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Hysterectomy Surgery

Hysterectomies are one of the most common surgical procedures performed on women. A hysterectomy is a surgical procedure that removes parts or all of the female reproductive system to treat various issues, including various forms of cancer, endometriosis, heavy vaginal bleeding, or uterine tumors. A hysterectomy can be performed either through the abdomen or through the vagina, depending on how many part of the reporductive tract are being removed, which is determined by the need for the procedure. After the hysterectomy has been performed, a woman can no longer become pregnant and she will usually go through menopause quicker.

While a hysterectomy is a necessary procedure for many women, there are several potential hysterectomy side effects that could result from the procedure. Most of the major hysterectomy side effects come from the inherent risks that major surgerys bring. The hysterectomy side effects from the procedure alone are:

  • Infection

  • Bleeding

  • Anesthisial Reaction

  • Blood Clots

  • Vaginal or Anal Bleeding (this could result in additional surgical repair)


These are not fairly common, and a hysterectomy is considered to be a safe procedure for most women. Your doctor will inform you if you are at a high risk to experience any of these effects.

In addition to the surgical risks, there are several hysterectomy side effects that come well after the procedure. If the ovaries are removed along with the cervix, a hormonal adjustment will be made in the body. Depending on how much is removed, the hysterectomy side effects could result in an increase in the rate of osteoporosis and heart disease. The hysterectomy side effects can be adjusted if you are allowed to take hormone supplements, but this is not recommended by many doctors, since the hysterectomy side effect solution could result in an increase in the change for hormonal based cancers.

Along with those hysterectomy side effects, there will be a drastic lifestyle switch. Since the woman is no longer producing estrogen at the level it once was, depression, mood swings, loss of sexual desire, and emotional issues can be a hysterectomy side effect. A decrease in the enjoyment of sexual stimulation is also a hysterectomy side effect. All of these hysterectomy side effects will vary on the person and the amount of the reproductive tract that is removed. It can take anywhere from two weeks to six months for hysterectomy side effects to begin to manifest, and most women will experience hysterectomy side effects to some degree.


Purpose

The most frequent reason for hysterectomy in American women is to remove fibroid tumors, accounting for 30% of these surgeries. Fibroid tumors are non-cancerous (benign) growths in the uterus that can cause pelvic, low back pain, and heavy or lengthy menstrual periods. They occur in 30–40% of women over age 40, and are three times more likely to be present in African-American women than in Caucasian women. Fibroids do not need to be removed unless they are causing symptoms that interfere with a woman's normal activities.

Treatment of endometriosis is the reason for 20% of hysterectomies. The endometrium is the lining of the uterus. Endometriosis occurs when the cells from the endometrium begin growing outside the uterus. The outlying endometrial cells respond to the hormones that control the menstrual cycle, bleeding each month the way the lining of the uterus does. This causes irritation of the surrounding tissue, leading to pain and scarring.

Twenty percent of hysterectomies are done because of heavy or abnormal vaginal bleeding that cannot be linked to any specific cause and cannot be controlled by other means. Another 20% are performed to treat prolapsed uterus, pelvic inflammatory disease, or endometrial hyperplasia, a potentially pre-cancerous condition.

About 10% of hysterectomies are performed to treat cancer of the cervix, ovaries, or uterus. Women with cancer in one or more of these organs almost always have the organ(s) removed as part of their cancer treatment.

 

Diagnosis/Preparation

Before surgery the doctor will order blood and urine tests. The woman may also meet with the anesthesiologist to evaluate any special conditions that might affect the administration of anesthesia. On the evening before the operation, the woman should eat a light dinner and then have nothing to eat or drink after midnight.

 

Aftercare

After surgery, a woman will feel some degree of discomfort; this is generally greatest in abdominal hysterectomies because of the incision. Hospital stays vary from about two days (laparoscopic-assisted vaginal hysterectomy) to five or six days (abdominal hysterectomy with bilateral salpingo-oophorectomy). During the hospital stay, the doctor will probably order more blood tests.

Return to normal activities such as driving and working takes anywhere from two to eight weeks, again depending on the type of surgery. Some women have emotional changes following a hysterectomy. Women who have had their ovaries removed will probably start hormone replacement therapy.

 

Risks

Hysterectomy is a relatively safe operation, although like all major surgery it carries risks. These include unanticipated reaction to anesthesia, internal bleeding, blood clots, damage to other organs such as the bladder, and post-surgery infection.

Other complications sometimes reported after a hysterectomy include changes in sex drive, weight gain, constipation, and pelvic pain. Hot flashes and other symptoms of menopause can occur if the ovaries are removed. Women who have both ovaries removed and who do not take estrogen replacement therapy run an increased risk for heart disease and osteoporosis (a condition that causes bones to be brittle). Women with a history of psychological and emotional problems before the hysterectomy are likely to experience psychological difficulties after the operation.

As in all major surgery, the health of the patient affects the risk of the operation. Women who have chronic heart or lung diseases, diabetes, or iron-deficiency anemia may not be good candidates for this operation. Heavy smoking, obesity, use of steroid drugs, and use of illicit drugs add to the surgical risk.

 

Normal Results

Although there is some concern that hysterectomies may be performed unnecessarily, there are many conditions for which the operation improves a woman's quality of life. In the Maine Woman's Health Study, 71% of women who had hysterectomies to correct moderate or severe painful symptoms reported feeling better mentally, physically, and sexually after the operation.

 

Alternatives

Women for whom a hysterectomy is recommended should discuss possible alternatives with their doctor and consider getting a second opinion, since this is major surgery with life-changing implications. Whether an alternative is appropriate for any individual woman is a decision she and her doctor should make together. Some alternative procedures to hysterectomy include:

  • Embolization. During uterine artery embolization, interventional radiologists put a catheter into the artery that leads to the uterus and inject polyvinyl alcohol particles right where the artery leads to the blood vessels that nourish the fibroids. By killing off those blood vessels, the fibroids have no more blood supply, and they die off. Severe cramping and pain after the procedure is common, but serious complications are less than 5% and the procedure may protect fertility.

  • Myomectomy. A myomectomy is a surgery used to remove fibroids, thus avoiding a hysterectomy. Hysteroscopic myomectomy, in which a surgical hysteroscope (telescope) is inserted into the uterus through the vagina, can be done on an outpatient basis. If there are large fibroids, however, an abdominal incision is required. Patients typically are hospitalized for two to three days after the procedure and require up to six weeks recovery. Laparoscopic myomectomies are also being done more often. They only require three small incisions in the abdomen, and have much shorter hospitalization and recovery times. Once the fibroids have been removed, the surgeon must repair the wall of the uterus to eliminate future bleeding or infection.

  • Endometrial ablation. In this surgical procedure, recommended for women with small fibroids, the entire lining of the uterus is removed. After undergoing endometrial ablation, patients are no longer fertile. The uterine cavity is filled with fluid and a hysteroscope is inserted to provide a clear view of the uterus. Then, the lining of the uterus is destroyed using a laser beam or electric voltage. The procedure is typically done under anesthesia, although women can go home the same day as the surgery. Another newer procedure involves using a balloon, which is filled with superheated liquid and inflated until it fills the uterus. The liquid kills the lining, and after eight minutes the balloon is removed.

  • Endometrial resection. The uterine lining is destroyed during this procedure using an electrosurgical wire loop (similar to endometrial ablation).

 

Exercising After Undergoing a Hysterecomy

Post-hysterectomy exercise is one of the key factors in the healing process by promoting healthy sleep, assisting in weight loss, relieving muscle tension and preventing a range of diseases, from various types of cancer to diabetes and Alzheimer’s. Women who were physically fit before undergoing this procedure are more likely to have an easier recovery and will be able to quickly return back to their routine physical activities.
The safe routines to get you moving again posy hysterectomy include the following:

  1. Walking: You can start walking on your doctor’s approval. Take short, frequent walks; this will help to speed up the healing and recovery process and will reduce the risk of blood clots.

  2. Breathing Exercises: It is quite common to experience difficulty breathing in the hours and days following a hysterectomy. Take long, slow breaths, completely filling the lungs, belly and rib cage before slowly exhaling. Targeted breathing exercises will help you return to a normal, comfortable respiratory pattern.

  3. Stretching: Gentle stretches will help relieve muscle tension and promote healthy blood circulation. Stretch your upper back and shoulders while lying on the bed or on the floor. Bend your knees and reach your arms up over the head, lightly press them against the floor or the bed and then release. Repeat this procedure. As you get stronger and more mobile, you can add more advanced stretches to this routine.

  4. Pelvic Tilts: It helps to strengthen the pelvic floor. Lie on your back with your knees bent and support your head with a pillow. Lift your bottom up into a bridge position while contracting your stomach muscles. Keep your middle back flush against the floor. Maintain this position for a few seconds, release and repeat this procedure.

  5. Kegels: Post hysterectomy, your pelvic floor may be weakened and this can cause loss of the bladder control, shifting of pelvic organs and other problems. They can be performed in any position and at any time. Simply, squeeze the muscle you would normally use to stop the flow of urine, release and repeat. Aim for high repetitions of varying lengths.

  6. Head Sit-Ups: If you are not ready for full-crunches, then start with a head sit-up. Lie on your back, bend your knees and cross your arms over the belly. Cinch the stomach muscles with your hands, slowly raise your head off the floor and bring your chin to your chest. After a few seconds, release and repeat.

  7. Stomach “Vacuums”: This move helps strengthen the stomach muscles safely. Start from your hands and knees, inhale and then tighten your tummy as you slowly exhale. After a few seconds, release and repeat it.

  8. Lower Back Exercises: They help to strengthen the core while improving the posture and stability, thereby aid in healing and recovery. It also helps to alleviate and prevent the back pain post hysterectomy.

  9. Other Abdominal Exercises: It’s normal to experience bloating or loss of abdominal strength after a hysterectomy. Although diet and cardio help in slimming down the midsection, targeted core exercises helps to strengthen those muscles. Ensure to give special attention to the transverses abdominis (TA) muscles by performing, planks, Pilates moves, bridges and forward ball rolls.


Hysterectomy Side Effects

After the hysterectomy, most women will enter menopause earlier. Since the reproductive tract, or parts of it, have been removed, the woman can no longer get pregnant and will cease to have a menstral cycle. If you are planning on having children, you should discuss this hysterectomy side effect with you doctor to see if there is an alternative solution to the condition.

You should make sure you discuss all options with your doctor before having a hysterectomy in order to avoid hysterectomy side effects. Most of the reasons for a hysterectomy have an alternative, but they may not be as effective.


Types of Hysterectomy Surgery in India

There are different types of hysterectomy. The type you have depends on the reason for your surgery and how much of the womb and surrounding reproductive system can safely be left in place. The main types include:

  • Total hysterectomy: 

  •  Subtotal hysterectomy

  • Total hysterectomy with bilateral salpingo-oophorectomy

  • Radical hysterectomy


Hysterectomy Surgery in India

Hysterectomy surgery India is a major surgical procedure and is performed under general anesthesia. In addition to the different types of hysterectomy, there are various ways by which a gynecologist might perform the operation. This will be influenced by the reason for performing the hysterectomy in the first place, the size of the uterus and the experience and preference of the individual gynecologist.

  • Abdominal hysterectomy is the most common method and is performed through an approximately six-inch scar made across the lower abdomen.

  • A vaginal hysterectomy is performed through the vagina and will leave no visible external signs that the woman has had an operation.

  • In a laparoscopically assisted vaginal hysterectomy (LAVH) the gynecologist uses keyhole surgery in combination with surgery through the vagina to complete the operation

Your doctor will help you decide which type of hysterectomy is best for you.

 

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