What is Hysterectomy: Types, Purpose, Procedure and Side Effects

Hysterectomy refers to the surgical amputation of the uterus or womb through surgery. It implies that one cannot get pregnant or menstruate after this procedure. Surgeons use various manual and automated techniques to carry out such operations. Hysterectomy is undertaken in cases of uterine prolapse, bleeding, cancer or any other reason.

Keep reading to know about this procedure in detail.

Different health conditions determine the type of surgery to be chosen by a doctor. Various types of surgery include –

• Total hysterectomy – This involves removal of uterus and cervix.
• Supracervical hysterectomy – Doctors remove the uterus but not cervix.
• Radical hysterectomy – This process involves removal of the entire uterus, surrounding tissues, cervix and top part of vagina.
• Total hysterectomy involving bilateral salpingo-oophorectomy – Entails the amputation of cervix, uterus, ovaries and fallopian tubes as well.

The main purpose of hysterectomy procedures are to treat –

• Uterine fibroids, abnormal pelvic pain and vaginal bleeding
• In case of uterine prolapse, where the uterus slides into the vaginal canal
• Cancer of uterus, cervix and ovaries
• If the walls of a uterus thicken, generally known as adenomyosis

Underlying are the different procedures used by the surgeons -

• Vaginal hysterectomy
• Laparoscopic hysterectomy
• Abdominal hysterectomy
• Robotic-assisted laparoscopic hysterectomy

Rates of such surgeries are pretty high in India compared to those in the US and UK. More than 3% of women aged 30 – 34 years undergo such surgeries in India, increasing to 5% - 11% among women aged 35 – 49 years. In comparison, women who lack knowledge are at a higher risk of acquiring uterus problems.

Healthcare facilities determine the surgical method to implement based on the condition of women. The first step of hysterectomy is carried by an anesthesiologist, which involves –

• General anaesthesia – Here, one is not awake during this procedure.

• Regional anaesthesia – The patient remains awake, and doctors administer anaesthesia near the nerves in one’s lower back.

Surgeons use the following steps for hysterectomy procedure –

• Vaginal hysterectomy – Surgeons remove the uterus by incision on the vagina with no scars visible.
• Laparoscopic hysterectomy – Doctors perform this operation from outside while it is displayed on a screen with the help of a laparoscope.
• Abdominal hysterectomy – Under this procedure, the uterus is removed with a six to eight-inch long cut on the abdomen.
• Robotic-assisted laparoscopic hysterectomy – Doctors perform this procedure with the help of robotic arms. They insert a laparoscope to monitor the operation.

This procedure generally lasts for one to three hours. It also depends on the condition of the uterus and complexities of the patient’s condition. The operation might be longer if there is a need to remove the surrounding tissues or other organs like ovaries and fallopian tubes.

Irritation due to vaginal discharge is a side effect of hysterectomy. Apart from that, other symptoms include –

• Hot flashes
• Vaginal dryness
• Loss of libido
• Difficulty sleeping (insomnia)
• Urinary inconsistency
• In some cases, the vagina seems to project out of the body
• Formation of a vaginal fistula or abnormal connection between the vagina and bladder or rectum
• Chronic pain in the pelvic region

Take specific steps to restrict further complications after a hysterectomy. One should not lift heavy loads and avoid sex for at least six months or as directed by a physician. Furthermore, a hysterectomy can result in a better lifestyle as you can stay away from the irregular pains and bleeding after this procedure.

Though hysterectomy comes with its clichés, not opting for it can lead to cancer. This is a procedure that health professionals opt for only if all treatment options fail for non-cancerous symptoms.