Hysterectomy is the surgical removal of the uterus. It doesn't essentially mean removal of the ovaries.

Hysterectomy is one among the most ordinarily performed operations. In fact, it's the second commonest major surgical treatment after cesarean for women below the age of sixty. This procedure is usually performed as a definitive cure of the many gynecological conditions and undesirable symptoms, resulting in better health, wellbeing and improved quality of life.

Why do I need a hysterectomy?

A hysterectomy is also suggested for numerous reasons, such as:

Uterine fibroids – once there are massive or multiple fibroids that cause pressures, pain and discomfort, or turn out heavy periods;

Heavy or irregular menstrual bleeding – particularly when the matter doesn't improve with first-line therapies; Endometriosis – specially when endometriosis involves the uterus, resulting in a condition known as “adenomyosis”. The uterus becomes enlarged, leading to heavy, painful periods;

Prolapse of the uterus – once the uterus prolapses into the vagina or beyond the vaginal open as a result of pelvic floor dysfunction or “weakness”;

precancer modification of the uterine line cells (atypical endometrial hyperplasia); and

persistent abnormal pap smear results; or some pre cancer changes of the cells on the cervix.

These conditions will cause disabling level of pain, discomfort, severe disturbance to normal activities, or emotional distress.

For women with these unpleasant symptoms, hysterectomy offers a welcome cure.

What are the alternatives?

Heavy periods is treated with medical therapies or operation of lining of uterus. Each of those ways have a failure rate. The sole definitive treatment is that the removal of the uterus, i.e. hysterectomy.

Know more about heavy periods

Fibroids is removed with a surgical operation known as myomectomy. Myomectomy is mostly suggested for women who are coming up with for pregnancies in the future. However, because the uterus is preserved after myomectomy, there are possibilities that fibroids might regrow, or the symptoms might come before the woman reaches menopause. Hysterectomy offers a definitive treatment of problematic fibroids for women who not want to get pregnant.

Know more about fibroids and its treatment options

Our doctor would be happy to outline the obtainable choices and facilitate to seek out out the simplest alternative for you.

Different ways of hysterectomy

There are alternative ways to perform a hysterectomy. The selection of approach depends on diagnosis, pathology, prior pelvic surgeries, size of the uterus, and also the preference and ability of the surgeon.

  • Abdominal (Open) hysterectomy – It's the foremost invasive variety of hysterectomy as a result of it involves an oversized incision within the abdominal wall, i.e. laparotomy. The incision could also be either horizontal - the “bikini incision” – or vertical from just low the umbilicus (“belly button) right down to the level of pubic bone. The operation is followed by a hospital stay of 4-5 days. Complete recovery takes around six weeks.
  • Vaginal hysterectomy – The complete hysterectomy is performed through the vagina. An incision is formed within the upper vagina, and also the uterus is pull down and removed from down below. The vagina is then sutured from below and there's no scar in the abdomen. This procedure is most acceptable for women who have delivered kids vaginally and have significant prolapse, as a result of the ligaments supporting the uterus are stretched and the uterus is connected more loosely. Also, there should be no alternative significant pelvic pathology because the surgeon wouldn't be able to totally assess the pelvis from the tiny incision within the vagina.
  • Laparoscopic hysterectomy – The uterus is removed entirely using the keyhole technique and also the incision at the vagina is closed from above. There's no vaginal surgery with this method.
Why use Laparoscopy?

The laparoscopic approach permits an operation that might have been done with open abdominal surgery.

Because the procedure is minimally invasive, laparoscopic surgery could be a less traumatic method of removing the uterus. Compared to open abdominal procedures, it's associated with a dramatic decrease in pain, less scarring and quicker recovery. Patient will typically get up and move around on the primary day after the hysterectomy. The hospital stay is usually one – three day only, and also the patient will typically come back to her traditional activities once concerning 2 to a few weeks. This is often a lot of faster than having an open abdominal hysterectomy, where complete recovery would take up to six weeks.

Another advantage is reduced risk of infection, as a result of tissues are not exposed as they're in open surgery.

In summary, a laparoscopic hysterectomy offers you the advantages of:

  • less pain
  • less scarring
  • faster recovery
  • shorter hospital stay
  • earlier return to work and normal activity

In comparison to vaginal hysterectomy, the newest camera technology permits laparoscopic surgeons to possess an correct view of all pelvic organs, and thus have higher control of bleeding and perform a really precise surgery during laparoscopic hysterectomy. This can be significantly necessary for women who have had previous abdominal surgery, Caesarean sections, pelvic infection or some gynecological procedures.

Is it safe?

Studies have shown that in experienced hands, the chance of major complications with laparoscopic hysterectomy is similar to an abdominal open hysterectomy. These risks include those associated with anaesthesia, bleeding and also the need for transfusion, infection and damage to surrounding organs.

When discussing a surgery, our doctor can continually undergo with you the surgical risks in specific to your general health and gynecological conditions.

What happens before the surgery?

You will have the opportunities to discuss any queries with our doctor before the surgery. You may need to sign a consent form, have some routine blood test and be told about what to eat the days before surgery. You may also receive medication to assist cleanse the bowel.

How long is recovery?

TThe average stay in hospital after a laparoscopic hysterectomy is 1-3 days. Most patients can get out of the bed and move round the day following the surgery and are eating and drinking usually at intervals this period. This contrasts with open abdominal hysterectomy wherever the usual stay is 6-7 days and normal eating/drinking patterns will take 2-3 days.

The average return to work and normal activities is at intervals roughly 2-3 weeks, compared to six weeks when an open abdominal surgery.

Our doctor can answer any of those queries throughout postoperative visits within the hospital and later at the follow-up visits within the clinic..

Will my sex life be the same?

Your vagina is preserved thus you'll be able to maintain your usual sex life after a hysterectomy. In fact, many ladies experience better sex lives after having their uterus removed. this is often as a result of the uncomfortable symptoms are cured, there's no additional inconvenience of menstrual bleeding, and also the couple doesn't need to practice contraception or worry regarding unplanned pregnancy. Indeed, several of our patients described that they have become a new happy woman after the hysterectomy!

We do advise a rest of 6 weeks before resuming sexual intercourse after a hysterectomy. Our doctor can discuss this with you.

How about my female hormone function?

Uterus doesn't secret hormone. Its solely functions are to hold pregnancies and to provide menstrual bleeding. Ovaries are the reproductive organs that secrete female hormones.

If the ovaries are preserved throughout a hysterectomy, your female hormone cycles can continue till you reach the natural menopause. This avoids undesirable menopausal symptoms and reduces the necessity of hormonal replacement therapy (HRT). The hormones secreted from the preserved ovaries can still defend your bones and alternative bodily functions.

The current normal practice is to preserve the normal ovaries throughout a hysterectomy for women below sixty five years old. Exceptions are when the ovaries are diseased, there's a strong family history of ovarian cancer, or when the woman’s symptoms are related to her female hormonal cycle.

In alternative words, a extirpation doesn't cause menopause unless the ovaries are removed at a similar time. It doesn't speed up the ageing method.

Before the surgery, our doctor can go through the details of those choices and assist you to create an informed decision.

We are skilled in laparoscopy and hysterectomy and would be happy to provide additional info if desired. Please contact us to make an appointment for a private consultation and discussion of your case.

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