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A hysterectomy procedure is a surgical operation performed to remove the uterus (womb).

The procedure is a very common surgery around the world and about 1 in 5 women will undergo a hysterectomy procedure by the age of 50+. However, the number of hysterectomies are going down because of new treatments available to manage conditions that previously could only be cured with a hysterectomy.

  • Cancer of the uterus or ovaries or cervix will almost certainly need a hysterectomy
  • Abnormal uterine bleeding such as irregular bleeding or very heavy menstrual bleeding that can fail to cure with other methods such as tablets, ablation
  • Adenomyosis or endometriosis of the uterus(womb) when the cells from the lining of the Uterus (womb, endometrium) grow inside of the stomach and cause enormous pains during the menstrual periods as well as very heavy bleeding
  • Large uterine fibroids (more than 12 weeks) or fibroids that cause pain and bleeding. A hysterectomy may be the safest option for women who do not plan to have more children and have very large fibroids. After assessing the case the doctor will discuss all the options that are available and recommend the most appropriate option for the patient.

There are three approaches to performing a hysterectomy procedure such as an abdominal (Caesarean type, up and down cut on the stomach), laparoscopic (or keyhole surgery involving a 1 cm cut in the belly button and three 0.5 cm cuts on the sides of the abdomen) or vaginal (when there is no cut on the abdomen at all and the whole operation is done through the vaginal part). The choice of hysterectomy procedures (abdominal, laparoscopic or vaginal) depends on the actual problem, size of the uterus, ability to move the uterus, other conditions that the woman may have and her medical condition overall.

No, usually ovaries are not removed unless they have abnormalities. Nowadays, removing the tubes during the hysterectomy procedure is a common practice as it prevents ovarian cancer in the future and it does not have any negative implications.

As with any surgical procedure there are some , a hysterectomy can be complicated by infection, fever, bleeding during and after surgery, injury to bladder, ureter, bowel and large vessels, blood clots in legs and lungs, breathing, heart problems related to anaesthesia and even death. Risk of hysterectomy depends on each individual with their pre-operative medical condition, post-operative outcome, other medical problems, adhesion from previous surgeries if any.

Every patient who is undergoing a hysterectomy procedure receives an antibiotic. Just the cut is made to prevent infection, has compression stocking and calf compressors as well as a medication to thin the blood after surgery to prevent clots. Patients are monitored closely during and after surgery. Any individual risk is discussed before the surgery and dealt with it appropriately.

After the hysterectomy procedure has been conducted the patient will not have periods and will not be able to get pregnant.

Patient should rest initially and need to increase physical activity gradually. Can walk the following day after the hysterectomy procedure, but should avoid heavy lifting and heavy physical activity for 4-6 weeks. Should also avoid having sex and inserting anything in the vagina for 6 weeks after the hysterectomy procedure.

No, a hysterectomy procedure does not lead to menopause unless the ovaries are removed.

Women do not need a uterus to experience an orgasm so sexual satisfaction generally does not change. Some women may find more pleasure in sex because their symptoms of pain or bleeding are gone, others may develop problems because of vaginal dryness especially if the ovaries are removed. Whatever the issue is, Need to be discussed with the patient prior to the operation and can be manage easily afterwards.

There are a number of alternatives to a hysterectomy procedure depending on what the reason for the hysterectomy is. For example, abnormal uterine bleeding and adenomyosis can be treated with hormonal tablets (pill or other hormonal tablets), or tablets that decrease blood flow or endometrial ablation (destruction of the lining of the womb with high temperature).

Usually patient comes to the hospital on the day of surgery and go home the following day after a laparoscopic or vaginal hysterectomy procedure and in 2-3 days after an abdominal hysterectomy procedure (laparotomy).