What Is Hysterectomy?
The uterus is the female organ that’s responsible for the conception and development of the fetus. It’s susceptible to a wide variety of conditions that alter its function and structure. Hysterectomy is usually one of the surgical procedures used to alleviate discomfort and improve a woman’s health condition.
Hysterectomy is a surgical technique in which the uterus is removed and removed. Studies estimate that it’s the second most frequent gynecological surgery performed in women of reproductive age. Uterine extraction can be either total or partial.
Why is hysterectomy performed?
In general, hysterectomy is one of the last options when treating abnormalities of the uterine tissue. There are several conditions that warrant performing this procedure, among which we find the following:
- Fibroids: These are non-cancerous growths that originate in the walls of the uterus and are usually accompanied by continuous bleeding, pain, and a sensation of pelvic weight. Research suggests that uterine fibroids are one of the most common reasons why hysterectomy is recommended.
- Abnormal uterine bleeding: Uterine removal may be helpful in women who experience large amounts of blood loss, which may or may not be associated with menstruation.
- Uterine prolapse: This is the displacement of the uterine apparatus through the vagina, associated with the weakness of the ligaments and supporting structures. It’s usually the result of multiple vaginal deliveries or postmenopausal changes.
- Endometriosis: This is the growth of the inner lining of the uterus outside of the organ, in the area of the fallopian tubes, ovaries, or other pelvic regions. It’s associated with ongoing bleeding, pain, and persistent discomfort.
- Adenomyosis: This occurs due to the proliferation of endometrial tissue within the uterine myometrium, causing a thickening of the walls and intense pelvic pain during the menstrual cycle.
- Gynecologic cancer: Hysterectomy is one of the most common treatment options for people with cervical cancer. Its use depends on the stage and severity, and can be associated with chemotherapy and radiotherapy.
Risks
In general terms, hysterectomy is a safe surgical procedure with satisfactory therapeutic results. However, it’s associated with several complications or side effects, being an invasive procedure.
Among the main risks of surgery are the following:
- Damage or injury to the bladder, ureters, or rectum
- Clots and thrombosis
- Infections
- Subsequent heavy bleeding
- Early menopause in case of ovarian extraction
- Pain or discomfort during sexual intercourse
Considerations before the procedure
Hysterectomy is an irreversible procedure that requires adequate psychological preparation and detailed planning. In this sense, it’s vital to learn about all aspects of the surgery.
Similarly, the doctor’s instructions about the consumption of medications and changes in daily habits should be followed. In most cases, it’s recommended that you don’t take aspirin, clopidogrel, warfarin, and any other blood thinners. In addition, it’s usually advisable to give up smoking in the days before the surgery.
It’s important to make prior arrangements for the hospital stay and post-procedure assistance. The hospitalization period depends on the type of hysterectomy, however, the minimum length of stay is usually one to two days.
In general, the doctor will usually recommend that you don’t eat food in the 8 hours before the surgery. Similarly, a thorough washing of the skin should be performed in order to reduce the risk of infection.
What to expect during hysterectomy surgery
In-hospital preparation before starting the procedure includes the administration of prophylactic antibiotic therapy and general anesthesia. In addition, a urinary catheter is usually placed to empty the bladder, which will remain during the surgery and a prudent time afterwards. The surgical procedure usually lasts about 1 to 2 hours.
Once the person is on the operating table, the vagina and abdomen will be cleaned with an antiseptic solution. The surgeon will then make an incision or cut in the lower abdomen to address the pelvic cavity.
The incision can be vertical, from the navel to the pubis, or horizontal. This choice will depend on the need for exploration, the volume of the uterus, and the type of hysterectomy to be performed.
In the case of a partial hysterectomy, the body of the uterus is removed, leaving the cervix in place. On the other hand, a total hysterectomy involves the removal of the entire uterine system. In addition, the fallopian tubes, ovaries, and surrounding tissue may be resected.
After the procedure
At the end of the surgery, the medical staff will be in charge of transferring the patient to the hospitalization area. They will keep you under continuous surveillance during the first few hours.
In general, vital signs will be monitored from time to time and intravenous medications will be administered, in order to relieve pain and reduce the risk of infection. Similarly, the doctor will encourage the person to get up and resume walking as soon as possible, with the aim of preventing the appearance of thrombi.
It’s common to have slight vaginal discharge or bleeding for several days after the intervention. Profuse or persistent vaginal bleeding should be reported to the specialist. For its part, the incision in the abdomen will heal progressively.
Expectation and lifestyle after hysterectomy
After the hysterectomy, it can take between 2 to 6 weeks to return to normal daily activities. Most women have an excellent long-term prognosis.
It should be taken into account that, after the procedure, menstruation will cease and the woman won’t be able to get pregnant. Similarly, the performance of hysterectomy in reproductive age can accelerate or induce the onset of menopause in the case of ovarian removal.
Studies suggest that hysterectomy provides great relief for women with painful periods and dyspareunia. However, psychological monitoring is vital.
In the months after the intervention, it’s advisable to carry out mild or moderate physical activity in order to maintain adequate blood circulation. On the other hand, a healthy eating plan, rich in proteins and vegetables, is important.
For most women of reproductive age, hysterectomy is an invasive surgery that can be alarming. However, it may be the only way to alleviate the discomfort that affects their day-to-day life.
If you have any questions regarding hysterectomy, don’t hesitate to consult your family doctor. Health professionals are trained to address your concerns, providing you with the best support and guidance in the resolution of your condition.
- Solà V, Ricci P, Pardo J, Guiloff E. Histerectomía: una mirada desde el suelo pélvico. Rev. chil. obstet. ginecol. 2006; 71( 5 ): 364-372.
- Márquez J, Barrabí A, Armas B, Rubinos J. Histerectomía abdominal en un servicio de cirugía general. MEDISAN. 2014;18(2):172-180.
- Hernández A, Reza G, Castillo E, Olivia C. Histerectomía Abdominal: Vivencias de 20 Mujeres. Index Enferm. 2006;15( 52-53 ): 11-15.
- Sardiñas R. La histerectomía laparoscópica y sus aspectos fundamentales. Rev Cubana Cir. 2015;54( 1 ): 82-95.
- Parada R, Bravo E, Franck C, Parry S et al. Histerectomía y corrección de incontinencia urinaria con TVT (Tension-free Vaginal Tape). Rev. chil. obstet. ginecol. 2002; 67(2): 94-99.
- Carmona J. Análisis de 100 casos de histerectomía vaginal en pacientes sin prolapso uterino. Rev Obstet Ginecol Venez. 2016;76(1):4-10.