Hysterectomy, the surgical procedure used to remove a woman's uterus, is performed on more than 600,000 women in the United States every year, according to the National Women's Health Center. A woman who is considering having a hysterectomy can choose to undergo an abdominal hysterectomy or a vaginal hysterectomy. Vaginal hysterectomies are often preferred because they offer shorter hospital stays and quicker recovery times than abdominal procedures.
Reasons for Surgery
A hysterectomy may be needed if a woman suffers from severe endometriosis, a painful condition in which the uterine lining begins to grow on the fallopian tubes, ovaries and other organs in the abdomen. For women with large fibroids that haven't responded to other treatment, a hysterectomy may be the best solution to eliminate heavy bleeding and pain. A fibroid is a non-cancerous tumor that grows in the walls of the uterus. According to the National Women's Health Center, fibroids are the most common reason that hysterectomies are needed. Other reasons that a hysterectomy is recommended include cancer of the cervix, ovaries or uterus; persistent vaginal bleeding; chronic pelvic pain; or a prolapsed uterus that sags into the vagina.
Restrictions
If a hysterectomy must be performed due to cancer, an abdominal hysterectomy is usually needed, as this type of procedure allows the doctor to examine other organs in the abdominal cavity for signs of cancer. Abdominal hysterectomies are also needed if the uterus or fibroids are particularly large or endometriosis is widespread.
Vaginal Hysterectomy
Vaginal hysterectomies are performed under general anesthesia. During the surgery, an incision is made in the upper vagina, allowing access to the uterus. Blood vessels, fallopian tubes and connective tissue are carefully cut away from the uterus using special surgical instruments with long handles. The disconnected uterus is pulled out through the vagina and the incision is sutured. In some cases, the uterus may be cut into several smaller pieces to allow for easier removal.
Laparascopically Assisted Vaginal Hysterectomy
During a laparascopically assisted vaginal hysterectomy (LAVH), a tiny lighted camera is passed through a small incision in the abdomen, allowing the doctor to see the uterus and other organs on a video monitor. Two additional incisions are made for the insertion of forceps, clamps and other surgical instruments. The uterus is still removed through the vagina when LAVH is used. After surgery, the incisions in the vagina and abdomen are stitched shut. If a woman has adhesions, scar tissue that binds abdominal organs and tissue together, use of the laparascopic camera will allow the doctor to determine where cuts should be made to free the adhesions from the uterus. LAVH can also be helpful if the fallopian tubes and ovaries are removed along with the uterus.
Recovery
Following a vaginal hysterectomy or LAVH, a one- to three-day hospital stay is usually required. It may only take one or two weeks before a woman feels well enough to resume normal activity, compared to four to eight weeks for women who have abdominal hysterectomies. Women may have a bloody discharge for a few days following surgery because of the stitches in the vagina. Pads, and not tampons, should be used during this time. Avoid lifting anything that weighs more than 20 pounds for at least six weeks following surgery. Sex and baths should also be avoided during the first six weeks.
Warning
Call your doctor if you develop nausea, vomiting, fever or chills following surgery. While bleeding is to be expected, bleeding that is heavier than a menstrual period is not normal and should be reported to a doctor. Other possible signs of complications include worsening pain, chest pain, shortness of breath, trouble urinating or having bowel movements, or redness or pus around abdominal incisions.
Tags: fallopian tubes, following surgery, other organs, abdominal hysterectomy, fallopian tubes ovaries, from uterus