If you are considering hysterectomy, perhaps you are dealing with severe menstrual bleeding, pelvic infection, chronic pain, endometriosis or fibroids in your uterus. Worse, you may have been diagnosed with a type of uterine or cervical cancer. For these or other reasons, your gynecologist may have suggested that you have a hysterectomy ( removing the uterus). A hysterectomy can relieve symptoms or stop an infection. And if you have cancer, it may save your life. Still making a decision about surgery can be difficult. Problems that a hysterectomy can alleviate or cure are : endometriosis. fibroids, pelvic relaxation, cancer of the cervix ( lowest part of the uterus) or the uterus itself.
Your doctor should perform a complete health history and asked about your specific symptoms, such as pain or bleeding. Be sure to mention any reproductive health problem you have had in the past. A complete physical exam must be performed as well, including a pelvic exam. Your doctor will look for organ enlargement, lumps, tender spots etc.
Diagnostic tests that can be performed before the surgery are: pap test, ultrasound, endometrial biopsy, hysteroscopy ( a lighted tube inserted through the uterus too see its inside), D&C ( removing the lining of the uterus), laparoscopy ( a tube inserted through a tiny incision in your abdomen to look the internal organs) and other laboratories.
Before the surgery, you and your doctor will discuss how the uterus will be reached. You will also discuss the type of hysterectomy you will have. Or, if the ovaries and tubes may be removed as well.
1) Abdominal hysterectomy: A 4-6 inch incision is made in the abdomen. This incision can be vertical or horizontal. And the uterus is removed thorough this incision.
2) Vaginal Hysterectomy: The incision is made inside the vagina.
3) Laparsocopic hysterectomy: Small instruments are inserted through tiny abdominal incisions. This are used to move and see the organs.
4) Subtotal hysterectomy: Your uterus is removed, except the cervix. Pap smears will still be required. A subtotal hysterectomy can be performed via an abdominal, or laparoscopic hysterectomy.
Preparing for surgery
In most cases, a hysterectomy takes 1-3 hours.
Before the day of surgery: stop smoking, consider donating your own blood, eat a healthy diet but do not eat or drink anything after midnight and the day of surgery. This will help avoid peri operative complications.
Risks and complications of hysterectomy surgery: Side effects from the anethesia, surgical site infection, bleeding, (possible needing blood transfusions), damage to organs ( bladder, intestines, ureter, vessels), blood clots in the legs or the lung.
Recovery in the hospital inmediately after a Hysterectomy
After surgery, you will spend a few hours in the recovery room. Then you will be moved to a hospital room. Depending on what type of hysterectomy you have, you may stay in the hospital for 24 hours up to 3 days if there are no complications. You and the doctor will watch that the incision stays closed, pain medication will be given to you, will verify that you are urinating well, no vaginal bleeding is noted and that you are eating correctly. Vitals signs will be taken at regular schedules to ensure your well being.
Recovery at home after Hysterectomy
Take care of yourself physically: Take showers instead of baths, use pads to absorb any bleeding, do not use tampons or douches, do not have sex for at least 6-8 weeks, eat a healthy diet. After a few weeks your doctor will instruct you to follow up in the office to verify how you are recovering and answer any question you might have.
by Joel Rivera MD
Pink Women’s Center is a board certified OBGYN group located in Katy and west Houston Texas. We care for normal and high risk pregnancies, gynecologic and menopausal problems, including abnormal vaginal bleeding, abnormal pap smear, stress incontinence, osteoporosis, sexual dysfunction, hysterectomy, endometriosis and much more. We are a certified menopause OBGYN group, the only one in Houston Texas