You lose the ability to become pregnant and no longer menstruate. Reasons for this surgery include abnormal bleeding, uterine prolapse, fibroids and cancer. Recovery usually takes four to six weeks, depending on the type of surgery you have.

Importance of Early Decision

Women often ignore uterine health and rely on home remedies/ oral medicines for relief. While lifestyle changes and medicines can effectively help manage the symptomatic pain, they are never the definite resolve. Therefore, if you have been suffering from any of the persistent/ frequent uterine health conditions, please consult a specialist at the earliest and let your doctor decide the best course of action. Any delay could lead to worsening of the condition, unbearable pain, nausea, internal bleeding, infertility, and risk of uterine cancer. 

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Types of Hysterectomy

Partial hysterectomy
Total hysterectomy
Total Hysterectomy with bilateral salpingo-oophorectomy
Radical Hysterectomy

Why is a hysterectomy performed?

  • Healthcare providers perform hysterectomies to treat:

  • Abnormal or heavy vaginal bleeding that is not controlled by other treatment methods.

  • Severe pain with menses that is not controlled by other treatment methods

  • Leiomyomas or uterine fibroids (noncancerous tumors).

  • Increased pelvic pain related to the uterus but not controlled by other treatment.

  • Uterine prolapse (uterus that has "dropped" into the vaginal canal due to weakened support muscles) that can lead to urinary incontinence or difficulty with bowel movements.

  • Cervical or uterine cancer or abnormalities that may lead to cancer for cancer prevention.

  • Conditions with the lining of your uterus like hyperplasia, recurrent uterine polyps or adenomyosis.

DIAGNOSIS

Some of the common tests suggested before hysterectomy are:

  • Imaging Tests: These may include one or more of either- 

  1. Xray

  2. Ultrasound 

  3. MRI 

  4. CT Scan

Imaging tests are those medical tests that help paint an image of your internal organs, tissues, and blood flow using high-frequency sound waves. They can help confirm any abnormalities in or around your uterus. Typically a simple pelvic ultrasound is the first step to support the confirmation of any uterine abnormality. However, in some rarer cases, other imaging tests such as MRI, CT Scan, or sonography might also have to be considered. 

  • Endometrial Biopsy: This is done to examine multiple factors, such as abnormalcy in the hormonal level, any changes in the cell growth, the reason for your post-menopausal bleeding, causes of infertility, and screening for endometriosis and uterine cancer.

It is typically a less than 10 minutes procedure where your doctor takes a sample of your endometrial tissue and sends it into the lab for a biopsy report. 

  • Pap Smear: This test is done to check for any abnormal cell growth/changes in your cervix. For the same, your doctor uses a specialized speculum to hold open your vaginal walls, and then a brush is used to gently extract the cervical cells. These cells are then checked under a microscope for any abnormalities/ diseases.  

Pap Smear is one of the most important and commonly recommended tests in gynecology. Multiple health care organizations and medical journals suggest taking a pap smear test at least once a year. This helps screen cervical cancer and diagnoses any abnormal changes at the early stage. 

How do I prepare for a hysterectomy?

  • A healthcare provider will explain the procedure in detail, including possible complications and side effects. Talk to them about any concerns you have. You may be asked to provide blood and urine samples.

What happens during a hysterectomy?

  • Your healthcare provider will determine the type of hysterectomy you need and the best surgical method to perform that procedure. You will change into a hospital gown and get hooked up to monitors that track your heart rate. An intravenous (IV) line is placed in a vein in your arm to deliver medications and fluids.

  • An anesthesiologist will give you either:

  • General anesthesia in which you will not be awake during the procedure; or

  • Regional anesthesia (also called epidural or spinal anesthesia) in which medications are placed near the nerves in your lower back to "block" pain while you stay awake.

How to prevent it?

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Image by Jo Sonn
Image by Julia Zolotova

  1. A balanced diet: With changing times, we are increasingly becoming more dependent on fast food, junk, and packaged foods. While this food is high on instant energy and carbs and makes you feel full, it has no substantial nutrients or fiber. This then leads to a weaker digestive system, lower immunity, and hormonal fluctuations. If you replace your diet with more healthy, sustainable, and balanced meals, you will find your metabolism and hormones balancing better. As a result, you are more likely to have regular periods with only mild-moderate cramping.

  2. Active Lifestyle: An active lifestyle is a solution to a thousand problems. Multiple reports suggest how a small 30-minute walk every day can reduce the risk of PCOS/ PCOD/ infertility and many more hormonal issues in women. So just pick up a simple activity of your choice and practice daily.

  3. Water is your best friend: Water not only helps break down food and makes digestion easier, it also helps maintain your body’s temperature and hormones. Also, in times of stress/ injury, it helps your body heal. So, if you usually forget drinking water, give yourself a conscious habit of drinking at least 8 glasses of water every day.

  4. Give yourself a routine: Medically, it is not as much about ‘early to bed and early to rise’, as it is about a routined life. So give yourself a routine. Wake up, work, eat and sleep at the same time. This would help your body understand what hormones to produce when and help prevent hormonal fluctuations.

  5. Conscious vaginal Hygiene: Maintain good vaginal health at all times. Maybe switch to cotton undergarments and change often. Clean yourself pat dry and maintain a good vaginal Ph. Also, if you are at the age of puberty, make sure you change your sanitary pad/ tampons every 4-8 hours and keep your vaginal area free of prolonged sweat and moisture. This would help reduce the risk of UTI and any pelvic inflammatory diseases.

  6. Practice safe sex: Any unprotected sexual encounter with a person with STD can lead to vaginal infections, pelvic infections and at times, also increase the risk of cancer. Therefore, always practice safe sex as a method of good sexual hygiene and uterine health.

  7. Quit Smoking: Smoking cigarettes is never a great idea. Cigarettes and their nicotine affect both ovarian functions and hormones. They also run the risk of causing ovarian cysts, cancer, and emphysema. Therefore, quitting cigarettes can be a great first step to balanced uterine health.

  8. Regular checkups: Get yourself checked regularly, at least once a year. This would help detect any abnormalities before they turn severe and let you prepare for timely treatment.

  9. Timely treatment: Many times, hysterectomy can be delayed with alternative conservative treatments such as hormonal medications, hormone replacement therapy, uterine balloon therapy, etc. However, these are possible only through early diagnosis and timely treatments.

HYSTERECTOMY SPECIALISTS DOCTORS

Dr. ABCD
MBBS,
10 yrs of experience

Dr. ABCD
MBBS,
10 yrs of experience

Dr. ABCD
MBBS,
10 yrs of experience

TYPES OF HYSTERECTOMY

  • Vaginal hysterectomy:

  • Your uterus is removed through an incision at the top of your vagina. There is no external incision.

  • Dissolvable stitches are placed inside the vagina.

  • Most commonly used in cases of uterine prolapse and other non-malignant (or noncancerous) conditions.

  • Fewest complications and fastest recovery (up to four weeks) and is considered the preferred approach.

  • Patients often go home the same day of surgery.

  • Laparoscopic hysterectomy:

  • A laparoscope (a thin tube with a video camera on the end) is inserted in the lower abdomen through a small incision in the belly button.

  • Surgical tools are inserted through several other small incisions.

  • Your uterus can be removed in small pieces through the incisions in your abdomen or through your vagina.

  • Some people go home the same day or after one night in the hospital.

  • Full recovery is shorter and less painful than an abdominal hysterectomy.

  • Robotic-assisted laparoscopic hysterectomy:

  • Your surgeon performs the procedure with the help of a robotic machine.

  • A laparoscope is inserted in the abdomen so the pelvic area can be viewed.

  • Small, thin surgical tools are inserted through three to five incisions around the belly button. Robotic arms and instruments are controlled by the surgeon.

  • The recovery is similar to a laparoscopic hysterectomy.

  • Abdominal hysterectomy:

  • Your uterus is removed through a six- to eight-inch-long incision in your abdomen.

  • The incision is made either from your belly button to your pubic bone, or across the top of your public hairline. The surgeon will use stitches or staples to close the incision.

  • Most commonly used when cancer is involves, when the uterus is enlarged or when disease spreads to other pelvic areas.

  • It generally requires a longer hospital stay (two or three days) and a longer recovery time.

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