Having a hysterectomy can be one of the most difficult decisions a woman ever has to make. It can threaten your identity, sexuality, and fertility, and lead to lingering feelings of grief, depression, and loss. But sometimes a hysterectomy is necessary in order to increase quality of life, reduce painful symptoms, or even save lives. If you are thinking about having a hysterectomy, it is important to weigh your decision carefully. This article is designed to give you some important background information on hysterectomy procedures and on how a hysterectomy might affect you.
What is a Hysterectomy?
A hysterectomy is a surgical operation that removes a woman's uterus. The uterus is the organ, which is designed to nourish a developing baby. Sometimes, a hysterectomy procedure may also remove a woman's cervix, ovaries, and fallopian tubes. These are also parts of a woman's reproductive system. Since a hysterectomy involves the complete or partial removal of your reproductive organs, you will no longer have the ability to bear children after this procedure.
Hysterectomies are one of the most common surgical procedures in the United States. Every year over 600 000 hysterectomies are performed in hospitals across America. In fact, by the time they are 60, 1 in 3 American women will have had a hysterectomy.
Types of Hysterectomies
There are a number of different types of hysterectomies. The type of hysterectomy that you receive will depend upon the reasons for surgery.
- Total Hysterectomy
- The total hysterectomy is typically the most common type of hysterectomy performed. It involves the removal of both your uterus and your cervix. It is commonly referred to as a complete hysterectomy.
- Subtotal Hysterectomy
- Also known as a partial hysterectomy, the subtotal hysterectomy involves the removal of the upper part of your uterus. Your complete cervix is left behind.
- Radical Hysterectomy
- During a radical hysterectomy, your uterus, cervix, upper vagina, and pelvic lymph nodes are removed. This type of hysterectomy is usually reserved for uterine, ovarian, and cervical cancer patients.
Removal of Ovaries
Depending upon your medical history, you may also wish to have your ovaries removed during you hysterectomy. This procedure is referred to as an oophorectomy. An oophorectomy may be required in some patients suffering from cancer or endometriosis. Ovaries can sometimes encourage cancer growth or perpetuate endometriosis, so their removal acts as a safeguard against recurrent illness. If you have your ovaries removed, your fallopian tubes will also be removed.
It is important to know that if you have your ovaries removed, you will enter into surgical menopause. Without your ovaries, your body will no longer produce certain hormones, thus mimicking natural menopause. Surgical menopause can onset rapidly, and is associated with more severe menopause symptoms.
When do You Need A Hysterectomy?
A hysterectomy is quite a radical procedure and is usually the last form of treatment that you will choose to pursue. Most conditions can be treated using alternatives to hysterectomy, however, there are some reasons for a hysterectomy. If your condition is causing you pain, bleeding, or is life-threatening, a hysterectomy may be the best treatment option. Conditions that may lead to the need for a hysterectomy include:
- uterine fibroids
- uterine prolapse
- uterine cancers including: cervical cancer, endometrial cancer, fallopian cancer, ovarian cancer, and uterine sarcoma
- pelvic inflammatory disease
- pelvic adhesions
- heavy bleeding
Hysterectomies are performed in hospital under general anesthetic. There are three main techniques used to perform a hysterectomy:
The abdominal hysterectomy procedure is performed through the abdomen. A cut is made either vertically or horizontally along the pubic hairline. This procedure allows a complete view of the uterus and other reproductive organs, making it easier to remove the uterus and any large uterine fibroids. Abdominal hysterectomy recovery is generally longer, and the procedure will leave a permanent scar.
A vaginal hysterectomy is much less invasive and is associated with minimal pain and a shorter recovery time. A small incision is made at the rear of the vagina. The uterus is then cut away and slipped out through this incision. Vaginal hysterectomies are not appropriate when large uterine fibroids are present. Sometimes it is difficult for the surgeon to see the reproductive organs fully with this procedure.
This procedure uses an instrument called a laparoscope in order to make the vaginal hysterectomy easier to perform. The laparoscope is a small tube with a camera attached to it. An incision is made beneath your navel, and the laparascope is inserted. This allows a picture of your uterus to be transmitted on to a television screen. This enables the surgeon to perform the procedure more easily.
After a Hysterectomy
Hysterectomy recovery depends upon which type of surgery you end up having. Abdominal hysterectomies are generally associated with longer recovery periods than vaginal hysterectomies. You will probably experience some pain after hysterectomy surgery. You will remain in hospital for 2 to 4 days and receive pain medication. After 4 days you can return home; by this time you should be able to walk around again. For two to three weeks after the surgery you should rest and only engage in minimal activity. After four weeks you should be able to return to work and perform light chores around the house. Complete recovery usually takes about 8 weeks.
Complications of Hysterectomy
Though regarded as one of the safest medical procedures, there is always a possibility that you may develop some hysterectomy complications. These include:
- difficulty urinating or urinary incontinence
- nausea and vomiting
- heavy bleeding
- internal bleeding
- allergic reactions associated with anesthesia