Over 600,000 hysterectomies are performed each year in USA, 70% (420,000) of hysterectomies performed are done using open abdominal surgery. This leaves a larger scar, is more painful, has a longer hospital stay and a longer recovery. Minimally invasive procedures, like laparoscopic hysterectomy is our routine method of performing hysterectomy. 99% of all of our surgeries are performed using minimally invasive techniques. We perform complicated pelvic surgeries and large hysterectomies on a routine basis; this allows for a shorter stay on an outpatient which is less expensive for the patient and a shorter recovery.
Hysterectomy — removal of the uterus — is a way of treating problems that affect the uterus. Many conditions can be cured with hysterectomy. Because it is major surgery, your doctor may suggest trying other treatments first. For conditions that have not responded to other treatments, a hysterectomy may be the best choice.
About the Uterus
The uterus is a muscular organ in the pelvis. The opening of the uterus is the cervix.
What Is Hysterectomy?
Hysterectomy is the surgical removal of part or all of the uterus. It is the second most common major surgery among women of child-bearing age.
Some reasons a hysterectomy may be needed include:
Uterine fibroids
Endometriosis
Pelvic support problems (such as uterine prolapse)
Abnormal uterine bleeding
Cancer
Chronic pelvic pain
A hysterectomy can be:
Subtotal (also called partial or supracervical), in which the upper part of the uterus is removed but the cervix is left in place
Total, in which the entire uterus, including the cervix, is removed
Radical, in which the entire uterus and support structures around the uterus are removed (this is done if certain types of cancer are present)
A hysterectomy does not include removal of the ovaries and fallopian tubes.
Types of Hysterectomy
The type of hysterectomy chosen depends on the reason for the surgery. It also depends on the findings of a pelvic exam.
Abdominal Hysterectomy
In abdominal hysterectomy, the doctor makes an incision (cut) through the skin and tissue in the lower abdomen to reach the uterus. The incision may be vertical or horizontal.
Abdominal hysterectomy requires a longer healing time than vaginal or laparoscopic surgery. But there can be advantages to having an abdominal hysterectomy. This type of hysterectomy gives the surgeon a good view of the uterus and other organs during the operation
Vaginal Hysterectomy
In vaginal hysterectomy, the surgery is done through the vagina. With this type of surgery, you will not have any scarring on your abdomen. Because the incision is inside the vagina, the healing time may be shorter than with abdominal surgery.
Laparoscopically Assisted Vaginal Hysterectomy
With laparoscopically assisted vaginal hysterectomy (LAVH), the doctor removes the uterus through the vagina. Your doctor may suggest LAVH if standard vaginal surgery cannot be done. LAVH involves the use of a small light-transmitting device called a laparoscope.
Total Laparoscopic Hysterectomy
Total Laparoscopic hysterectomy is done through small incisions in the abdomen. The total uterus is removed in through the vagina and the top of the vagina is sutured closed.
Supracervical Laparoscopic Hysterectomy
Supracervical Laparoscopic hysterectomy is done through small incisions in the abdomen. The uterus is removed in small pieces through these incisions but the cervix is left in place. This particular procedure has the shortest recovery time.
What to Expect
It is helpful to know what to expect before any major surgery. Before hysterectomy:
Your blood and urine may be tested.
You may be given one or more enemas.
Your abdominal and pelvic areas may be partially shaved.
Antibiotics will be given to prevent infection.
Risks
The risk of problems related to hysterectomy is among the lowest for any major surgery. As with any surgery, though, problems can occur. These problems could include:
Blood clots in the veins or lungs
Infection
Bleeding during or after surgery
Bowel blockage
Injury to the urinary tract or nearby organs
Problems related to anesthesia
Early menopause (if ovaries are removed)
Death
Your Recovery
If you have a hysterectomy, you may need to stay in the hospital for a few days. The length of your hospital stay will depend on the type of hysterectomy you had.
Effects of Hysterectomy
Hysterectomy can have both physical and emotional effects.
Physical Effects
After hysterectomy, a woman’s periods will stop. If the ovaries are left in place, they continue to produce hormones. Although the ovaries still function, a woman can no longer get pregnant.
Emotional Effects
Many women have an emotional response to the loss of their uterus. This response depends on a number of factors and differs for each woman.
Sexual Effects
Some women notice a change in their sexual response after a hysterectomy. Because the uterus has been removed, uterine contractions that may have been felt during orgasm will no longer occur.
Some women feel more sexual pleasure after hysterectomy. This may be because they no longer have to worry about getting pregnant. It also may be because they no longer have the discomfort or heavy bleeding caused by the problem leading to hysterectomy.
Finally…
Hysterectomy is just one way to treat uterine problems. It is major surgery. Before you decide whether it is right for you, find out as much as you can about:
Your condition
Other treatment options
How hysterectomy may affect you