The Impact of Hysterectomy on Women’s Health: Unveiling Effects and Alternatives in 2024
What is hysterectomy
Hysterectomy is the surgical removal of the uterus, most likely the cervix. Depending on the cause of the surgery, hysterectomy may involve the removal of surrounding organs and tissues, such as the fallopian tubes and ovaries.
The uterus is the place where the fetus grows during pregnancy and the lining is the blood that comes out during menstruation.
After a hysterectomy, you will not be able to get pregnant and you will not have a menstrual cycle.
Types of hysterectomy
- Complete hysterectomy: removal of the uterus and cervix, leaving the ovaries.
- Suprauterine hysterectomy: removing only the upper part of your uterus while leaving the cervix.
- Total hysterectomy with oophorectomy: removal of the uterus, cervix, fallopian tubes, ovaries. If you have not experienced menopause, the removal of the ovaries will begin to cause symptoms of menopause.
- Radical hysterectomy with oophorectomy: removal of the uterus, cervix, fallopian tubes, ovaries, upper part of the vagina, some surrounding tissues and lymph nodes. This type of hysterectomy is performed when it comes to cancer.
Causes of hysterectomy
Gynaecologists perform hysterectomies to treat the following conditions:
- Abnormal or severe vaginal bleeding is not managed in other therapeutic ways.
- Severe pain with menstruation is not managed in other therapeutic ways
- Liomas or uterine fibroids (non-cancerous tumors).
- Increase pelvic pain related to your womb but not managed by other treatments.
- Uterine prolapse (uterus that fell into the vaginal canal due to muscle weakness and which can lead to incontinence or difficulty in bowel movements.
- Cervical or uterine cancer or abnormalities that may lead to cancer.
- Endometrial conditions, such as hyperplasia, repeated uterine muscles or adenocarcinomyosis.
Methods of hysterectomy
There are many different surgical techniques that a healthcare provider may use to perform a hysterectomy:
Vaginal hysterectomy
- Your uterus is removed through an incision in the upper part of the vagina so that there is no external incision.
- Dissolvable stitches are placed inside the vagina.
- This method is most common in cases of uterine prolapse and other non-cancerous conditions.
- The least number of complications and the fastest recovery (up to four weeks).
- You often come home the same day as the surgery.
Laparoscopic hysterectomy
- A laparoscope (a thin tube with a video camera at the end) is inserted into your lower abdomen through a small incision in your abdomen.
- Surgical instruments are introduced through many other small cracks.
- The uterus can be removed as small pieces through cracks in your abdomen or through your vagina.
- Some women return home the same day or after one night in the hospital.
- Full recovery time is shorter and less painful than abdominal hysterectomy.
Robotic-assisted laparoscopic hysterectomy
- The surgeon performs the operation with the help of a machine, which is a robot.
- A laparoscope is inserted into your abdomen so that the doctor can see the pelvic area.
- Small and thin surgical instruments are inserted through three to five incisions. Robotic arms and instruments are controlled by the surgeon.
- Your uterus is removed through a six-to eight-inch incision in your abdomen.
- The most common method is when developing cancer, when the uterus is enlarged or when the disease has spread to other pelvic areas.
- It generally requires a longer hospital stay (two or three days) and a longer recovery time.
Situations requiring hysterectomy
Resorting to hysterectomy surgery may be necessary to treat several conditions, including:
- Cancer: In case of cancer in the uterus or cervix, hysterectomy is an effective option for treatment, in conjunction with other therapeutic methods such as radiotherapy and chemotherapy.
- Fibroids: Hysterectomy is the permanent solution for the treatment of fibroids that grow inside the womb and cause problems such as severe bleeding, anemia and pelvic pain.
- Endometriosis (migratory endometriosis): In a severe case, hysterectomy is necessary to get rid of external tissue similar to the endometrium.
- Uterine decline: When muscle and ligaments in the pelvis are stretched, hysterectomy may be necessary to treat the condition of uterine decline and improve support.
- Abnormal heavy vaginal bleeding: Hysterectomy can be considered a solution to severe or irregular bleeding during the menstrual cycle.
- Chronic pelvic pain: In some cases, hysterectomy can be considered as a last resort option for the treatment of chronic pelvic pain, especially if it is released from the womb.
How long does the hysterectomy last
The procedure lasts from one to three hours. The time can vary depending on the size of the uterus and the need to remove scars from previous surgeries, as well as whether other tissues, such as endometrial tissue, and other organs are removed using the uterus (such as the fallopian tubes or ovaries).
The most common side effects of hysterectomy
Some of the most common side effects of hysterectomy are vaginal discharge (which may occur up to six weeks after surgery) and irritation at the incision sites.
If the ovaries were removed at the time of hysterectomy, you may experience menopausal symptoms such as:
- Hot flashes.
- Dryness of the vagina.
- Loss of libido.
- Difficulty falling asleep (insomnia).
Post-hysterectomy
The amount of time you spend in the hospital after a hysterectomy varies depending on the type of surgery you had. The specialist will want to monitor you and make sure that there are no signs of complications such as blood clots or bleeding.
If you have an abdominal hysterectomy, you may stay in the hospital for a few days. Vaginal and laparoscopic hysterectomies are less invasive and usually do not require an overnight stay in the hospital.
After a hysterectomy, your menstrual cycle will stop. Sometimes, you may feel bloated and have symptoms similar to when you were menstruating.
It is normal to have light vaginal bleeding or dark brown discharge for four to six weeks after surgery.
You may feel discomfort at the incision site for about four weeks, and any redness, bruising, or swelling will disappear within four to six weeks.
A burning or itching feeling around the incision is normal. You may also feel a feeling of numbness around the incision and down your leg.
This is normal, and if it is present, it usually lasts about two months. It’s normal to have scars. Laparoscopic surgeries will cause smaller and less visible scars unlike abdominal hysterectomy.
If the ovaries remain, then you should not suffer from hormone-related effects.
If the ovaries were removed along with the uterus before menopause, you may experience symptoms that often occur with menopause, such as hot flashes. The doctor may prescribe hormone replacement therapy to relieve menopausal symptoms.
People who undergo partial hysterectomy may continue to have a mild period for a year after the operation. This happens because small amounts of endometrium can remain in the cervix, causing a light menstrual cycle.
Advantages of the hysterectomy procedure
A hysterectomy can help you live a healthier life, especially if you have constant pelvic pain or heavy, irregular bleeding.
If you are at a higher risk of developing uterine cancer, a hysterectomy can reduce this risk and is potentially life-saving.
Disadvantages of the hysterectomy procedure
Hysterectomy is a major surgical operation that needs a long period of recovery. It comes with risks and side effects.
Depending on the type of surgery you have, you can enter menopause or experience menopausal symptoms. You will also not be able to get pregnant after the operation.
Complications of hysterectomy
As with any surgery, there is a small probability of problems, including:
- Blood clots.
- Severe infection.
- Bleeding
- Intestinal obstruction.
- Internal stitches are torn.
- Injury to the urinary tract.
Time required for recovery after hysterectomy
Most women recover from a hysterectomy in about four to six weeks. Your recovery depends on the type of hysterectomy you had and how the surgery was performed.
Recovery from vaginal and laparoscopic hysterectomy takes less time than recovery from abdominal hysterectomy.
You should gradually increase your activity and pay attention to how you feel. If anything is causing you pain, you should stop.
Common instructions after hysterectomy
- Do not lift heavy objects (more than 10 pounds) for at least four to six weeks.
- Do not put anything in the vagina for four to six weeks.
- Do not have a marital relationship for six weeks after surgery.
- You can take a shower. Wash the incision with soap and water (stitches do not need to be removed, as they will dissolve in about six weeks). A bandage on the incision is not necessary. If surgical strips are used, they should fall off on their own within a week.
- Resume your exercise routine in four to six weeks, depending on how you feel.
- You can usually return to work in three to six weeks, depending on the type of work you are doing.
