Hysterectomy is the surgery of the uterus and is one of the most common surgeries that women past the age of 45-50 years undergo. The uterus, also known as the womb, is where the baby grows and the uterine lining is the source of the menstrual blood. The ovaries are responsible for the production of estrogen and other hormones while the fallopian tubes carry the egg from the ovaries to the uterus. The surgery involves the removal of the uterus, cervix, ovaries and fallopian tubes. You may opt for this surgery for a number of reasons, such as preventing post-menopausal bleeding, removal of cancers of the cervix or the endometrium (uterus lining) and to address persistent uterine fibroids which are non-cancerous (benign) growths in the muscles of the uterus.
The procedure can result in various changes in your body depending on the specific organs that have been removed. The results are likely to vary depending on the kind of hysterectomy that you opt for.
The types of Hysterectomy include:
- Radical Hysterectomy: This involves the removal of uterus, cervix, ovaries and fallopian tubes and pelvic lymph nodes. Once you have undergone this surgery, you will attain menopause.
- Simple Hysterectomy: This surgery will only involve the removal of the uterus and cervix but won’t remove the ovaries and fallopian tube. Undergoing this surgery will not result in menopause.
- Partial Hysterectomy: Also known as supracervical hysterectomy, this procedure will remove your uterus while your cervix, ovaries and fallopian tubes remain. This procedure will not result in menopause.
- Total Hysterectomy: This procedure will remove your entire uterus along with the cervix, ovaries and fallopian tubes, thus bringing about menopause. In case only one ovary is removed, estrogen production is maintained and, consequently, menopause is prevented.
Why opt for Hysterectomy?
You are likely to opt for the surgery for a number of reasons such as:
- Severe bleeding from the vagina which can be a result of some infection, cancer, uterine fibroids or changes in hormonal level.
- Uterine prolapse, a condition in which the uterus moves into the vagina from its original position in the abdomen, thereby causing troubled urination or pressure on the pelvis. This is likely to occur due to childbirth or obesity.
- Endometriosis, a condition in which the uterine lining grows on the ovaries and pelvic structures, causing severe pain and bleeding.
- Severe bleeding after childbirth.
- Adenomyosis, a condition where the inner lining of the uterus grows into the muscles of the uterus.
- Uterine fibroids which is a common issue troubling women today and are composed of non-cancerous tumor-like growths in the uterine muscles. They vary in size and can interfere with childbirth. Fibroids result in tremendous back pain, frequent urination and severe bleeding.
- In case you are diagnosed with cancer in the uterus, cervix or ovaries, the removal of the uterus may be imperative to prevent the cancer from spreading to the rest of your body.
How is a Hysterectomy carried out?
The three most common techniques are Abdominal, Vaginal, Laparoscopic Hysterotomy. All the procedures are carried out under general or local anesthesia. A local anesthesia is likely to numb your body below the waistline. However, sometimes the anesthesia is also combined with a sedative that will put you to sleep while the procedure is carried out.
- Abdominal Hysterectomy: This surgical procedure involves the removal of the uterus through an incision made in the lower abdomen. The incision may be either horizontal or vertical. Both heal quickly and are not likely to leave deep scars. You might be advised to opt for abdominal hysterectomy if you have a large uterus or if the doctor wants to check other pelvic organs for any signs of disease.
- Vaginal Hysterectomy: This procedure involves the removal of the uterus through an incision made in the vagina. During this procedure, the surgeon detaches the uterus from the vagina, fallopian tubes, upper vagina, as well as the blood vessels and the connective tissues. Vaginal Hysterectomy requires far less recovery time as compared to abdominal hysterectomy. The procedure also costs less than a abdominal hysterectomy. Since the cuts are not external, there will not be any visible scarring.
- Laparoscopic Hysterectomy: This procedure involves the use of an instrument called a laparoscope which consists of a long, thin tube accompanied by a high intensity light and high resolution camera. The surgeon makes three to four small incisions in the lower abdomen instead of just one incision. The surgeon then inserts the laparoscope through the small incisions and once the uterus is located, the surgeon cuts the uterus into small parts and remove them one by one.
Is Hysterectomy a safe procedure?
The procedure is relatively safe and is not likely to cause many side effects. However some risks involved include:
- Severe Bleeding
- Reaction to anesthetics
- Injury to surrounding organs such as bladder, intestines and blood vessels
How long does it take to recovery from a Hysterectomy
Recovery time from the surgery would depend on the exact procedure that you have opted for. If you have opted for abdominal hysterectomy, you are likely to return home after two to three days but complete recovery is likely to take around six to eight weeks. In case you have opted for vaginal hysterectomy, which is a less invasive procedure, your recovery time will take around two to three weeks but you can go home after a day or two. For laparoscopic hysterectomy, the recovery time is around two weeks.
After having undergone vaginal hysterectomy, your vagina will be packed with gauge to control the bleeding. Once it has been removed, you might experience bloody or brownish discharge from your vagina and may want to use a sanitary napkin to absorb this discharge.
You are advised to walk around the hospital and even once you return home in order to prevent blood clots in your legs. You must however abstain from lifting heavy objects or pushing and pulling them. It is advisable to avoid sexual intercourse for few weeks too after having undergone the surgery.
How much will a Hysterectomy cost you?
The cost of hysterectomy will vary depending on the type of procedure that you opt for. The procedure typically range from around $9,000-$12,000 in the United States. But is much less expensive in parts of Asia, costing around $2,000 in Philippines, $3,500-$4,500 in Malaysia and around $3,000-$5,000 in Thailand.