Hysterectomy- Overview, Causes, types, and treatment procedure

The uterus (or "womb") is surgically removed during a hysterectomy. During a hysterectomy, your doctor may also remove other reproductive organs, such as your fallopian tubes or ovaries. For gynecologic issues such as uterine cancer and severe, uncontrolled bleeding, hysterectomy can be a life-saving procedure. A woman who has undergone a hysterectomy will be unable to conceive and will no longer have monthly periods.



Causes

For some women, a hysterectomy alleviates the discomfort of uterine health problems. Others undergo the operation to treat uterine cancer or as an emergency procedure to halt excessive bleeding following delivery.

The following are some of the most frequent reasons your doctor may propose a hysterectomy:

  • Uterine fibroids are benign (non-cancerous) uterine tumors. The most frequent reason for the hysterectomy is uterine fibroids.
  • Periods that are consistently heavy.
  • Precancerous development in the uterus, cervix, or ovaries, or cancer of the uterus, cervix, or ovaries. Having a family history of ovarian cancer or testing positive for the BRCA gene (which raises the risk of hormone-sensitive malignancies such as ovarian and breast) may lead to a hysterectomy recommendation in some circumstances.
  • Endometriosis is a condition in which uterine tissue grows outside of the uterus.
  • Pelvic discomfort that persists.
  • Uterine prolapse is a disease that mostly affects women who have given birth several times. Because the pelvic floor is insufficient to support the uterus, it descends (lowers down) and might protrude from the body.
  • Adenomyosis is a disease in which the uterine wall is excessively thick or the uterine lining develops into the muscle, producing discomfort and heavy bleeding.
  • Infection of the pelvic region. Infections in the pelvic area are generally treated with medicines, but if the infection is severe enough, it may necessitate hysterectomy.
  • Hyperplasia is a disease in which the uterus thickens, resulting in excessive bleeding and an increased risk of cancer. Although hormone treatment is frequently used to treat hyperplasia, certain instances may necessitate a hysterectomy.
  • Obstacles to delivery Some uncommon postpartum occurrences, such as severe hemorrhage or placenta accreta, may also necessitate hysterectomy.

Hysterectomy types

There are five different forms of hysterectomy:

Total hysterectomy removal of the uterus and cervix

Subtotal (partial) hysterectomy removing the uterus but leaving the cervix in situ. While it is typically recommended that the cervix be removed since it is a possible cancer location, some women believe that it serves a role during penetrative intercourse. Even if the cervix is preserved, frequent cervical screening is still required.

hysterectomy with bilateral salpingo-oophorectomy removal of the uterus, fallopian tubes, and ovaries. If a woman has cancer of the ovaries or uterus, or if she suffers from persistent discomfort due to recurrent pelvic infection or endometriosis.

radical hysterectomy the most comprehensive version of the procedure. The uterus, fallopian tubes, ovaries, upper section of the vagina, and related pelvic ligaments and lymph nodes are all removed.

hysterectomy with prophylactic bilateral salpingectomy If a woman has cancer of the cervix, ovaries, fallopian tubes, or uterus, she will undergo hysterectomy with prophylactic bilateral salpingectomy – most doctors now recommend removing the fallopian tubes at the time of hysterectomy due to research suggesting that early ‘ovarian' cancers originate in the tubes.

Treatment Procedure

Hysterectomy surgery

The procedure can be conducted by an incision (cut) in your lower abdomen (abdominal hysterectomy), three to four tiny incisions in your abdomen (laparoscopic hysterectomy), or through your vaginal canal (vaginal hysterectomy) (vaginal hysterectomy).

Abdominal hysterectomy

A horizontal cut along your pubic hairline is generally made by the surgeon during an abdominal hysterectomy (your pubic hair may have been shaved around the incision). Most women are left with a tiny scar as a result of this. A vertical midline incision in the lower abdomen may be required in certain women, especially if the hysterectomy is for a big uterine fibroid. When a woman has very big fibroids or malignancy, an abdominal hysterectomy is usually advised.

Laparoscopic hysterectomy During a laparoscopic hysterectomy, the surgeon inserts a telescope (laparoscope) through a small incision in your navel to view your pelvic organs and then creates three or four more small incisions through which various tools are utilised. Carbon dioxide gas is used to distend (inflate) your belly like a balloon, allowing you to see all of your organs plainly.

The uterus, with or without fallopian tubes and ovaries, is subsequently removed through the vagina by the surgeon. A complete laparoscopic hysterectomy is performed when the top of the vagina is sutured (sewn) using keyhole incisions. A laparoscopically assisted vaginal hysterectomy is performed when the gynecologist sutures the top of the vagina via the vagina. A robot may be used to conduct this sort of hysterectomy.

Vaginal hysterectomy

A vaginal hysterectomy is done through an incision in the vaginal wall. It is typically used when there is a uterine prolapse (the cervix and uterus come down into the vagina, or protrude out of the vaginal entrance).

After-Hysterectomy Self-Care

Follow your doctor's instructions, but here are some basic ideas for the four to six-week postoperative period:

Relax - For at least two weeks, try to rest as much as possible. During this period, you should avoid driving. Rest lying down exercise is always recommended - continue with the exercises you were given in the hospital. Unless otherwise directed by your doctor, you should strive to go for a walk every day. Avoid standing for more than a few minutes at a time in the early postoperative period. As your recuperation develops, you can increase your standing time.

lifting – avoid heavy lifting and stretching constipation – drink lots of water and eat fresh fruits and vegetables to avoid constipation You may be recommended to use stool softeners for the first few days of treatment - if antibiotics have been prescribed, make sure you complete the entire course, even if you feel well.