What is a Hysterectomy?
A hysterectomy is a surgical procedure to remove the womb (uterus). It the most common surgical procedure performed on women after cesarean section. Various studies show that on an average 7-8 % of women undergo hysterectomy every year in India.
Hysterectomies are carried out to treat conditions that affect the female reproductive system, including:
- heavy periods (menorrhagia)
- non-cancerous tumours (fibroids)
- long-term pelvic pain due to endometriosis
- ovarian cancer, uterine cancer, cervical cancer or cancer of the fallopian tubes
A hysterectomy is a major operation with a long recovery time and is only considered after alternative, less invasive, treatments have been tried.
Let us first look at what alternatives you may have before you take this decision!
Many women don’t know there are alternatives or less-invasive options, like laparoscopic surgery. For women aged 35 to 54, the most common reasons for a hysterectomy are fibroids, endometriosis, and abnormal bleeding; after age 55, the most frequent reasons are uterine prolapse or cancer. However, there are new treatments for fibroids and bleeding that can help women avoid a hysterectomy.
Even the largest fibroids can be removed surgically (Myomectomy); others methods that have been tried are Hi-frequency focused ultrasound waves and cutting off their blood supply with tiny plugs in blood vessels (uterine artery embolization). Abnormal bleeding can be halted by various means of destroying the uterine lining. Prolapse can usually be corrected surgically without removing the uterus.
Myomectomy means the surgical removal of just the fibroid, with reconstruction and repair of the uterus. It is usually offered for women who are young and those who wish to conserve their uterus for fertility or until menopause.
While bothersome symptoms such as very heavy bleeding or pain often respond to medications or other non-surgical treatment, sometimes the symptoms do not get better. For some women, when other minimally invasive surgical techniques may have failed, hysterectomy may be appropriate.
There are times when hysterectomy may be unavoidable; some women who have endured years of pain and bleeding do choose hysterectomy.
If there is no option other than going in for a hysterectomy, are there different ways of doing it?
There are various ways to remove the uterus - Abdominal, Vaginal and Laparoscopic.
Out of all these, vaginal hysterectomy is the most comfortable for the woman and has least complications when performed by a well-trained gynecologist.
Laparoscopic surgery has made it possible for reducing the hospital stay and also providing more comfort with less pain. Abdominal surgery is opted for in some patients where the other methods are not feasible and in cases of cancer usually. It is a safe procedure but the woman has more pain and longer recovery time.
Currently, laparoscopic hysterectomy has gained popularity due to its relatively pain-free recovery and shorter hospital stay, and since it does not cause scars on the abdomen like an abdominal surgery. Hysterectomy is a major surgery. Do not opt for it unless a qualified gynecologist has evaluated you and recommended it.