A hysterectomy is a major surgery that removes, at the very least, the uterus. It may be done for a variety of reasons, and depending upon the specific situation, and other organs may be removed at the same time. As with all surgical treatments, it comes with general risks, along with some specific to the operation.
Hysterectomy Options
A hysterectomy can be a minimally invasive procedure (MIP) or an open operation. There are a few different ways to perform MIPs. During a vaginal hysterectomy, the uterus is removed through a small incision made in the vagina, which is then stitched up and leaves no visible scarring. The other alternatives all involve a laparoscope, which is a tiny tube with a light and a camera on the tip. A very small incision is made in the stomach, the laparoscope is inserted, and then the surgical tools are inserted similarly. The doctor performs the procedure using the tools, or using robotic tools, watching with the camera on the laparoscope. The laparoscope can be used in combination with the vaginal method as well.
On the other hand, abdominal hysterectomies require an incision about six inches long in the abdomen, and then takes out the uterus through it. The open surgery method means a longer hospital stay, a longer recovery time, a bigger risk of infection, and more scarring.
Types of Hysterectomies
Depending on the reason for the hysterectomy, various types of hysterectomies may be used.
- Supracervical: Also called a partial or subtotal hysterectomy, only the uterus is removed in this procedure.
- Complete or Total: This is the most common sort of hysterectomy; the uterus and cervix are removed, but the fallopian tubes and ovaries remain.
- Radical: The uterus is removed, along with everything else. Supporting tissues, nearby lymph nodes, fallopian tubes, and the cervix must come out. If the ovaries are removed as well, it is considered a salpingo-oophorectomy, and it may be unilateral (one side) or bilateral (both sides).
Reasons for a Hysterectomy
Cancer is one of the most common reasons for a hysterectomy. The aggressiveness of the cancer and how far it’s spread factor into how much is removed. While radiation or chemotherapy may be an alternative, they may have to be performed in addition to the hysterectomy as well.
Fibroids are tumors that occur in the region, but aren’t cancerous. They may, however, cause pain, anemia, or bleeding when they get too big. A hysterectomy is the only permanent solution. If they aren’t causing any problems, they may not need any treatment; if the problems aren’t too bad, there may be nonsurgical options instead.
The endometrium is the tissue lining of the uterus. Sometimes, it starts to grow on the outside of the uterus and on other nearby organs. A hysterectomy and salpingo-oophorectomy may be necessary if less radical alternatives don’t work for this condition, called endometriosis.
A uterine prolapse occurs when the tissue that keeps everything in place gets weak or strained and the uterus falls, leading to incontinence, constipation, and pain or pressure, which may only be relieved by a hysterectomy. Other reasons for this procedure include excessive bleeding or pelvic pain caused by the uterus that cannot be stopped through any other means. However, a hysterectomy may cause more harm than help in some of these cases. It’s important to discuss your situation thoroughly with your doctor and to know all of your options.
