Table of Contents
Definition of Hysterectomy Surgery
A surgical operation to remove the uterus. Hysterectomy may be treatment for endometrial cancer or for noncancerous conditions that cause significant symptoms and do not respond to less invasive treatments.
Among such conditions are uterine fibroids, uterine prolapse, dysfunctional uterine bleeding (dub), and endometriosis. Whatever its reason, a consequenceof hysterectomy is immediate loss of fertility. Hysterectomy is the second-most common operation women undergo in the United States; cesarean section (surgical childbirth) is the most common.
Surgeons in the United States perform more than 600,000 hysterectomies each year.
The anesthesia for hysterectomy may be regional, such as epidural block, with sedation or general (deep sleep). The choice of anesthesia depends on the type of hysterectomy the woman is having, the woman’s preferences, and the recommendations of the surgeon and anesthesiologist.
A simple hysterectomy removes only the uterus (sometimes called a supracervical hysterectomy); a total hysterectomy removes the uterus and cervix. Both operations leave the ovaries in place to continue providing hormones that carry the woman to a natural menopause if she has not already reached that stage of her life.
Radical hysterectomy may be necessary when endometrial cancer or cervical cancer is the reason for the operation. In radical hysterectomy the surgeon removes the uterus, cervix, and upper vagina along with much of the tissue that supports these structures.
The operation may be an open surgery, in which the surgeon makes a long incision through the skin and layers of muscle to expose the uterus, or laparoscopically assisted vaginal hysterectomy, in which the surgeon removes the uterus through multiple small incisions in the abdomen and vagina and removes the uterus with the aid of a lighted, magnifying laparoscope that displays the pelvic structures on a monitor.
A laparoscopically assisted vaginal hysterectomy is somewhat more complex for the surgeon to perform though significantly faster recovery for the woman. It is an appropriate option when hysterectomy is to treat noncancerous conditions.
A laparoscopically assisted vaginal hysterectomy generally requires no more than an overnight stay in the hospital the night after the surgery. A woman often can return to regular activities in about six weeks with the laparoscopic operation. The typical hospital stay for open hysterectomy is three to five days, with full recovery and recuperation in about eight weeks.
Risks, Complications and Side Efffects
The primary risks associated with hysterectomy are possible excessive bleeding, blood clots, and infection. Complications may include damage to the nerves that control the bowel or bladder that results in fecal incontinence or urinary incontinence or damage to the structure of the bladder or ureters (tubelike structures that drain urine from the kidneys to the bladder).
These complications are uncommon though may have long-term consequences. When the surgeon leaves the fallopian tubes and ovaries intact, these structures sometimes atrophy (shrink). Women who have total hysterectomies with removal of the cervix sometimes experience pain during sexual intercourse for the first few months after surgery. Women who have hysterectomies tend to enter menopause somewhat earlier even when they retain their ovaries.
Outlook and Lifestyle Modifications
Most women return to full, regular activities within two months of surgery (and many sooner). Hysterectomy means the end of menstruation (though not necessarily the start of menopause), which is sometimes an emotional adjustment.
The relief of symptoms related to the condition that necessitated the hysterectomy is sometimes profound, allowing the woman to return to a lifestyle and activities that she had long enjoyed but had stopped participating in because of the symptoms.
n circumstances other than cancer, it is important for a woman to understand the nonsurgical options that are available to treat her condition so she can make a fully informed decision.
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