What are the potential side effects of hysterectomy. How does hysterectomy affect a woman’s health long-term. Why should women consider alternatives to hysterectomy when possible. What are the surgical risks associated with hysterectomy procedures.

The Prevalence and Purpose of Hysterectomies

Hysterectomy, the surgical removal of the uterus, is a common procedure performed on women for various reasons. In Australia alone, an estimated 30,000 hysterectomies are conducted annually. While this surgery can be life-saving in cases of uterine cancer, the majority of hysterectomies in developed countries are performed for benign conditions such as fibroids or adenomyosis.

Are all these hysterectomies necessary? This question has sparked debate in the medical community, leading to a closer examination of the procedure’s risks and long-term effects.

Immediate Surgical Risks of Hysterectomy

As with any major surgery, hysterectomy carries several immediate risks:

• Complications from general anesthesia
• Need for blood transfusion
• Deep vein thrombosis (DVT)
• Injuries to surrounding organs

How common are severe complications from hysterectomy? Studies indicate that the risk of severe complications ranges from 3.5% to 11.0%. These can include injuries to the bladder, ureters, bowel, and blood vessels, potentially requiring additional surgeries for repair.

Is hysterectomy a safe procedure overall? While generally considered safe, it’s important to note that the mortality rate for hysterectomy in Australia has been reported at 1.5 per 1,000 procedures.

Long-Term Side Effects of Hysterectomy

Beyond the immediate surgical risks, hysterectomy can have several long-term impacts on a woman’s health:

Early Menopause

How does hysterectomy affect menopause? Women who undergo hysterectomy may experience menopause almost 4 years earlier than average. This early onset can be due to compromised blood supply to the ovaries during surgery, whether through ligation, spasm, or thrombosis.

Pelvic Organ Prolapse and Incontinence

Can hysterectomy lead to pelvic floor issues? Yes, hysterectomy is known to potentially cause prolapse and incontinence years after the procedure. The removal of supporting structures and weakening of the pelvic floor during surgery can predispose women to these conditions.

Sexual Function Changes

How might hysterectomy impact a woman’s sex life? The effects can vary among individuals. Some women may experience decreased libido and intensity of orgasm, particularly after total hysterectomy. These changes could result from nerve damage, alterations in vaginal anatomy, or loss of uterine contractions during orgasm.

It’s worth noting that for women whose severe menstrual symptoms previously affected their sex lives, hysterectomy might lead to improvements in this area.

Post-Hysterectomy Syndrome and Recovery

What is Post-Hysterectomy Syndrome? This condition, characterized by urinary problems, fatigue, and depression, affects some women following the procedure. While the exact cause is uncertain, it’s thought to be related to hormonal imbalances post-surgery.

How long does recovery from hysterectomy typically take? Women who undergo hysterectomy often require more time to recover compared to those who have other major surgeries. The standard recovery period is typically 4-6 weeks, but individual experiences may vary.

Cardiovascular Risks Associated with Hysterectomy

Does hysterectomy affect heart health? Recent research from the Mayo Clinic suggests a concerning link between hysterectomy and cardiovascular health. The study found that hysterectomy, even without ovary removal, is associated with a 33% increased risk of coronary heart disease.

Is the risk higher for younger women? Yes, the study revealed that for women under 35 years of age who undergo hysterectomy, the risk of coronary heart disease increases by 250%.

Alternatives to Hysterectomy

Given the potential risks and side effects, are there alternatives to hysterectomy for benign conditions? Yes, several less invasive options exist, depending on the underlying condition:

• Uterine Fibroid Embolization (UFE) or Uterine Artery Embolization (UAE)
• Myomectomy (surgical removal of fibroids while preserving the uterus)
• Endometrial ablation (for heavy menstrual bleeding)
• Hormonal treatments

For women with fibroids, UFE/UAE has emerged as an effective non-surgical alternative to hysterectomy. This minimally invasive procedure can often provide symptom relief while preserving the uterus.

Making an Informed Decision

How can women make the best decision regarding hysterectomy? It’s crucial for women to have thorough discussions with their healthcare providers about the necessity of the procedure, potential risks, and available alternatives. Understanding both the short-term and long-term implications of hysterectomy is essential for making an informed choice.

Are there situations where hysterectomy is unavoidable? In cases of uterine cancer or certain severe benign conditions that haven’t responded to other treatments, hysterectomy may indeed be the best or only option. However, for many benign conditions, exploring alternatives first may be prudent.

The Future of Uterine Health Management

As medical technology and understanding advance, how might the approach to uterine health conditions evolve? The trend is moving towards more conservative, uterus-sparing treatments when possible. This shift acknowledges the importance of the uterus beyond its reproductive function and aims to minimize the potential long-term health impacts of its removal.

What role will patient education play in this evolution? Increasing awareness about the potential risks and alternatives to hysterectomy is likely to empower more women to explore all options before deciding on surgery. This informed approach may lead to a reduction in unnecessary hysterectomies and improved overall outcomes for women’s health.

In conclusion, while hysterectomy remains a necessary and potentially life-saving procedure in certain cases, the growing body of evidence regarding its long-term effects underscores the importance of careful consideration and exploration of alternatives when possible. As medical science progresses, the management of uterine health conditions is likely to become increasingly nuanced and personalized, prioritizing uterine preservation when feasible and safe.

Why should women try to avoid hysterectomies? Risks and Side Effects

October 22, 2019 |
Hysterectomy

An Evidence Based Biased Opinion by Eisen Liang

Hysterectomy is a major surgical operation that requires general anaesthetic, few days in hospital and 4-6 weeks of down time to recover. Hysterectomy is associated with surgical complications and long-term side effects.

Hysterectomy Risks:

Anaesthetic complications, blood transfusion, DVT, injuries to other organs.

Since hysterectomy is a major surgical operation, hysterectomy is associated with the risks of any major operations, including risks associated with general anaesthetic, blood transfusion, infection, wound healing and deep venous thrombosis. Rare but severe hysterectomy complications are injuries to bladder, ureteric, bowel and blood vessels, that might mean a second trip to the theatre for repair by another specialist.

Even to date, the risk of severe complications from hysterectomy remains at 3. 5 to 11.0 %¹.

Studies from Melbourne reported hysterectomy mortality rate of 1.5 /1,000 in Australia².

Hysterectomy Long-term Side-effects:

Early menopause, prolapse, incontinence, sexual dysfunction, constipation, coronary heart disease.

Women who had hysterectomy may enter menopause almost 4 years earlier ³. Blood supply to the ovary maybe compromised during surgery by ligation, spasm or thrombosis.

It is well known that hysterectomy may cause prolapse and incontinence many years later⁴. Hysterectomy removes supporting structures and weakens pelvic floor. Removal of or cutting of the ligaments supporting the cervix and vagina may predispose to development of prolapse.  Furthermore, the effectiveness of prolapse repair can be compromised by the removal the cervix and ligaments which are used to anchor an effective repair.

The effect of hysterectomy on a woman’s sex life depends on individual. Women need to be aware that decreased libido and intensity of orgasm can occur after hysterectomy, especially total hysterectomy⁵. This may be the result of nerve damage, changes to the vaginal anatomy, resulting in altered sensation or loss of uterine contraction, leading to failure to orgasm or changes in the nature of orgasm.  For those women whose sex lives are affected by their severe menstrual symptoms may find hysterectomy improves sex life afterwards.

Constipation following hysterectomy has been reported, and this may be a result of nerve damage⁶.

Woman who have had a hysterectomy takes longer to recover than those who have undergone other major surgery. Symptoms include urinary problems, tiredness and depression. The underlying cause is uncertain, and the condition has been labelled Post Hysterectomy Syndrome ⁷. It is thought to be due to hormone imbalance after hysterectomy.

A recent Mayo Clinic study has shown that hysterectomy, even with without removal of ovaries, is associated with 33% increased risk of coronary heart disease, and the risk is increased by 250% is the hysterectomy is performed in women younger than 35 years of age ⁸.

Is Hysterectomy still the only solution in the 21st Century?

If a woman had a uterine cancer, there is no doubt hysterectomy might be absolutely necessary. However, in a developed country like Australia, over majority of hysterectomies are performed for benign conditions like fibroids or adenomyosis. It is estimated that 30, 000 hysterectomies are done in Australia each year. Is hysterectomy still the only solution in 21^st Century?

Check out UFE / UAE as an effective non-surgical alternative to hysterectomy on: https://www.sydneyfibroidclinic.com.au/

References:

1. Uptodate 2019 : Differentiating uterine leiomyomas (fibroids) from uterine sarcomas Elizabeth A Stewart, MD https://www.uptodate.com/contents/differentiating-uterine-leiomyomas-fibroids-from-uterine-sarcomas Accessed 28th August 2019

2. Ten-year review of hysterectomy morbidity and mortality: can we change direction? Varol, N; Healey, M; Tang, P; Sheehan, P; Maher, P; Hill, D Australian & New Zealand Journal of Obstetrics & Gynaecology, 2001 Aug, Vol. 41(3), pp.295-302

3. The association of hysterectomy and menopause: a prospective cohort study. Farquhar CM, Sadler L, Harvey SA, Stewart AW. BJOG: An International Journal of Obstetrics & Gynaecology. 2005;112(7):956–962.

4. Urinary Symptoms following hysterectomy Smith P, Roberts M, Slade N. British Journal of Urology. 1970;42(1):3–9.

5. Supra Vaginal Uterine Amputation VS. Hysterectomy: Effects on libido and orgasm. Kilkku P, Grönroos M, Hirvonen T, Rauramo L. Acta Obstetrica et Gynecologica Scandinavica. 1983;62(2):147–152.

6. Papachrysostomou M. Disordered colorectal motility in intractable constipation following hysterectomy. Smith A, Varma J, Binnie N, British journal of surgery. 1990;77(12):1361–1365.

7. A post-hysterectomy syndrome. Richards D. The Lancet. 1974;304(7887):983–985.

8. Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study Laughlin-Tommaso, K. , Shannon; Khan, L., Zaraq; Weaver, Y., Amy ; Smith, A., Carin ; Rocca, A., Walter ; Stewart, A., Elizabeth Menopause, 2018, Vol.25(5), p.483-492

Read more Hysterectomy blogs

Hysterectomy Side Effects, Disparities That Women Should Know

Renée Meyer always had period pain so bad she “couldn’t function” without ibuprofen. But in 2016, at 37 years old, she started going to the bathroom every hour and having problems with bladder leakage. Her doctor’s initial suggestion was Kegel exercises. But when Meyer noticed her pelvic area was starting to appear pregnant when she wasn’t, she returned to the doctor. An ultrasound uncovered the true problem: fibroids, masses in the uterus that are benign over 99 percent of the time. And the solution? Removing her uterus, so the fibroids could no longer grow.

Meyer, now 42, didn’t plan to have kids, so she was on board with getting a hysterectomy. But the surgeon also suggested removing the cervix, the opening to the uterus, so she would no longer need Pap smears. Meyer asked how that might affect her sex life; she couldn’t find much online about which reproductive organs were involved in an orgasm. But the doctor she consulted told her “there would be no difference,” she recalls. Except there was. A lot of what women feel during orgasm is the contractions of the uterus and cervix. While she doesn’t regret going the route she did, “I’m pissed off there wasn’t more information,” says Meyer, who lives in Sacramento. “I miss cervical orgasms.”

She’s not the only one who has dealt with a major information gap around such a life-altering procedure. Hysterectomies have been around since before the Middle Ages, but only in the past couple of decades have researchers started to prove what, for years, was whispered among those who had one: Removing the organ sometimes causes problems, at least as much as it solves them.

And although there are now less-drastic options, many women aren’t provided with them—or they are encouraged to go full-bore and remove the uterus because that solution is the obvious and easiest. (We’re not talking about instances of cancer or possible cancer, where removing the uterus really may be the only option. About 90 percent of hysterectomies are done for reasons unrelated to cancer.)

Jamie Chung

Hysterectomies are the second most common surgery among women in the U.S. And they’re also one of the most controversial.

The procedure popped up in celebrity news when Girls star Lena Dunham made headlines for choosing to have one at age 31; and tales of doctors forcing patients into the procedure without any medical reason, such as the Virginia ob-gyn convicted late last year after he performed hysterectomies at his discretion for insurance fees, sometimes come to light. But the question of who receives a hysterectomy—and why—was a contentious topic in the medical community long before all of this.

A hysterectomy is technically only the removal of the uterus—a. k.a. the womb, where a fetus develops and grows, and which plays a critical role in your menstrual cycle and fertility. But people tend to use the term hysterectomy as shorthand to cover a lot of other procedures that may happen at the same time, like removal of ovaries and fallopian tubes, and as a catchall word for various techniques. The procedure is most commonly performed to fix pain and bleeding from a variety of reproductive health issues ranging from fibroids—which may affect as many as two-thirds of women by age 50—to endometriosis and adenomyosis, conditions in which the endometrial tissue (the cells that line the womb) grows in places it shouldn’t.

Here’s where things get sticky: The number of alternate treatments for these types of health issues is growing (and we’ll get into those). Yet the number of women getting hysterectomies seems to have remained fairly stable: roughly 500,000 a year. “Seems to” because, like many things in women’s health, the truth is murky.

Jamie Chung

Some studies and CDC figures suggest the rate of hysterectomies has declined. But a bunch of these studies included only women receiving treatment for fibroids, which excludes an awful lot who received hysterectomies for other reasons, notes a brief from the Agency for Healthcare Research and Quality. Other figures include only abdominal and vaginal types, excluding outpatient hysterectomies done robotically or via laparoscopy, which are on the rise because they’re less invasive, require a much smaller incision, and typically have a shorter, easier recovery. (Abdominal hysterectomies are the traditional open-surgery kind your grandmother might have had. Laparoscopic and robotic have been around since 1988 and 1999, respectively.)

No matter the numbers, there are still a lot of reasons to believe hysterectomies are done more often than they should be. “Are we doing too many hysterectomies? I’d say the consensus among providers who perform them would be that there are probably too many performed right now,” says Christopher Tarnay, MD, division chief of urogynecology and reconstructive pelvic surgery at UCLA. There are now less-invasive hysterectomy techniques, so “that approach has taken over,” he says. “But the trend hasn’t moved away from hysterectomy entirely.”

The facts: As many as one in five women who underwent the surgery for a benign condition may not have needed the procedure, found a study published in the American Journal of Obstetrics & Gynecology. For women under 40, that figure may be as many as two in five.

What’s more, Black women are getting these procedures more than any other group.

Black women are 2.4 times more likely to have a hysterectomy than white women, according to a study in the Journal of Women’s Health. Part of the reason for that is because they are also three times more likely to develop fibroids. (The Real Housewives of Atlanta’s Cynthia Bailey and Porsha Williams opened up on the show about their fibroids—and the condition is so sufficiently under-studied that then-senator [now VP] Kamala Harris introduced a bill proposing $30 million a year for five years to expand fibroid research. )

The hard truth is that many Black women grow up expecting to grit their teeth through the pain until they’ve had kids and can get a hysterectomy. “My mother had a hysterectomy in her 40s because of her fibroids, and she didn’t look back,” says Carol Cook, 57, of Phoenix. Because of her own fibroids, Cook herself endured pain she describes as “fear-inducing—I wanted to curl up in a ball and have someone knock me out until it was over.” After her son was born, she had a hysterectomy at 35 and is happy with the results.

But Black women are less likely to be offered a minimally invasive hysterectomy (which comes with shorter recovery times and fewer complications), even when you account for risk factors like weight and general health, says Amy Alexander, MD, a gynecologist oncologist in Asheville, North Carolina.

Dr. Alexander began studying racial disparities in care when she was working in Chicago and noticed the patients at Northwestern University’s hospital—which has a larger percentage of white patients than Cook County hospital, a Chicago public hospital—seemed more likely to receive minimally invasive hysterectomies. “Doctors work hard, nurses work hard, everybody tries their best,” she says. “But people end up with different care because there are different systems.”

Doing a minimally invasive hysterectomy also depends on the training of the doctor and the equipment available at the medical center. Dr. Alexander herself says she couldn’t do a complicated one if the hospital didn’t have a robot, something many county and small hospitals can’t afford. Nor might a county hospital have a bed that tilts the patient back so the doctor can see into the pelvis—an essential for a long, minimally invasive surgery. Because of this, many women in underserved hospitals just end up getting the old-school procedure.

Hysterectomies are not always the magical fix women and doctors expect them to be.

But if the problematic organ isn’t there anymore, all your issues are solved, you’d think? Not so much. One example: Women who opt for a hysterectomy to address endometriosis have a 15 percent probability of persistent pain even after the surgery, with a 3 to 5 percent risk of worsening pain or new symptom development, according to a review of studies in Facts, Views and Vision: Issues in Obstetrics, Gynecology and Reproductive Health.

Meanwhile, removing the uterus can cause side effects, including bladder dysfunction and pelvic pain from the scarring. Because your organs shift after one is removed, some women report various types of chronic pain, like hip or back, which then radiates up to neck pain and can cause migraines, says Heather Hirsch, MD, an internist specializing in women’s health at Brigham and Women’s Hospital in Boston.

Women who have hysterectomies also face a nearly twofold-increased risk of going into early menopause, a study in Obstetrics & Gynecology found. And women who undergo the surgery younger than 35 also have a greater chance of suffering from depression, per a Mayo Clinic study. There’s also the consequence Meyer experienced, which is that women can no longer have a cervical orgasm.

So why, then, are so many women still getting hysterectomies if there are a not-insignificant number of downsides? It’s complicated.

The range of treatments for pain and bleeding now includes everything from progesterone IUDs (which help thin the endometrium and, in turn, treat abnormal bleeding and pain) to uterine artery embolizations (where the artery that leads to the uterus is cauterized, a procedure that requires a referral to an interventional radiologist). For fibroids specifically, there’s the option of a myomectomy—where the growths are snipped out but the uterus is spared—but they can grow back.

That’s the reality with many alternate options: They simply might not be a permanent solve for the underlying health issue. IUDs, for example, often don’t work for women with larger uteruses, says Daniel Morgan, MD, professor of obstetrics and gynecology at the University of Michigan Medical School and Von Voigtlander Women’s Hospital. And because fibroids in particular change the shape of the uterus, it may be difficult to get an IUD deployed safely. Another technique called an endometrial ablation, which destroys the uterus lining, comes with a risk of developing pain from regrowth and blood trapped under scar tissue.

The American College of Obstetricians and Gynecologists offered a caution about the procedure that reads, in part, that it “should be considered only if other treatments have been ineffective or contraindicated.” So you can imagine why the conversations about the risks and benefits of each option “can be difficult and lengthy,” says Dr. Hirsch. “That’s another barrier, and a big reason why it’s sometimes easier for doctors to say, ‘Let’s just take [the uterus] out.’ ”

Compounding the issue is that doctors (like all of us!) have many biases, says women’s health advocate and activist Nora Coffey, who founded the Hysterectomy Educational Resources and Services Foundation (HERS). “Women are routinely told, ‘What do you need your uterus for?’ if they’ve already had children,” she says.

So let’s clarify here. Why you do need a uterus, regardless of kid status: Besides the risk for early menopause and depression, women who’ve had hysterectomies are at increased odds for high blood pressure, obesity, and heart disease, a Mayo Clinic study found. (Researchers don’t yet understand what the role of the uterus is in all of this.) Long-term issues are especially pronounced the younger you have the hysterectomy: Women younger than 35 who had the procedure had a 4.6-fold higher risk for congestive heart failure, compared with women above that age, who had just a 0.6 percent higher risk.

When Dr. Hirsch sees new patients, she’ll ask those who underwent the procedure why they had a hysterectomy; she is curious about their understanding of it. And many don’t know because, for some women, speaking out and asking questions about their bodies is still taboo. “A lot of the women who tell me they aren’t sure why they got the procedure follow up with, ‘I wish I never did,’ or, ‘I wish someone told me there were alternatives.’ ”

It’s not as surprising as you might think for an expert not to know much about an alt treatment option, considering the sheer volume of information ob-gyns are expected to be on top of. One survey of ob-gyns suggested that surgical training was not adequate, in part because of how overloaded residents are. They “not only need to be competent in obstetrics, primary care, and office gynecology, but they must master a multitude of surgical techniques and be competent with evolving technology,” it noted.

“Hysterectomy has the advantage in that every gynecologist knows how to do one, but not every gynecologist is trained in some of the other procedures,” says Elizabeth Stewart, MD, a Mayo Clinic gynecologist who specializes in fibroid research. “I think one of the saddest things for women is that some are not presented with any alternatives to hysterectomy, when good ones exist.”

All the more reason to do your own research before you get on the exam table.

True story: Advocating for yourself and digging into the options can make a big difference.

True story: Advocating for yourself and digging into the options can make a big difference. Kristen Bennett, 37, of Los Angeles, was diagnosed with fibroids when she was 25. She suffered through the pain for more than a decade until, in the past few years, she began bleeding so badly that she worried she’d bleed out. She was so exhausted some days she couldn’t make breakfast, and she also developed heart palpitations and acid reflux.

Bennett started going to doctors. One suggested a radiofrequency ablation, which would destroy the fibroids but is not recommended for women who want to preserve their fertility, which Bennett did. Another told her he could try to do a myomectomy but that she should go in prepared to come out with a hysterectomy because he didn’t feel confident her uterus was “salvageable.” The others told her the only option was a hysterectomy (and if she wanted kids, she’d have to hang tough until she was done with that).

In the end, Bennett went to six (yes, six!) doctors until she found one who was confident he could do a myomectomy, which she had in June. “I did a lot of research; I knew there were options,” she says.

Wary after her experience with the other physicians, Bennett began instructing the sixth doctor about which organs she wanted to keep—her ovaries and cervix—if he had to do a hysterectomy in the end. “He said, ‘I hear what you’re saying, but this is not a complicated case. You’re going to be fine.’ ” He took out 24 fibroids; four were the size of oranges.

Within weeks, she felt relief. “I’m not terrified that I’m going to pass out from my period,” she says.

All of this may leave you wondering what you can do to make sure you’re getting the best care. And there *are* ways.

If you’ve been suffering from pain and bleeding, the hysterectomy conversation may be coming—but you can be prepared for it.

When you make the appointment, ask first for a consultation in the doctor’s office (so you’re not undressed in a gown in stirrups, in a vulnerable position). You can be blunt: “Introduce yourself, and say, ‘I’m here for an evaluation, and I’m not having a hysterectomy,’ ” Coffey says. “That changes the dynamic immediately.”

It may turn out that you do need a hysterectomy, but at least you will know that you and your provider have considered all the options. And keep in mind that some women do say it’s life-changing, but in a good way. “I was overjoyed,” says Leslie Mullin, 41, of Houston, who had one at age 36. Among other things, Mullin had, for years, dealt with pain during sex, which disappeared with her hysterectomy.

Dr. Alexander suggests asking what the doctor recommends to patients before resorting to a hysterectomy, as you would with any procedure. If they go ahead and suggest a hysterectomy, ask what the alternatives are, and what the likelihood is that those alternatives would be successful for you. If you’re having difficulty getting answers, seek a second (or third) opinion. It’s your body, after all.

“There’s such a long history of hysterectomy being frequently used that the conversation can get to that very quickly,” says Dr. Morgan. “But we all need to slow down and say, ‘Hey, wait, what about these other options?’ Let’s make sure we’re doing the right thing for you.” As it should be.

This article appears in the March 2021 issue of Women’s Health. Become a WH Stronger member for a print subscription and more great perks now.

Laparoscopic Hysterectomy in India

What is Hysterectomy?

A hysterectomy is an operation performed to remove the uterus. This is most common in women and is preferably done by laparoscopy. Studies show that 300 out of 10,000 women undergo a hysterectomy. When fibroids develop in the uterus, a hysterectomy must be performed to remove the uterine fibroids. Let’s take a closer look at the causes of a hysterectomy. After a hysterectomy, a woman will not have her period and will not be able to get pregnant.

Common reasons for having a hysterectomy :

Some of the most common reasons include:

1. Myoma Hysterectomy

As mentioned earlier, one of the most common reasons for hysterectomy is the presence of fibroids. Also known as uterine fibroids, these are non-cancerous extra growths of the uterus. The reason for this growth is unknown. Although they are harmless, there is a chance that they can turn into cancerous tumors and lead to uterine cancer. Most of these growths are harmless, but they carry potential risks and may cause medical problems in women.

Reasons for hysterectomy for fibroids are as follows:

A. Excessive size of the fibroids.

B. Severe bleeding during periods of pain and anemia.

2. Weak vaginal wall

When the vaginal wall is weak, the pelvic floor becomes heavy. Because of this, fertility becomes a problem. In women after pregnancy, the heaviness of the pelvic floor causes pain and pressure. There is a noticeable loss of urine when they laugh, sneeze, jump, or do any physical activity that puts little strain on the abdomen. A hysterectomy is a mandatory procedure to be performed when these symptoms begin to worsen.

Different types of hysterectomy

Hysterectomy is performed in a variety of ways based on the patient’s symptoms, needs and condition. Let’s take a closer look at the different types.

1. Laparoscopic Hysterectomy

Laparoscopic hysterectomy is performed using laser technology, as opposed to traditional open hysterectomy. In this method, incisions are made inside the abdomen and a small camera is inserted through it. Once inside, the camera starts capturing images of the uterus, ovaries, and other surrounding organs, thereby helping doctors get a clear view of the internal organs and allowing them to complete the operation without any complications. The laparoscopy method ensures that the patient does not experience any discomfort, pain or complications, has fewer stitches, and is a relatively easy procedure compared to others. With this procedure, the patient can quickly return to his daily life, as it is hassle-free..

2. Subtotal hysterectomy

This method involves the surgical removal of only the uterus and no other parts associated with it. Since we are talking only about the removal of the uterus, the operation is quite quick and simple, and the blood loss is relatively small. The procedure for a surgical hysterectomy is also simple and takes relatively less time than other hysterectomies. Women who have this surgery can return to their normal lives within a week.

3. Total hysterectomy

Total hysterectomy is the process of removing the uterus and cervix. When performing a laparoscope, this is called a total laparoscopic hysterectomy (TLH). In this procedure, the uterus is removed through small incisions or through the vagina.

Laparoscopic total hysterectomy is performed only when women experience painful periods, pelvic pain, and uterine fibroids. Under these circumstances, TLH is performed. The operation procedure for TLH is the same as for all laparoscopic hysterectomies, where a small incision is made in the abdomen and then laparoscopy is introduced.

This operation to remove the uterus, however, creates some complications, such as:

1. Trauma to the internal organs, especially the urinary tract
2. Intestinal dysfunction
3. Hot flash
4. Longer recovery time

Since this is a major operation, some precautions must be taken before the operation. Doctors should explain the side effects and consequences after surgery, and tell patients to watch for warning signs. The risks and complications associated with this operation should be well discussed and explained in advance.

4. Radical hysterectomy

This type of hysterectomy is not for everyone who needs to have their uterus removed. A radical hysterectomy is used to treat cervical cancer and uterine cancer that has spread to the cervix. This includes removal of the uterus, fallopian tubes, ovaries, as well as nearby diseased tissues. This operation does not guarantee that you will be cancer-free after undergoing this procedure. There is always the possibility that cancer may recur if preventive measures are not taken.

This process has some side effects as more than 2 organs are removed. Women may experience nausea or vomiting, vaginal bleeding, and possible discharge for several weeks. Women may also experience pain and constipation. After the operation, proper care must be taken.

5. Partial hysterectomy

This procedure is done to treat ovarian cancer, cervical cancer, uterine fibroids, pelvic pain, or abnormal vaginal bleeding.

This operation also includes the removal of the uterus (uterus), but the cervix is ​​left intact. The ovaries are not removed in this procedure. But if a patient develops ovarian cancer before surgery, then the ovaries are also removed. Also, if the ovaries are not removed during surgery, there is a chance that the patient may develop ovarian cancer in the near future. Thus, it is desirable to remove both ovaries.

6. TAH BSO

TAH BSO stands for Total Abdominal Hysterectomy with Bilateral Salpingoophorectomy. It includes the removal of the cervix as well as the removal of the uterus. The operation is carried out in the same way as any other hysterectomy – through an incision in the abdominal cavity. It is used to treat cancer of the ovaries and pelvic masses. The presence of a pelvic mass cannot be determined prior to surgery. Thus, doctors find it difficult to assess whether a patient has a pelvic mass or not. To find out if there is a pelvic mass, doctors ask patients to take blood tests before surgery. Cancer or a pelvic mass cannot be determined with a blood test before surgery. The doctor will decide whether or not to have this surgery based on your symptoms. Some of them include:

a) bright red bleeding or blood clots with intense blood flow during menstruation;

b) high fever

c) foul-smelling discharge or changes in brownish, black or reddish discharge from the vagina.

Your doctor can tell if you have pelvic cancer, a tumor, or a malignant benign tumor only after surgery. Removal of the uterus, cervix, ovaries and fallopian tubes occurs at the same time. Because this is a major operation, doctors may also check your liver and spleen. Therefore, doctors may make an incision several inches deeper in your abdomen.

7. Caesarean section hysterectomy

This is done immediately after a caesarean section to save the mother’s life. This is a difficult task given the physical anatomy of the mother. This usually does not happen and happens very rarely. This is done when the mouth of the uterus does not automatically close by itself immediately after childbirth. When heavy bleeding occurs during childbirth and it does not stop even after a while, then doctors are left with no choice but to perform a caesarean section of a hysterectomy. This hysterectomy is performed through a vertical abdominal incision instead of a bikini line incision.

Depending on the mother’s situation, a total hysterectomy can also be performed to ensure that the mother’s life is saved. Because this is a risky procedure, the mother needs to be rested and cared for, monitored for any abnormal symptoms, and reported to the doctor immediately.

8. Wertheim Hysterectomy

This is a procedure for the treatment of cervical cancer. The operation involves the removal of the uterus, ligaments, connective and fatty tissue, including the pelvic lymph nodes, as well as the removal of vaginal tissues. Patients may then need to undergo radiation therapy.

Estimated cost during a hysterectomy:

Each type of hysterectomy has a different cost. Laparoscopic hysterectomies are budget-friendly, but then the type of hysterectomy you may have to undergo decides the cost. While a hysterectomy does not cost much, hysterectomies, used to treat cancer and remove the ovaries, fallopian tubes, and surrounding tissue, are more expensive.

Laparoscopic hysterectomy is the most advanced method of hysterectomy and is hassle-free and painless. More and more people are choosing this method because it is less labor intensive and hysterectomy is also affordable.

Before opting for a hysterectomy, consult and talk with your gynecologist about the results, side effects, and other precautions to take after a hysterectomy. Tell them about your symptoms, the problems you are facing in your body, and other details related to your problem. This will help the gynecologist, if necessary, to analyze, diagnose and plan the operation.

Laparoscopic Hysterectomy in India

India has become the first choice for treating international patients. Laparoscopic hysterectomy in India is not only cost effective but also has a good success rate. Every year, thousands of patients visit India for Laparoscopic Hysterectomy Treatment in India.

Cervical cancer treatment

Treatment for cervical cancer depends on the size and location of the tumor, its extent, and the woman’s overall health. In many cases, a team of physicians from different specialties determines the optimal treatment plan for the woman.

The most common treatments for cervical cancer are surgery, radiation therapy and chemotherapy. The type of treatment depends on the stage of the disease, the size of the tumor, the age of the woman, her state of health and her desire to have children in the future. A pregnant woman should discuss with her doctor the impact of treatment on her and the fetus and the possibility of delaying treatment until the baby is born.

Radiation therapy or surgery is usually used for small tumors. Chemoradiotherapy is usually given to women with invasive cervical cancer. Surgery and radiation therapy are called local therapies because they only affect the area around the tumor. Chemotherapy is systemic, as it affects the entire body.

Surgical treatment

During surgery, the doctor removes the tumor. If the cancer has not spread beyond the cervix, the following techniques are used:

• Conization – the same method as with a biopsy, to remove all pathological tissue. It can be used to remove minimally invasive cervical cancer.
• Loop excision – the use of an electric current passed through a thin wire hook. The hook removes the fabric. The method can be used to remove minimally invasive cervical cancer.
• Hysterectomy – removal of the uterus and cervix. It can be simple, in which the uterus and cervix are removed, or radical, in which the uterus, cervix, upper part of the vagina, and tissue around the cervix are removed. A radical hysterectomy also includes removal of the pelvic lymph nodes. If necessary, both fallopian tubes and ovaries are removed simultaneously with a hysterectomy.
• Radical trachelectomy (surgery to remove only the cervix, leaving the uterus intact) with lymph node dissection can be done in young patients who want to have children in the future. This method has been adopted as an alternative to hysterectomy.

For cervical cancer that has spread beyond the cervix, the following methods can be used:

• Radical hysterectomy with removal of the cervix, uterus and nearby lymph nodes.
• Evisceration with removal of the uterus, vagina, part of the colon, rectum, or bladder if the cancer has spread to these organs after radiation therapy.

Complications and side effects after surgery depend on the degree of intervention. Occasionally, patients experience significant bleeding, infection, or damage to the organs of the gastrointestinal tract or excretory system.

If sexual function is affected during major surgery, the vagina can be reconstructed using other surgical methods.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. Systemic chemotherapy through the circulatory system affects cancer cells throughout the body. The goal of chemotherapy may be to kill cancer left after surgery, slow tumor growth, or reduce side effects.

Although chemotherapy can be given orally, most cancer drugs are given intravenously. Chemotherapy drugs are given either directly into a vein or through a thin tube called a catheter that is temporarily inserted into a large vein to facilitate injection.

Side effects of chemotherapy depend on the individual and the dose used, and may include weakness, risk of infection, nausea and vomiting, loss of appetite, and upset stools.

Other possible long-term side effects include inability to conceive and premature menopause. Rarely, certain medications can cause hearing loss. Others may cause damage to the kidneys. Extra fluid may be given intravenously to protect the kidneys.

Cancer drugs are constantly being tested. Talking to your doctor is the best way to learn about prescribed medications, their purpose, possible side effects, and interactions with other medications.

Radiotherapy

Radiation therapy uses X-rays or other high-energy particles to kill cancer cells. Radiation therapy can be given as a standalone treatment or to shrink the tumor before surgery. Some women may be treated with a combination of radiation therapy and chemotherapy.

The most common type of radiation treatment is external radiation.