What is a Hysterectomy?
A Hysterectomy is a surgical removal
of the uterus. It ends menstruation and the ability
to become pregnant.
How is it done?
A hysterectomy generally takes 1
to 3 hours. It may be performed under general or regional
anesthesia. During a Hysterectomy, the uterus may
be completely or partially removed. The fallopian
tubes may also be removed. Removal may be done through
a low midline transverse (bikini) incision, a vaginal
incision or through laparoscopic incisions on the
abdomen. After surgery, a catheter may remain in place
for 1 to 2 days to help the bladder pass urine. The
average hospital stay depends on the type of surgery
but is usually from 2 to 3 days.
Why is it done?
Hysterectomy may be performed
- Abnormal uterine bleeding that is not controlled
by other treatment methods
- Severe endometriosis (uterine tissue that grows
outside the uterus)
- Uterine fibroids (benign tumors) that have increased
in size, are painful or cause bleeding
- Increased pelvic pain related to the uterus but
not controlled by other treatment
- Uterine prolapse - (uterus that has "dropped"
into the vaginal canal due to weakened support muscles)
that can lead to urinary incontinence or difficulty
with bowel movements
- Cervical or uterine Cancer
- Complications during childbirth (like uncontrollable
Risks & complications
There are possible risks and complications
associated with anesthesia, including respiratory
or cardiac malfunction. Other complications include:
- Wound complication (i.e. abscess, disruption)
- Excessive bleeding or blood clots
- Bladder, ureter or bowel injury
- Pain with intercourse, decreased libido, or reduced
ability to have an orgasm
- Temporary abdominal distention due to bowel ileus
or transient decreased bowel movement
Following surgery, some women may
feel a sense of loss or become depressed, but these
emotional reactions are usually short-lived.
Risks can be reduced by following
the surgeon's instructions before and after surgery.
Alternate treatment options will
depend very much on the source of the problem. The
surgeon may discuss alternative approaches to Hysterectomy:
- Birth control pills or other medications may be
helpful in treating prolonged bleeding
- Endometrial ablation (removal of the lining of
the uterus) may help with very heavy periods
- Drugs can be used to shrink uterine fibroids
- Myomectomy, or surgical removal of fibroids, is
major surgery; one in three women have tumors recur
in 5 years
- Chronic pain may be treated with anti-inflammatory
drugs, birth control pills, or physical therapy
Expectations after surgery
Removal of the ovaries along with
the uterus in pre-menopausal women causes immediate
menopause, and estrogen replacement therapy may be