What is a Hysterectomy? What should you expect

Hysterectomies are one of the most common elective surgeries performed on women in Australia. A number of different types of hysterectomies exist and are performed for several different reasons and with varying outcomes. In all cases of a hysterectomy performed on women who are pre-menopausal, menstruation will cease and the woman will no longer be able to bear children.

An operation involving removal of the uterus is known as a hysterectomy. Sometimes, the cervix as well as other reproductive organs are also removed.

The type of hysterectomy to be performed will depend on the diagnosis. For example, the only option for a woman who has been diagnosed with cancer may be a radical hysterectomy. In most instances, the patient will be offered a choice, particularly whether the ovaries will be removed or not.

Most common types of hysterectomy 

• ​Hysterectomy with Bilateral Salpingo-oophorectomy - This surgery includes the removal of the uterus, ovaries and fallopian tubes.
   
• Radical Hysterectomy - This procedure removes the uterus, the tissue on both sides of the cervix known as parametrium, the fallopian tubes, the upper part of the vagina and the ovaries. This type of hysterectomy also involves the removal of the attached pelvic ligaments as well as the lymph nodes.
   
• Total Hysterectomy - With this type of hysterectomy, the cervix and the entire uterus are removed. However, the ovaries are left intact. 

Hysterectomy proceedure

The way the surgery is performed depends on a number of different factors, such as the extent of the operation necessary, the reason for the procedure, previous medial history, surgeon’s preference and the patient’s anatomy, such as weight.

There are three different way sin which hysterectomies are performed, which include:

• Abdominal hysterectomy - performed through an incision in the lower abdomen
• Laparoscopic hysterectomy - also known as keyhole surgery, is through a small incision in the abdomen
• Vaginal hysterectomy

Why do Women Have Hysterectomies?

The most common reason that women in Australia have hysterectomies is fibroids, which are benign tumours, also known as myomas. Other common reasons to have a hysterectomy include:

• Cancer of the uterus, cervix, fallopian tubes or ovaries
   
• Endometriosis, which is when uterine glands develop in other pelvic tissue
   
• Menstrual problems such as excessive pain or heavy bleeding
   
• Chronic infection, such as pelvic inflammatory disease
   
• Uterine prolapse, which is when the uterus pushes into the vaginal area

The need for this type of procedure is rarely urgent. Therefore, all options should be fully explored and you should be satisfied that it is the appropriate course of action.

Recovering From a Hysterectomy

Following a hysterectomy, it is common to awake fatigued with pain, depending on the type of procedure, the reason it was performed and state of health. 

References

1. Medscape Multispeciality, News & Perspective; Domingo S, Pellicer A; Expert Review of Obstetrics & Gynecology; Overview of Current Trends in Hysterectomy; 2009
2. Gold Coast Gynaecology; Hysterectomy; The Hysterectomy Procedure in Australia – Hysterectomy Recovery and Side Effects; 2010
3. Breast Cancer Network Australia, Members, Dot42, Blog; Full hysterectomy
4. HCF, Hysterectomy
5. HysterSisters, Hysterectomy
6. Multi Cultural Communication; What women should know about hysterectomy; 2000
7. Better Health Channel, Conditions & Treatments, Surgery – Reproductive system, Hysterectomy
8. Women’s Health; Queensland Wide Inc., Conditions & Treatments, Hysterectomy fact sheet
9. The Royal Australian and New Zealand College of Obstetrics and Gynaecologists, Treatments, Hysterectomy
10. Mater Mothers’ Hospital, Women’s health – hysterectomy
11. National Institute for Health and Care Excellence
12. Queensland Government, Queensland Health; Howell S, Johnston T, Cones S, Wills R; StatBite #47; The incidence of peripartum hysterectomy in Queensland; 2012