Depending on your symptoms, these options may include: Surgery to treat endometriosis. Laparoscopic surgery uses a thin, lighted tube with a small camera. The doctor puts the camera and surgery tools into your pelvic area through very small cuts. This surgery can remove scar tissue or growths from endometriosis without harming the surrounding healthy organs such as ovaries. You may still get pregnant after this surgery.
Surgery to help stop heavy or long-term vaginal bleeding. Often, a hysteroscopy is done at the same time. Your doctor inserts the hysteroscope a thin telescope into your uterus to see the inside of the uterine cavity. Endometrial ablation destroys the lining of the uterus permanently. Depending on the size and condition of your uterus, your doctor may use tools that freeze, heat, or use microwave energy to destroy the uterine lining.
This surgery should not be used if you still want to become pregnant or if you have gone through menopause. Surgery to remove uterine fibroids without removing the uterus.
This is called a myomectomy. Depending on the location of your fibroids, the myomectomy can be done through the pelvic area or through the vagina and cervix. You may be able to get pregnant after this surgery. If your doctor recommends this surgery, ask your doctor if a power morecellator will be used.
The FDA has warned against the use of power morcellators for most women. Surgery to shrink fibroids without removing the uterus.
This is called myolysis. The surgeon heats the fibroids, which causes them to shrink and die. Myolysis may be done laparoscopically through very small cuts in the pelvic area.
You may still get pregnant after myolysis. Treatments to shrink fibroids without surgery. UAE puts tiny plastic or gel particles into the vessels supplying blood to the fibroid. Once the blood supply is blocked, the fibroid shrinks and dies.
MR f US sends ultrasound waves to the fibroids that heat and shrink the fibroids. How common are hysterectomies? What are the different types of hysterectomies?
A total hysterectomy removes all of the uterus, including the cervix. The ovaries and the fallopian tubes may or may not be removed. This is the most common type of hysterectomy. A partial , also called subtotal or supracervical , hysterectomy removes just the upper part of the uterus. The cervix is left in place. The ovaries may or may not be removed. A radical hysterectomy removes all of the uterus, cervix, the tissue on both sides of the cervix, and the upper part of the vagina.
A radical hysterectomy is most often used to treat certain types of cancer, such as cervical cancer. The fallopian tubes and the ovaries may or may not be removed. Will the doctor remove my ovaries during the hysterectomy? Will the hysterectomy cause me to enter menopause? How is a hysterectomy performed? Talk to your doctor about the different options: Abdominal hysterectomy.
Your doctor makes a cut, usually in your lower abdomen. Vaginal hysterectomy. This is done through a small cut in the vagina. Laparoscopic hysterectomy. A laparoscope is an instrument with a thin, lighted tube and a small camera that allows your doctor to see your pelvic organs. Laparoscopic surgery is when the doctor makes very small cuts to put the laparoscope and surgical tools inside of you. During a laparoscopic hysterectomy the uterus is removed through the small cuts made in either your abdomen or your vagina.
Robotic surgery. Your doctor guides a robotic arm to do the surgery through small cuts in your lower abdomen, like a laparoscopic hysterectomy. How long does it take to recover from a hysterectomy? The time it takes for you to return to normal activities depends on the type of surgery: Abdominal surgery can take from four to six weeks to recover.
Vaginal, laparoscopic, or robotic surgery can take from three to four weeks to recover. What changes can I expect after a hysterectomy? Other changes that you may experience after a hysterectomy include: Menopause. You will no longer have periods.
If your ovaries are removed during the hysterectomy, you may have other menopause symptoms. Change in sexual feelings. Some women have vaginal dryness or less interest in sex after a hysterectomy, especially if the ovaries are removed.
Increased risk for other health problems. Once a woman has had a hysterectomy of any kind, she cannot become pregnant. If the ovaries of a premenopausal woman are removed, she has had a surgical menopause.
This means she will have a drop in production of the sex hormones oestrogen, progesterone and testosterone. Vaginal dryness, hot flushes, sweating and other symptoms of natural menopause may occur. Women who undergo bilateral oophorectomy removal of both ovaries usually take hormone replacement therapy also called menopause hormone therapy ,This is also known as oestrogen replacement therapy, as usually only oestrogens are required to maintain their hormone levels and prevent the long-term risks of premature menopause.
The ovaries play a major role in maintaining the female hormonal system. Their removal results in menopausal symptoms within 24 hours, oestrogen levels fall by 50 per cent. Except if a woman has cancer, doctors recommend that hysterectomy should be a procedure of last resort, when all other treatment options have failed. Some conditions that in the past have been treated with hysterectomy, now have alternative treatment options. These include:.
Fibroids are non-cancerous growths that form within the muscular walls of the uterus. However, most fibroids are small, do not cause symptoms and do not require treatment. For those that do, treatment choice depends on the size, position, and symptoms caused by the fibroids. Heavy menstrual bleeding may be due to fibroids, adenomyosis, cancers, bleeding disorders, other medical conditions and also unknown causes.
Alternative treatment to a hysterectomy for heavy bleeding may include:. Since the introduction of the levonorgestrel-releasing IUD and endometrial ablation to treat heavy or irregular periods, hysterectomy rates have reduced. Alternative treatment to a hysterectomy for uterine prolapse depends on the degree of prolapse, but may include:. For endometriosis , alternative treatment to a hysterectomy may include hormonal therapies, surgical removal of areas of endometriosis, or a combination of both.
If, after talking about all the options with your doctor, you choose to have a hysterectomy, your doctor should discuss several things with you before the operation. You will have a range of tests before your hysterectomy, including a complete blood-count test to check for problems such as anaemia deficiency in red blood cells or haemoglobin.
The operation may be performed via an incision cut in your lower abdomen abdominal hysterectomy , three to four small incisions in your abdomen laparoscopic hysterectomy , or through your vagina vaginal hysterectomy. For an abdominal hysterectomy, the surgeon usually makes a horizontal cut along your pubic hairline your pubic hair may have been shaved around the incision.
For most women, this leaves a small scar. Some women may need a vertical midline incision in the lower abdomen, especially if the hysterectomy is for a large uterine fibroid. An abdominal hysterectomy is generally recommended when a woman has very large fibroids or cancer. For a laparoscopic hysterectomy, the surgeon inserts a telescope laparoscope to see your pelvic organs through a small incision in your navel, and makes another three or four small incisions through which other instruments are used.
Carbon dioxide gas is used to distend inflate your abdomen, like a balloon, so all of your organs can be clearly seen. The surgeon then removes the uterus, with or without fallopian tubes and ovaries, through the vagina. If the top of the vagina is sutured stitched through keyhole incisions, the operation is called a total laparoscopic hysterectomy. If the gynaecologist stitches the top of the vagina through the vagina, it is called a laparoscopically assisted vaginal hysterectomy.
A vaginal hysterectomy is performed through an incision at the top of the vagina. It is usually performed where there is a uterine prolapse the cervix and uterus come down into the vagina, or protrude out of the vaginal entrance.
With good pain relief, recovery may be similar for all forms of the hysterectomy. Although, more care is required regarding the pelvic floor, urination and bowel function after vaginal hysterectomy. It is important to start pelvic floor and abdominal exercises within the first few weeks after surgery.
In a study comparing different surgical methods of hysterectomy, some women noticed reduced sexual sensation. This included reduced feeling when their partner penetrated their vagina, a dry vagina and less intense orgasms. If, before hysterectomy, you had noticeable uterine contractions during orgasm you may find you do not experience these anymore.
If your hysterectomy has made your vagina feel drier than it used to be, try using a sexual lubricant. You can buy these over the counter at a pharmacy. Your surgeon will have advised you to do pelvic floor exercises to help your recovery. These exercises can also tone up the muscles of your vagina and help improve sexual sensation. Read more about pelvic floor exercises. Other women report their hysterectomy removed their pre-surgery symptoms such as pain , and they had a greater sense of wellbeing and happiness.
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