Hysterectomy: Facts About Removal of the Uterus, Including Risks Benefits Minimally Invasive Versions and Alternatives

The uterus is a small pear-shaped organ in a women’s lower body. A hysterectomy surgery takes this organ out of the women’s body. It is a reproductive organ, present in front of the rectum and at the back of the bladder. Uterus consists of an ovary and one fallopian tube.

A fertilized egg lives in the uterus until it is born.

After a hysterectomy, a woman can't have children or her period.

How Frequent Is Uterine Removal (Hysterectomy)?

US hysterectomy is widespread. After cesarean sections, it is the second most prevalent surgery for reproductive-age women in the US.

These surgeries are usually needed when medicine, hormone treatment, or less invasive procedures fail to relieve symptoms including pain and bleeding.

In rare situations, a hysterectomy may be needed to relieve life-threatening postpartum hemorrhage or gynecological malignancies.

What Is Taken Out During a Hysterectomy?

There are three main types of hysterectomy based on what parts are taken out −

Whole uterus removal   The cervix and uterus are taken out.

Total or partial hysterectomy above the cervix  Resection of the upper uterus. Cervix stays in this case.

An extreme hysterectomy  This is a full hysterectomy with removal of the fallopian tubes. Patients with cancer often need this surgery.

What Else Is Taken Out During a Hysterectomy Apart from the Uterus and the Cervix?

There may be more surgery needed after a hysterectomy.

The ovaries can also be taken out. This is what salpingo-oophorectomy is. Oophorectomy is surgery on the ovaries.

Salpingectomy means taking out the fallopian tubes. Ovaries and tubes that are affected by endometriosis can be taken out.

How Is Hysterectomy Surgery Performed?

Hysterectomy methods vary. The uterus may be removed by an open incision in the lower abdomen, vaginally, or laparoscopically through a few minor abdominal incisions.

Each treatment has dangers and advantages, and recovery time varies. If a woman has a big uterus, vaginal or laparoscopic procedures may not be possible.

Abdominal hysterectomy gives surgeons the greatest freedom. If you have a big uterus, lots of abdominal scar tissue, are obese, or have cancer, it may be suggested above other forms of hysterectomy. Most US women get abdominal hysterectomy.

Surgery typically takes one to two hours.

What Alternatives Exist to Conventional Hysterectomy Procedures?

Laparoscopic procedures in Vagina are less invasive because surgeons utilize smaller incisions and equipment.

Vaginal hysterectomy removes the uterus. No abdominal incision. Vaginal hysterectomy seldom causes difficulties. Most recover faster. It's best when feasible. The surgery will take 1-2 hours.

How Laparoscopic Hysterectomy Is Performed

This treatment requires just a few minor abdominal incisions (approximately 1/2 inch). A fiber optic laparoscope is put into one of these holes. Laparoscopes enable surgeons to see pelvic organs. Laparoscopic vaginal hysterectomy (LAVH) removes the uterus in tiny parts via the vagina, a larger abdominal incision, or the incisions. This approach is less infectious than abdominal. Procedure takes around two hours.

Treatment Options That Aren’t Hysterectomy

Most hysterectomies are elective, so women should have time to consider alternate pain and symptom management choices.

Alternatives to hysterectomy can address all conditions and symptoms that require uterine removal, save for certain gynecological cancers and uncommon emergencies such excessive bleeding after childbirth. Medication, hormones, and less invasive procedures are available.

Medical Solutions Depend on the Nature of the Issue

The effectiveness of any proposed remedies depends on how thoroughly they address the underlying problem. Noncancerous tumors like uterine fibroids may be treated medically so as to halt their growth. Orilissa (elagolix brand name) and other treatments may help with endometriosis pain.

Causes and Signs That Might Indicate a Need for a Hysterectomy

Many "women problems" can be treated with hysterectomy.

Uterine Fibroids: Painful, Noncancerous Tumors

Uterine smooth muscle cells form fibroid tumors. Up to 80% of women acquire fibroids during childbirth. Doctors commonly find them during pelvic exams or fetal ultrasounds because they rarely produce symptoms.

Symptoms of Uterine Fibroids

Heavy menstrual blood, lengthy periods (that lasts a week or even more), frequent urination, pelvic pain, low back pain, or uncomfortable interaction are it's symptoms.

Symptoms may require hysterectomy despite responding to medication or nonsurgical therapy. Only hysterectomy cures uterine fibroids.

Endometriosis: Uterine Lining Grows Outside the Uterus, Causing Pain and Infertility.

Endometriosis causes tissue to develop outside the uterus. 10% of childbearing women have this unpleasant ailment. Endometriosis often affects the ovaries, fallopian tubes, and peritoneum. Bowel and bladder infections are possible. Rarely, it occurs in the lungs.

Symptoms include severe menstrual cramps, persistent lower back and pelvic discomfort, bleeding, spotting between periods or intestinal pain, and digestive issues including constipation, nausea, and/or diarrhea particularly during periods.

Hormone treatment and painkillers may help. Lesions typically recur after minimally invasive disease removal. After many surgeries or unsuccessful hormonal therapy, women may choose a hysterectomy as a final option.

Cancer Treatment: Hysterectomy?

Hysterectomies are 10% cancer related. Hysterectomy treats the most common female cancer, endometrial. Many doctors advise surgery.

Abnormal vaginal bleeding can signal endometrial cancer. Hysterectomy frequently cures cancer.

Ovarian cancer begins in the ovaries, but endometrial cancer in the uterus. Ovarian cancer rarely appears until it spreads to the hips and belly, unlike endometrial cancer. Surgery and chemo treat ovarian cancer. Hysterectomy may be indicated if malignancy has spread.

Hysterectomy treats early cervical malignancies.

Is hysterectomy—Uterine Removal—Safe?

Yes. The surgery is safe, with a 1% death rate.

Some of the Associated Health Risks-

Hysterectomy is one of the safest surgeries, but complications might occur.

Hysterectomy risks −

  • Infection

  • Blood clots

  • Excessive bleeding

  • Anesthesia post reactions

  • Damage to the rectum, pelvic structures or the urinary tract.

Updated on: 10-May-2023


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