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Hysterectomy

A hysterectomy is an operation that removes a woman’s uterus. A woman may have a hysterectomy for different reasons, including:

– Uterine fibroids that cause pain, bleeding, or other problems
– Uterine prolapse (the sliding of the uterus into the vaginal canal)
– Cancer of the uterus, cervix, or ovaries
– Endometriosis
– Abnormal vaginal bleeding
– Chronic pelvic pain
– Adenomyosis

There are different types of hysterectomy. Your doctor will determine which type of procedure you may need depending on your symptoms and overall health. These include:

Total hysterectomy – The entire uterus, including the cervix, is removed.
Supracervical hysterectomy – The upper part of the uterus is removed, but the uterus is left in place.
Radial hysterectomy – This is a total hysterectomy that also removes the structures around the uterus. This may be recommended if cancer is diagnosed or suspected.

Types of Hysterectomy Procedures
There are various ways a hysterectomy procedure can be performed. Generally, there are three types of hysterectomy procedures: vaginal, abdominal, and laparoscopic.

Vaginal hysterectomy – In a vaginal hysterectomy, the uterus is removed through the vagina. Not all women are able to have a vaginal hysterectomy. Women who have adhesions from previous surgery or who have a very large uterus may be excluded from this type of surgery.

Vaginal hysterectomy generally causes fewer complications than abdominal or laparoscopic hysterectomy. Healing time may be shorter than with abdominal surgery, with a faster return to normal activities. It is recommended as the first choice for a hysterectomy when possible.

Abdominal hysterectomy – An abdominal hysterectomy is performed via an incision in the lower abdomen. Abdominal hysterectomy can be performed even if adhesions are present or if the uterus is very large. However, abdominal hysterectomy is associated with greater risk of complications, such as infection, bleeding, blood clots, and nerve and tissue damage. Generally, a longer hospital stay is required and needs a longer recovery time.

Laparoscopic Hysterectomy – Laparoscopic surgery requires a very small incision (about a half-inch long) in your abdomen. A laparoscope is inserted through one of these incisions and allows the surgeons to see the pelvic organs. Laparoscopic hysterectomy surgery results in less pain, has a lower risk of infection, and requires a shorter hospital stay. You may be able to return to your normal activities sooner.

How Safe is a Hysterectomy Procedure?
A hysterectomy is one of the safest surgical procedures a woman can have. However, some women are at greater risk of complications than others. For example, women who have an underlying medical condition may be at greater risk of problems related to anesthesia.

What to Expect After the Surgery
You may be required to stay in the hospital after surgery. The length of your hospital stay will depend on the type of hysterectomy you had and how it was performed. You will be urged to walk around as soon as possible after your surgery, which helps prevent blood clots in your legs. You also may receive medicine or other care to help prevent blood clots.

Some pain for the first few days is expected, but medication is given to help relieve pain and make you feel comfortable. You will have bleeding and discharge from your vagina for several weeks. Constipation is also common after a hysterectomy, and you may also have temporary problems emptying your bladder after the procedure. You also may find that you have an emotional response to the hysterectomy, which is common.

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