Everything You Need to Know About Hysterectomy: Importance, Procedure, Recovery and Risks

Hysterectomy is one of the most common surgical procedures conducted on women. In fact, in 2015-16, 3.59% of the women between the ages of 30 and 39 and 9.20% of the women between 40 and 49 years of age in India underwent hysterectomy, according to a study published in BJOG, an international journal of obstetrics and gyneacology. But still, there are many women who might not be aware of this procedure.

A hysterectomy is a surgical procedure conducted for the removal a woman’s uterus. The uterus is a sac in the abdominal area, where the baby grows when the woman is pregnant. The uterine lining is where blood comes from during the menstrual periods. In many cases, the fallopian tubes and ovaries are also removed during the procedure.

There are 3 types of hysterectomy procedures:

1. Supracervical or Partial Hysterectomy: This surgery is performed to remove only a part of the uterus. The cervix may be left intact.
2. Total Hysterectomy: Here, the complete uterus, including the cervix, is removed.
3. Radical Hysterectomy: In this, the removal of the uterus and part of the vagina takes place. This procedure is generally performed if cancer is present.

There can be many reasons why a doctor would recommend removal of the uterus, including:

• Uterine fibroids, which can cause bleeding, pain and other issues
• Cervical cancer
• Cancer of the uterus or ovaries
• Uterine prolapse, a condition in which the uterus slides into the vaginal canal
• Pelvic inflammatory disease, which is a type of infection of the female reproductive system
• Extremely heavy vaginal bleeding
• Thickening of the uterus or Adenomyosis.

There are many ways in which this major surgery can be performed. But in all methods, either general or local anesthesia is administered. The different procedures are:

1. Abdominal Hysterectomy: In this procedure, the uterus is removed via a large cut in the abdomen. The incision can be horizontal or vertical. The cut heals extremely well and leaves little to no scarring.
2. Vaginal Hysterectomy: Here, small cuts are made inside the vagina. The uterus is removed through them. There would be no visible scars due to the lack of external cuts.
3. Laparoscopic Hysterectomy: This surgery is performed using a laparoscope, a tube with a lighted camera. The surgical instruments are inserted through small cuts on the belly. The surgeon views the surgery on the screen through the camera of the laparoscope.

Once the surgery is over, you might need to spend 3 to 5 days in the hospital. Medications would be provided to ease the pain. You would be encouraged to walk around, since this reduces the chance of blood clots forming. But lifting heavy objects and having sex after a hysterectomy should be avoided. Your vagina may also be packed with a gauze to control bleeding after the surgery. The complete recovery time is around 4 to 6 weeks.

Most women who undergo a hysterectomy do not experience any serious complications or side effects. But sometimes complications can occur, like in any other major surgery. These are:

• Vaginal prolapse
• Vagina fistula formation
• Urinary incontinence
• Chronic pain

But these complications are rare. In case they do occur, they can be corrected with another surgery.