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    Hysterectomy Surgery

    A hysterectomy is a procedure to surgically remove the uterus, the womb of a woman. One may need to undergo hysterectomy for various reasons ranging from chronic pain during menstruation, fibroids, infections and cancer.

    In most cases, only the uterus is removed but in some cases, the doctor may also remove the ovaries and the fallopian tubes.

    When do you need hysterectomy?

    Your gynaecologist may suggest hysterectomy if a woman is suffering from any of the following conditions:

    1. Chronic pelvic pain
    2. Excessive vaginal bleeding.
    3. Cancer of Uterus, Cervix, or Ovaries
    4. Fibroids- benign tumours in uterus.
    5. Pelvic inflammatory disease.
    6. Uterine Prolapse
    7. Endometriosis
    8. Adenomyosis, a condition in which the inner lining of the uterus grows into the muscles of the uterus

    Hysterectomy types

    There are several different types of hysterectomy.

    Partial hysterectomy – Partial hysterectomy in which a surgeon removes only a portion of the uterus, and leave the cervix intact;

    Total hysterectomy – Total hysterectomy, in which entire uterus and cervix are removed.

    Salpingo oophorectomy – Salpingo-oophorectomy, doctors remove the uterus along with one or both the ovaries and fallopian tubes.

    Post salpingo-oophorectomy – The woman needs to be on the hormone replacement therapy (HRT).

    When you can avoid hysterectomy

    Though a hysterectomy is quite a common and safe procedure, not every woman who have symptoms similar to those written above need it. Besides, it should always be performed as the last option, especially in the younger women as they might want to have children.

    Doctors feel that many conditions which require surgical removal of uterus can be treated with medicines and alternate therapies also. Doctors may prescribe one or the other treatment options depending upon the condition:

    • Hormone therapy
    • Oral contraception
    • Pain medications
    • Surgery to sear pelvic nerves
    • Uterine artery embolization
    • Endometrial ablation

    In some conditions, however, hysterectomy is the best choice of treatment. In some, it is a life-saving surgery. It’s important to discuss your options with your doctor and determine the best choice for your specific condition.

    Understanding the hysterectomy procedure

    A hysterectomy can be performed under a general or local anaesthesia. In an abdominal hysterectomy, surgeon removes the uterus through a large incision in the abdomen. This incision can be vertical or horizontal. They take time to heal and leave some scar.

    In a Vaginal hysterectomy, the surgeons makes a small incision inside the vagina and from there the uterus gets removed. Since there is no external incision, there is no visible scar.

    Laparoscopic Hysterectomy

    In a laparoscopic hysterectomy, surgeons make 3-4 tiny incisions in the abdomen and inserts a laparoscope, a long and thin tube fitted with a high intensity light, and a camera

    Communicate with your doctor and choose the type of hysterectomy that’s best for you. On the surgery day, make sure, you have someone to help you.

    Risks associated with a hysterectomy

    Though a hysterectomy is quite a safe procedure, like all other surgeries—be it a small or big surgery, it too has some risks involved. Some people may have an adverse reaction to the anaesthesia. Some people are at risk of heavy bleeding post surgery or of developing infection around the incision site.

    There is also some risk of injury to surrounding tissues or organs, including urinary bladder, intestines, and blood vessels.

    Recovery post-hysterectomy

    Recovery also depends on the type of hysterectomy the patient has undergone. You may need hospitalisation from 1 to 5 days. Post-surgery, you will be on painkillers and the doctor will a watch on your vital signs such as breathing and heart rate. 

    It is advised to walk around as soon as you can, depending upon your health. It helps prevent the formation of the blood clots.

    In vaginal hysterectomy, the doctor will place a gauze to control the bleeding for a few days. Post that you may need to wear a sanitary pad for a few more days. Post-surgery, keep walking but avoid strenuous activities such as lifting heavy objects, pushing and pulling heavy weights, front bending, and intercourse.

    Laparoscopic Hysterectomy

    In laparoscopic hysterectomy, it takes 3 to 4 weeks to return to most routine activities. However, this recovery time will be a little longer in case of abdominal hysterectomy.

    Life post-hysterectomy

    A hysterectomy is a major surgery and brings some permanently changes

    1. You’ll no longer have menstrual periods
    2. You will not be able to become pregnant.
    3. There would be relief from the symptoms that caused the need for surgery.
    4. Due to hormonal disturbance, you may feel emotional. Contact your doctor who can recommend HRT, if needed.

    What discomfort can I face post surgery?

    You may some temporary side-effects such as:

    1. Pain
    2. Bleeding
    3. Infection
    4. Bladder problems
    5. Constipation
    6. Blood clots in legs or lungs

    Can there be any long-term side effects

    There are some rare long-term side effects that may develop after a hysterectomy. These include

    • Lymphedema accumulation of fluid in the legs or abdomen
    • Weakness of muscles or ligaments that support the vagina, bladder, and rectum
    • Shortening of vagina

    Please let your doctor know about any side effects you’re facing as many of them can be treated.

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