Hysterectomy

Hysterectomy is a procedure wherein the womb, or uterus, is removed surgically. In the US, this is the most common non-obstetrical surgery that is carried out on women. Out of each 100,000 women, about 300 will undergo this surgical procedure.

It was back in 1843 that the very first hysterectomy procedure was carried out, which was performed by Charles Clay, in Manchester, England. This involved removing the uterus, leaving the cervix intact. But it was much later, in 1929, that the first Total Abdominal Hysterectomy, or TAH, was performed, by Richardson, MD, wherein the whole uterus was taken out.

What are the Reasons for opting for Hysterectomy?

One of the main reasons that hysterectomy is resorted to is due to the growth of fibroid tumors in the uterus, which may result in pain and heavy bleeding.

Hysterectomy could also be advised for the following reasons:

• Endometrial Cancer - A cancer that occurs in the endometrium, or the mucous membrane that lines the uterus.
• Endometriosis – A condition wherein the endometrium grows elsewhere than in the uterus’ lining, such as on the fallopian tubes, the ovaries, or other organs of the abdominal region. Hysterectomy is usually resorted to, when it does not respond to medications, or other surgical methods fail in curing it.
• Severe Cervical Dysplasia or Cervical Cancer - The cervix detected as being in a pre-cancerous stage.
• Severe or Moderate Uterus Prolapse - The falling or slipping out of place of the uterus, such as into the vagina, which can result in difficult bowel movements, pressure in the pelvic region, or urinary problems.
• Continual Bleeding form the Vagina – A hysterectomy may provide relief if there is incessantly heavy bleeding during periods, or they are not regular, or continues for many days, and when the bleeding cannot be controlled by medications.
• Complications occurring during childbirth, such as uncontrollable bleeding.
• Ovarian Cancer

The Various Kinds of Hysterectomy Procedures

Radical Hysterectomy: This is usually resorted to when the organ becomes cancerous and involves the removal of the uterus as well as the cervix, the vagina’s upper part, and the tissues surrounding the area.

Partial Hysterectomy: This involves the removal of the upper part of the uterus, while leaving the cervix intact.

Total Hysterectomy: This procedure is the most common and involves the removal of the whole uterus along with the cervix.

There are a number of ways in which the hysterectomy can be performed:

• Laparoscopic Hysterectomy - A procedure that involves puncturing the abdomen in order to allow the insertion of a laparoscope along with other surgical instruments.
• Vaginal Hysterectomy - This procedure involves making a vaginal incision.
• Abdominal Hysterectomy - In this method an incision is made on the abdomen.

The patient will be advised by the doctor about deciding which kind of hysterectomy would be the most appropriate on the basis of her medical history as well as the particular condition for the surgery.

What is the Prognosis of Hysterectomy?

Generally, hysterectomy is a safe procedure, however, there are always some risks associated with any major surgery, such as an adverse reaction to anesthesia, excessive bleeding, infection, or blood clots.

Some of the other risks involved in a hysterectomy are:

• The loss of the function of the ovaries.
• The rectum, bladder, or urinary tract being damaged during the procedure, which could result in having to resort to further surgery to repair them.
• Menopause occurring early.

If the ovaries are removed along with the uterus in women who are pre-menopausal, it results in immediate menopause, in which case the doctor may advise estrogen replacement therapy.