A hysterectomy is a surgical procedure to remove the womb (uterus).It is the second most performed surgery for women of reproductive age. It shouldn’t be performed on women who still want to have children unless no other alternatives are possible.

Reasons for a hysterectomy

Hysterectomies are carried out to treat conditions that affect the female reproductive system:

• Chronic pelvic pain
• Uncontrollable vaginal bleeding
• Fibroids
• Pelvic inflammatory disease ( infection of the reproductive organs
• Uterine prolapse ( uterus comes down through the cervix and protrudes from the vagina)
• Endometriosis ( disorder in which the inner lining of the uterus grows outside uterine cavity)
• Adenomyosis (causes pain and bleeding)
• Gynecologic cancer of the uterus, cervix, ovaries or of the fallopian tubes

A hysterectomy is a major operation and is only considered after alternative, less invasive, treatments have been tried.

Things to consider

If you have a hysterectomy, you may have to decide whether to also have the cervix or ovaries removed. The decision will usually be based on one`s personal feelings, medical history and any recommendations doctors may have.

Types of hysterectomy

There are various types of hysterectomy:

• Total hysterectomy – the womb and cervix are removed; this is the most commonly performed operation
• Subtotal or Supracervical hysterectomy – the main body of the womb is removed, leaving the cervix in place.
• Total hysterectomy with bilateral salpingo-oophorectomy – the womb, cervix, fallopian tubes and the ovaries are removed
• Radical hysterectomy – the womb and surrounding tissues are removed, including the fallopian tubes, ovaries, part of the vagina, lymph glands and fatty tissue

Different ways to carry out a hysterectomy:

• Vaginal hysterectomy – the womb is removed through a cut in the vagina.
• Abdominal hysterectomy – the womb is removed through a cut in the lower abdomen
• Minimal Invasive hysterectomy (keyhole surgery) laparoscopic or robotic – the womb is removed through several small cuts in the abdomen.

Keyhole surgery requires only a few small incisions in the abdomen. A laparoscope inserted through one of these incisions allows the surgeon to see the pelvic organs. Other surgical instruments are used to perform the surgery through small 5 mm incisions.

Benefits of keyhole hysterectomy.

Compared with abdominal hysterectomy, laparoscopic /robotic surgery results in less pain, has a lower risk of infection, and requires shorter hospital stay.

Recovery after Hysterectomy.

You may need to stay in the hospital for one to a few days after surgery. The length of your hospital stay will depend on the type of hysterectomy and how it was done. If it is a keyhole surgery then one may be discharged within 24 hours. You can expect to have some pain for the first few days after the surgery. There will be medication given to relieve pain. You may have discharge from your vagina for several weeks.

Some important things about recovery.

Follow your health care provider’s instructions. Be sure to get plenty of rest, but you also need to move around as often as you can. Do not put anything in your vagina during the first 6 weeks. That includes douching, having sex, and using tampons.

After you recover, you should continue to see your specialist for routine gynecologic exams and general health care. Depending on the reason for your hysterectomy, you still may need pelvic exams and cervical cancer screening.