A Hysterectomy is a way of treating problems that affect the uterus. It can help cure various conditions, but because it is a major surgery you may want to explore other options first. If other treatments have been unsuccessful your Doctor at the Women's Clinic may discuss why having a hysterectomy may be the best choice. Some reasons for having a hysterectomy are:
- Total hysterectomy—The entire uterus, including the cervix, is removed. In a total radical hysterectomy, the entire uterus and support structures around the uterus are removed. It often is done to treat certain types of cancer.
- Supracervical (also called subtotal or partial) hysterectomy—The upper part of the uterus is removed but the cervix is left in place. Hysterectomy with removal of the fallopian tubes and ovaries—A hysterectomy does not include removal of the ovaries and fallopian tubes. Surgery to remove the ovaries is called an oophorectomy. Surgery to remove the fallopian tubes is called a salpingectomy. One or both of these procedures can be done at the same time as a hysterectomy. Sometimes, only one ovary or tube is removed. There are various ways that a hysterectomy can be done.
- In a vaginal hysterectomy, the uterus is removed through the vagina. There is no incision (cut) on your abdomen and because the incision is inside the vagina, the healing time may be shorter than with abdominal surgery. Vaginal hysterectomy causes fewer complications than the other types of hysterectomy and is a very safe way to remove the uterus. But for many women a vaginal hysterectomy is not always possible.
In an abdominal hysterectomy, the doctor makes an incision through the skin and tissue in the lower abdomen to reach the uterus.This gives the surgeon a good view of the uterus and other organs during the operation and this procedure is usually chosen if you have large tumors or if cancer may be present.
As with any major surgery there are some things you need to know beforehand. You will undergo a physical exam a few weeks before the surgery and there may be lab tests that need to be done. Depending on your health and your age, a chest X-ray or electrocardiography (ECG) may need to be done.
On the day of your surgery, the following things may happen:
A needle is placed in your arm, wrist, or hand. It is attached to a tube called an intravenous (IV) line that will supply your body with fluids, medication, or blood. You will be given an antibiotic to prevent infection. Special stockings or devices may be placed on your lower legs to prevent deep vein thrombosis (DVT). This condition is a risk with any surgery. Women at high risk of DVT may be given a drug to prevent blood clots from forming in the legs. Monitors will be attached to your body before anesthesia is given. You may be given general anesthesia, which puts you to sleep, or regional anesthesia, which blocks out feeling in the lower part of your body. Pubic hair may be clipped. You may be awake or asleep while this is done. Before you are given anesthesia, you likely will be asked to state your name, the type of surgery you are having, or other information. This standard procedure, called a “time-out,” is done to ensure that the right surgery is being done on the right patient. A thin tube called a catheter will be placed in your bladder. The catheter will drain urine from your bladder during the surgery. Because a hysterectomy is a major surgery there are possible risks that include infection, bleeding and problems regarding anesthesia. Be sure to talk with your gynecologist before the surgery about any apprehensions you may have and questions.
In addition to the physical effects of the surgery there may also be some emotional effects. These may last several days or several months. Some women feel depressed because they can no longer have children. If depression lasts longer than a few weeks, see your health care provider. Other women may feel relieved because the symptoms they were having have now stopped.
Occasionally 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.
While a hysterectomy may help reduce the problems you have you do want to make sure you know all of the risks and results of this surgery so be sure to talk with your gynecologist. They will be able to answer any questions and may be able to connect you with other women who have had a hysterectomy that can help support you.