Hysterectomy Surgery

Management and Treatment by Dr Shruti Kainth(Obs & Gyne)

What is Hysterectomy?

Hysterectomy is the surgical removal of the uterus (womb) in women. The surgery is usually performed to treat cancer, fibroids, endometriosis, adenomyosis, or other conditions that can cause pain and heavy bleeding.

It sometimes removes her ovaries and cervix for the same reason. It is also possible to remove both if necessary. Hysterectomy is a complex, multi-step process; it does not happen overnight and requires an in-depth understanding of each patient’s anatomy, physiology, and surgical approach. 

It’s crucial to explore the risks and advantages of a hysterectomy procedure and any other potential alternative treatment alternatives if you have been advised to have one.

Why hysterectomy?

Hysterectomy is intended to treat gynecologic conditions that are causing problems for you. A hysterectomy is sometimes performed for non-gynecologic reasons, including abnormal bleeding (hormone disorders), uterine prolapse, and chronic pelvic pain syndrome.

What are the different kinds of hysterectomy?

Depending on the illness being treated or the desired outcome, the uterus can be removed in a variety of methods. Hysterectomy procedures are divided into four groups:

1. Total Hysterectomy 

The uterus must be removed to treat conditions such as uterine cancer (uterine sarcoma), uterine fibroids, and endometriosis. A total hysterectomy is usually performed in an operating room under general anaesthesia. This operation may also be performed using a minimally invasive laparoscopic-assisted technique.

2. Radical Hysterectomy 

In this type of hysterectomy, the entire uterus and cervix are removed. This type of hysterectomy is usually reserved for uterine tumour removal. Still, with more advanced cancers, it is sometimes appropriate to remove all of the uterus to preserve some healthy tissue.

3. Vaginal Hysterectomy 

A vaginal hysterectomy removes the uterus and cervix through a small incision (less than 2 inches) in the vaginal wall.

What is Non Descent Vaginal hysterectomy ( NDVH)?

Non-Descendent Vaginal Hysterectomy (N-dVH) is a relatively old surgical procedure to remove the uterus with laparoscopy. This procedure can be performed as an outpatient surgery (with sedation or general anaesthesia) and is done rather easily.

Why do women choose it? 

Not to have the incision in the abdomen and a lot less pain, in about 30 mins, it’s all done. The scarring is also thinner and less visible.

What happens after a hysterectomy?

After surgery, patients should expect some recovery time. They may also experience emotional changes following the procedure due to unknown reasons. After surgery, patients can often perform simple tasks like daily chores, mild exercise, and light housework.

Physiotherapy can be very beneficial in healing the abdominal muscles and directly or indirectly affect the uterus. It will also aid in the reduction of pain. Some women need longer bedrest because of the incision and nerve damage. 

Upon discharge from the hospital, it is important to consult with a Gynaecologist / Obstetrician about what steps need to be taken to continue their normal activities, i.e., work, routine, etc.

How long does it take to recover from a hysterectomy?

Depending on the type of surgery they underwent, the patient’s age, weight, other medical issues, potential complications during or after surgery, and the amount of time since the procedure, patients may recover from surgery at different rates.

Total recovery time depends on each patient’s individual recovery tasks. Recovery time varies from a few weeks to several months.

What are the risks of hysterectomy?

In a hysterectomy, the heart and other major blood vessels that supply the uterus can be damaged, leading to embolism (blood clot in the lungs), stroke, or heart attack. A hysterectomy may also cause nerve damage.

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