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Performing a Hysterectomy and Complications

Performing a hysterectomy

Performing a Hysterectomy and Complications should be a key discussion between a Doctor and patient. There are various ways a hysterectomy can be performed and it is important that you understand them before you have treatment.

• laparoscopic hysterectomy
• vaginal hysterectomy
• abdominal hysterectomy
• Supracervical hysterectomy—removal of the uterus only
• Total hysterectomy—removal of the uterus and cervix (the opening of the uterus leading to the vagina)
• Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
• Salpingo-oophorectomy —removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)

Laparoscopic hysterectomy

Laparoscopic surgery is keyhole surgery. A small tube containing a telescope (laparoscope) and a tiny video camera are inserted through a cut in your tummy . The surgeon can then see your internal organs. Through other incisions, instruments are inserted to remove the womb, cervix and any other parts of your reproductive system.

Vaginal hysterectomy

Specifically the womb and cervix are removed through an incision in the top of the vagina. Special surgical instruments are inserted into the vagina to detach the womb from the ligaments that hold it in place. The operation takes about an hour to complete. A vaginal hysterectomy is less invasive than an abdominal surgery. You have a shorter stay in hospital and a quicker recovery time.

Abdominal hysterectomy

An incision is made in your tummy (abdomen). This could be horizontally along your bikini line, or vertically from your belly button to your bikini line. A vertical incision is used if there are large fibroids (non-cancerous growths) in your womb, or for some types of cancer. The operation takes about an hour.

An abdominal hysterectomy is recommended if your womb is enlarged by fibroids or pelvic tumours or if the ovaries need to be removed.

Open Abdominal Hysterectomy

An incision is made in the lower abdomen to expose the tissue and blood vessels that surround the uterus. They are cut and the uterus removed. The abdominal wall is sewn back together and the skin closed with stitches or staples. If the cervix is removed, stitches are put in the top of the vagina.

Consent

You shouldask your Doctor

1. Why they recommend a hysterectomy

2. Whether you have an abdominal or vaginal hysterectomy

3. Whether you wish to retain the ovaries, fallopian tubes, upper part of the vagina, cervix, and the pelvic lymph nodes

Consequently you will understand what to expect in terms of risks and complications.

Possible Complications

Ensure that you discuss these complications :

• Reactions to anaesthesia
• Pain
• Infection
• Bleeding
• Fatigue
• Injured pelvic organs (bowel and/or bladder)
• Urinary incontinence (problems controlling your urine) which may manifest in the future and need surgical intervention
• Loss of ovarian function and early menopause – needing treatment to protect your bone density, hormones and heart.
• Depression
• Sexual dysfunction  – e.g pain on intercourse and inability to have intercourse.