Hysterectomy basics - WLTZ 38 | Columbus Georgia Regional News & Community

By Jenilee Matz, M.P.H., Staff Writer, myOptumHealth
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What is a hysterectomy?
A hysterectomy is surgery to remove the uterus (womb), an organ that is a part of the female reproductive system. Once a hysterectomy is done, a woman can no longer become pregnant and she will not have menstrual periods.

Different types of hysterectomy include:

• Subtotal hysterectomy. Removal of the uterus, but not of the cervix.
• Total hysterectomy. Removal of the entire uterus, including the cervix.
• Radical hysterectomy. Removal of the entire uterus and the lymph nodes. This is often done for cancer.

The ovaries and fallopian tubes are sometimes taken out at the same time as the uterus. When they are removed also, it's called a hysterectomy with a salpingo-oophorectomy.

Why does a hysterectomy need to be done?
There are many reasons why the uterus may need to be taken out, including:

• Uterine cancer. A hysterectomy may be done to remove cancerous and precancerous cells.
• Fibroids. These are common, noncancerous tumors in the uterus. If you have fibroids that begin to cause problems, your doctor may suggest a hysterectomy.
• Endometriosis. This condition occurs when tissue that lines the uterus grows implants on other places in the abdomen, such as the fallopian tubes, ovaries and other organs. It can be very painful. When other treatments don't work and your symptoms are severe, your doctor may advise a hysterectomy.
• Prolapse of the uterus. This happens when the uterus slips down into the vagina. It can lead to pain and urinary and bowel problems.
• Adenomyosis. This painful condition occurs when uterine tissue grows into the uterine muscle. A hysterectomy may be advised if other treatments have not helped.
• Severe vaginal bleeding Treatment for abnormal vaginal bleeding depends on the cause. When other treatments don't work, a hysterectomy is sometimes done to correct severe bleeding. A hysterectomy may sometimes be needed in an emergency situation.This may happen right after a woman delivers a baby, if bleeding can not be stopped. A hysterectomy in this case could be life-saving.

These are just a few examples. Hysterectomies can be done for other reasons as well. It is important to note that conservative treatment (such as medication) should be tried first before considering hysterectomy. A hysterectomy is usually done only as a last resort when other treatments don't work.

A hysterectomy is not done as a method of permanent birth control.

How is a hysterectomy performed?
There are several ways to remove the uterus. The method your surgeon chooses depends on why you need a hysterectomy, your medical history and possibly your preferences:

• Abdominal hysterectomy is done by an incision in the lower abdomen.
• Vaginal hysterectomy is when the uterus is removed through a cut in the vagina.
• Laparoscopy is when a lighted scope with a camera (called a laparoscope) is inserted through a small incision in your abdomen. Your surgeon will remove your uterus in pieces through several small incisions in your abdomen or through the vagina (laparoscopically assisted vaginal hysterectomy or LAVH).

How long does the procedure take?
The surgery time depends on the type of operation. Usually, it takes about an hour. General anesthesia (being put to sleep) may be used. Sometimes an epidural (which numbs the area) is used.

Many patients go home from the hospital after one to two days if there are no major problems. The type of scar you get depends on what type of incision was made.

How long does recovery take?
Recovery time also depends on the type of procedure you had. It's important to rest and follow your doctor's orders to heal well:

• Abdominal surgery. Recovery usually takes four to six weeks.
• Vaginal or laparoscopic surgery. Recovery can take three to four weeks.

Your doctor will let you know how long you should limit your activity after the procedure. Do not drive, lift heavy objects, use tampons, douche, take baths or have sex until your doctor says it is OK.

What are the risks?
Like all operations, a hysterectomy comes with risks:

• Vaginal bleeding
• Blood clots in the legs or lungs
• Bleeding and infection at the site of the incision
• Injury to nearby internal organs
• Pain during intercourse
• Bowel blockage
• Early menopause if the ovaries were removed
• Reactions to medication or anesthesia

Death can occur very rarely.

SOURCES:

• National Women's Health Information Center. Hysterectomy. Accessed: 03/25/2010

• American College of Obstetricians and Gynecologists. Accessed: 03/25/2010