Hysterectomy is a surgery performed to remove the uterus. The reasons for this surgery are:
Uterine fibroids, which cause women pain and bleeding problems
- Uterine cancer
- Chronic pelvic pain
- Uterine prolapse
- Abnormal vaginal bleeding
Sometimes in hysterectomy, the fallopian tube and ovary (one or both) along with the uterus are also removed. This is called a total hysterectomy.
There are many myths surrounding hysterectomy which need to be dispelled. Today, we will learn more about these myths, but let us understand the types of hysterectomy before that.
Types of Hysterectomy
There are three types of hysterectomy. Doctors choose the appropriate one according to the disease and the condition of the patient.
- Supracervical or subtotal hysterectomy: In this, only the upper part of the uterus is removed. The cervix is left untouched.
- Total hysterectomy: In this procedure, the entire uterus and the cervix are removed.
- Radical hysterectomy: The entire uterus, cervix, the tissue surrounding the uterus, and the upper part of the vagina are removed. A radical hysterectomy is generally performed when a woman has uterine cancer.
Techniques of Hysterectomy
Abdominal Hysterectomy: In this procedure, your surgeon removes the uterus through a six- to eight-inch-long incision in your abdomen. Your physician may suggest this technique for:
- Large fibroids
- Removal of fallopian tubes and ovaries
- An enlarged uterus
- Cancer, endometriosis or other diseases in the pelvic cavity
The main incision might ether be vertical – from navel down to your pubic bone – or horizontal – along the top of your pubic hairline.
Vaginal Hysterectomy: Your surgeon removes the uterus through your vaginal opening. Most often, this technique is used for treatment of uterine prolapse, or when the vaginal repairs become necessary for related conditions. Since the procedure does not involve external incision, there is no visible scarring.
Minimally Invasive Laparoscopic Hysterectomy: Your surgeon removes the uterus using very small incisions on your lower abdomen. The surgeon inserts a laparoscope (a thin, flexible tube having a video camera) through a cut in your belly button. Your surgeon makes many other small incisions in your abdomen to insert small scalpels and other surgical tools. The surgeon removes the uterus in sections through the laparoscope tube or through your vagina.
Minimally Invasive Robotic Hysterectomy: Your surgeon uses a combination of miniature instruments, robotic technology and high-definition 3D magnification to view, manipulate and remove the uterus. Typically, the surgeon makes four or five small incisions in the abdomen to allow small robotic arms and surgical tools to reach your uterus.
Myth #1: Hysterectomy affects sexual life.
Fact: Women are often scared that they will not be able to enjoy sex after a hysterectomy. But, after hysterectomy, sex life becomes more enjoyable. Before a hysterectomy, a woman experiences bleeding, pain, and cramps in the pelvic area and sex in such conditions is quite painful. Therefore, when the pain goes away, a woman’s libido increases.
Hysterectomy does not affect a woman’s sex life at all because the vagina remains intact. During sexual intercourse, sensations arise from the nerves in the front of the vagina. Therefore, removal of the uterus does not affect a woman’s sexual life. After a hysterectomy, if scar tissue is present in the vagina, it may cause unbearable pain during sex. But this condition is a complication of surgery that does not usually occur.
Myth #2: Menopause will begin immediately after surgery.
Fact: Hysterectomy will not be the cause of menopause if a woman’s ovaries are not removed. After crossing 40, the amount of estrogen in women’s bodies starts to decrease. And when women reach their 50s, the production of this hormone stops. The ovaries produce these hormones. Usually, in hysterectomy, the uterus is removed, not the ovary. The ovaries can also be removed during surgery, but only in some cases. Hysterectomy causes menopause only when both the ovaries are removed along with the uterus.
However , after a hysterectomy, a woman stops having periods. This does not mean that she has gone into menopause. A woman will go into menopause only if the natural production of estrogen in her body stops.
Myth #3: This is a complex surgery from which it is not easy to recover.
Fact: Recovery time may vary after a successful hysterectomy. It generally depends on the type of hysterectomy performed. The recovery period is usually six weeks. A vaginal hysterectomy is one where the woman can recover quickly after surgery. The uterus is extracted through the vagina with no visible scars . In this type of hysterectomy, the patient has to stay a day or two in the hospital, and recovery usually takes two to four weeks.
Laparoscopic hysterectomy and Robotic options now make hysterectomy even easier with minimal incisions , hospital stay and pain.
Myth #4: After surgery, you should not get up from the bed till you recover.
Fact: Walking a little after surgery helps you recover. You should not walk immediately after the surgery. Based on your health, your doctor will suggest when and how long you should walk. Staying in bed can lead to blood clots forming around the wound. Walking ensures a normal blood flow, helping the wound heal quickly.
You can go for walks after a hysterectomy. You can increase the walking time a little every day. After a few days, you will be able to live your normal life.
Myth #5: Hysterectomy can force your vagina to come out.
Fact: The truth – a hysterectomy in fact treats vaginal prolapse. When the muscles supporting the vagina become weak or break, the vagina comes out. It is called vaginal prolapse. The position of the uterus can also change due to the hanging vagina. Obesity, smoking, vaginal delivery, or menopause increase the risk of vaginal prolapse.
Myth #6: Surgery will result in a big scar.
Fact: Scar may or may not remain after surgery. In most cases, it is a scar that heals easily. The size of the scar after a hysterectomy depends on the type of surgery. Vaginal hysterectomy involves multiple small-sized incisions that can cause scarring but are not noticeable as they are internal. A laparoscopic hysterectomy usually leaves no scar.
In an abdominal hysterectomy, a long incision is made, and the scar is also slightly larger. But over time, it can be treated. Several methods can help you get rid of the scar.
Myth #7: The only way to treat my problem is a hysterectomy.
Fact: Usually, it depends on the disease and its cause. In some cases, there is no need for a hysterectomy. Hysterectomy is the last option. It is not done unnecessarily if treatment is possible through other methods. If the patient has uterine cancer or suffers from abnormal bleeding, immediate treatment is required. In this case, a hysterectomy is performed as soon as possible.
Some physical therapies may be used in a uterus prolapse. With these therapies, the problem of a rising or falling uterus can be managed. If a patient has endometriosis, it can be treated by medicines or other surgeries. When all other options fail, a hysterectomy is considered.