Generally, a hysterectomy is carried out when other treatments have not resulted in the desired improvements.
What types of hysterectomy are there?
There are three main types of hysterectomies:
- Partial / subtotal hysterectomy – removal of the uterus but the cervix is left behind
- Total hysterectomy – removal of the uterus and cervix
- Radical hysterectomy – removal of the uterus, cervix and surrounding tissue due to cancer or non-cancerous diseases
Why a hysterectomy?
A hysterectomy may be recommended for a number of reasons including:
- Uterine fibroids
- Abnormal uterine bleeding
- Prolapse of the uterus
- Enlarged uterus due to adenomyosis
- Heavy or irregular menstrual bleeding
- Pelvic Inflammatory Disease (PID)
- Endometrial hyperplasia
- Persistent abnormal pap smear
- Gynaecological cancers
- Not responding to medical or minimally invasive surgery, such as endometrial ablation and Mirena
During a hysterectomy, the ovaries can be removed if the patient is menopausal or at high risk of developing ovarian cancer. Nevertheless, the ovaries can be preserved for hormone production.
For young women or those not at risk of ovarian cancer, the ovaries should be preserved. Removing ovaries will bring on menopause if you are not menopausal as yet.
Hysterectomy can be performed in different ways based on the patient’s history and conditions. These different methods are listed below:
- Laparoscopic hysterectomy – this is an operation that is done through keyhole incisions that are 5-12mm long, also known as keyhole or minimal access surgery.
- Abdominal hysterectomy – this surgery is performed through an abdominal incision and is also known as open surgery. The recovery time is longer due to the need for a longer incision to heal.
- Vaginal hysterectomy – there are fewer complications with this type of hysterectomy. This includes a shorter hospital stay, quicker recovery and reduced healing time. Some hysterectomies are too risky to be performed vaginally though.
Most hysterectomy procedures are uncomplicated, however, ss with any surgical procedure there can be several complications afterwards. These include:
- Deep vein thrombosis and pulmonary embolus, which are blood clots in legs and lungs
- Injury to internal organs, such as the bladder, bowel and ureters
- Very rarely, women can develop new onset bladder issues, however, they typically respond to medication