Hysterectomy surgery: it sounds serious and you’d be lying if you said you were not worried. After all, the removal of all or part of your reproductive organs is not something that anyone takes lightly and hysterectomy surgery is considered a major surgery.
But
if you are suffering from a painful condition or you have received a diagnosis
of serious illness, it might be the best option.
Surgery
is a big step to take and it’s OK to feel scared, apprehensive or unsure if it’s
the right thing for you to do.
Don’t
be afraid to ask questions about your hysterectomy surgery
Your surgeon and your doctors take your condition seriously and there are good reasons for their advice. After surgery, your symptoms are likely to be more manageable and your quality of life is likely to be better than what you are experiencing now.
Let
your doctor guide you through the procedure and don’t be afraid to ask questions.
Hysterectomy surgery is major surgery and you need to be well-informed so that
you are comfortable with committing to such a big decision.
Reasons for having hysterectomy surgery
There are a number of reasons why you
might need a hysterectomy and they include the following conditions:
- Cancer of the reproductive organs including
the ovaries, uterus, cervix or fallopian tubes - Continuous, uncontrollable uterine bleeding
- Endometriosis (heavy bleeding and severe pain
occur when uterine cells are found on surrounding organs and tissue) - Persistent heavy bleeding
- Pelvic Inflammatory Disease (infections in
the reproductive organs or pelvic area are the most common causes). - Severe, chronic pelvic pain caused by
endometriosis, adenomyosis or infection. - Adenomyosis (a condition where uterine
cells grow in the muscle layer of the uterus, causing painful heavy bleeding) - Fibroids that are painful and are increasing
in number or size
Hysterectomy surgery explained: Which type of procedure will your doctor use?
When you and your doctor have decided that
a hysterectomy is the best option for you, you will undergo one of the
following procedures:
1. Vaginal Hysterectomy
Your
surgeon will make an incision in the upper part of your vagina, allowing your
uterus to be removed through the incision. This is the preferred surgery for
non-cancerous conditions because it is less painful and the recovery time is
shorter. There is also no visible scarring.
2. Laparoscopic Hysterectomy
A laparoscopic hysterectomy is often
performed for fibroids, painful or heavy periods, severe pelvic pain, or as
part of cancer treatment.
Your surgeon will make up to four small incisions in your abdomen. A laparoscope (a thin tube with a light and camera) inserted into one of the incisions will allow your surgeon to see your reproductive organs on a screen, while the other incisions enable access for surgical instruments.
3. Abdominal Hysterectomy
This type of surgery is more extensive than the others. Your surgeon will make a horizontal incision across the pubic hair line but occasionally, a vertical incision is also necessary.
This
type of surgery is most common when treating cancer, extensive fibroids, or
endometriosis.
Hysterectomy types: What’s the
purpose of your surgery?
The type of surgery you will undergo depends on your diagnosis because different conditions require different types of surgery. The different types of hysterectomy surgery include:
Hysterectomy with Ovarian Conservation
Sometimes known as a total hysterectomy, this is one of the most common hysterectomy surgeries. It involves the removal of the uterus, fallopian tubes and the cervix, while the ovaries remain intact. It is often used to treat bleeding disorders.
Partial or Sub-total Hysterectomy
During
this surgery, the surgeon removes the upper two-thirds of the uterus, along
with the fallopian tubes, leaving the cervix intact.
Hysterectomy with Oophorectomy
This procedure removes one or both ovaries along with the uterus. The reason for this type of surgery is usually ovarian cancer or a high risk of ovarian cancer that justifies the possible complications and side effects. It is likely to cause early menopause in pre-menopausal women.
Radical or Wertheim’s Hysterectomy
During a radical hysterectomy, the surgeon
removes the uterus, fallopian tubes, ovaries, surrounding lymph nodes and the
upper section of the vagina. The most common reason for
this type of surgery is cancer of the reproductive organs.
How long does a hysterectomy surgery take?
The
length of time the surgery takes depends upon the type of procedure and the
complexity of your condition.
If
all goes to plan, an abdominal or vaginal surgery usually takes 1 – 1 1/2 hours,
while a laparascopic procedure may take up to 1 hour and 40 minutes.
What to expect after surgery
- Pain around the surgery site (you will be
offered pain relief) - Wind pain for up to a week
- A hospital stay of 2-4 days
- You should start taking short walks while you
are in hospital - You will have a catheter for the first 24
hours unless you suffered bladder trauma during surgery and it needs to stay in
longer.
Hysterectomy complications
No
surgery is without risk and complications can occur. Hysterectomy risks are
rare but still need to be considered before you undergo surgery. Some of the possible
complications include:
- An allergic reaction to the anaesthetic
- Urination difficulty
- Nausea or vomiting
- Internal haemorrhage
- Internal scar tissue
- Haematoma beneath the stitches (a bulge or lump caused by blood collecting at the site)
- Fistula (an abnormal space between internal organs or structures)
- Bladder, bowel or ureter trauma
- Ongoing pelvic pain
- Unresolved feelings of grief or loss
Hysterectomy side effects
The
side effects of a hysterectomy vary according to the type of surgery and
whether you are pre-menopausal or post-menopausal when you have the surgery.
They can include:
- Surgical menopause (no more menstruation, along with other menopausal symptoms)
- Infertility
- Emotional trauma related to the loss of fertility
- Hot flashes
- Vaginal dryness
- Mood swings
- Night sweats
- Decreased libido
- Hormonal changes that lead to anxiety, depression and irritability
Do you still need cervical screening after a hysterectomy?
Many women assume that a hysterectomy
means they have no need for cervical screening in the future.
In many cases, you do still need to have cervical screening, especially if your hysterectomy was for the treatment of cancer. Your doctor will advise you if you no longer need to have regular cervical checks.
Your recovery time will depend upon
the type of surgery that you had. For laparascopic surgery, recovery time is
shorter and there are fewer restrictions on what you can do. For more invasive
surgery, you will need to allow around 6 weeks for complete recovery.
Tips for recovery from hysterectomy surgery
Look after yourself with these tips:
- You will not be allowed to do any heavy lifting for at least two weeks
- Many housework duties will be unsuitable during this time
- You should aim for gentle regular walks to maintain your fitness and get your circulation and bowels moving
- Stay hydrated to aid in healing
- Avoid sex for 4 – 6 weeks
- Get at least 8 hours of sleep each night
- Eat nutritious food to boost healing
- Get plenty of fibre to combat the common problem of constipation after surgery
- Avoid smoking as it slows the healing process
- Don’t put anything in your vagina for 4 – 6 weeks (ie tampons or douching)
- Avoid swimming while your stitches are still in place
Hysterectomy Surgery: a Big Decision for a Better Life
Hysterectomy surgery is a big decision with life-changing consequences.
But once you have weighed up the options, it might turn out to be the best
thing you can do to improve your symptoms and quality of life. Talk to your
doctor, take your time, and think of the positive things that could arise from
taking this step.