Hysterectomy Surgery :

CAUSES

The hysterectomy surgery is performed when other alternative treatments have failed to address several underlying conditions. The main reasons for undergoing a hysterectomy may include:

• Endometriosis that doesn't respond to other treatments
• Prolonged vaginal bleeding that can't be controlled with other treatments
• Uterine tumors like uterine fibroids
• Adenomyosis, a condition that causes painful and heavy periods
• Uterine or cervical cancer
• Ovarian cancer
• Pelvic Inflammatory Disease (PID) that causes severe pelvic pain
• Hyperplasia, a condition that causes abnormal thickening of the uterine lining due to high estrogen levels
• Abnormal vaginal bleeding
• Gender affirmation
• Additionally, delivery complications or abnormal heavy bleeding may also necessitate a hysterectomy

HYSTERECTOMY TYPES

The type of hysterectomy performed varies depending on the condition being treated. There are different types of hysterectomies which can be classified based on whether all or only part of the uterus is removed.

1. Simple or Total Hysterectomy : This is the most common type of hysterectomy. It involves the removal of the entire uterus and cervix. In some cases, the ovaries and fallopian tubes may also be removed.
2. Supracervical Hysterectomy : Also known as Partial or Sub-Total Hysterectomy, this procedure involves the removal of only the upper part of the uterus while leaving the cervix intact.
3. Total Hysterectomy with Bilateral Salpingo-Oophorectomy : This process involves the removal of the uterus, cervix, fallopian tubes and ovaries. It is also referred to as Oophorectomy.
4. Radical Hysterectomy with Bilateral Salpingo-Oophorectomy : This type of hysterectomy is performed in cancerous conditions. It involves removal of the uterus, cervix, fallopian tubes, ovaries, the upper part of the vagina, and some of the surrounding tissue and lymph nodes.

DIAGNOSIS

Before starting any treatment, a medical professional may perform several diagnostic tests to identify the symptoms, determine the severity of the condition, and evaluate the overall health of the patient. The doctor will also ask about your previous surgical and medical history, as well as any medications you are currently taking. Based on this information, the doctor will decide on the best course of action and type of hysterectomy to be performed. To gain further insights, they may also conduct other tests such as:

• Physical examination : The diagnosis begins with a simple physical evaluation of the patient's reproductive organs to check for any abnormalities.
• Imaging evaluation : After the physical examination, the doctor may recommend imaging tests like CT scans, MRI, or ultrasound to provide more detailed information via images, which helps to detect any fibroids, tumors or other abnormalities in the reproductive system.
• Laboratory assessments : Various tests such as blood and urine tests are performed to check hormone levels, infections and assess the overall health of the patient.
• Biopsy : In some cases, a biopsy is conducted to check for pre-cancerous and cancerous conditions. In this process, a tissue sample from the cervix or uterus is collected and then tested under the microscope.
• Other diagnostic procedures : In some cases, a doctor may suggest diagnostic procedures like laparoscopy or hysteroscopy to diagnose the underlying cause for the hysterectomy, such as fibroids, endometriosis, polyps, etc.

TREATMENT PROCEDURES FOR HYSTERECTOMY

Medical professionals determine the type of hysterectomy based on the diagnosed condition. The surgery is performed under general anesthesia, which is administered by an anesthetist. The surgery can last up to 2-4 hours. There are different types of approaches for hysterectomy, including open surgery hysterectomy and minimally invasive procedure hysterectomy.

• Open surgery hysterectomy, also known as abdominal hysterectomy, involves removing the uterus through a 5-7 inch incision in the lower abdomen. This procedure may require a longer recovery period.
• Minimally invasive procedure hysterectomy includes three different techniques:
• 1. Vaginal hysterectomy : The uterus is removed through a small cut at the top of the vagina. This technique is the least invasive and has the shortest recovery time.
• 2. Laparoscopic hysterectomy : A laparoscope, which is a thin and narrow tube with a tiny camera, is inserted by the surgeon through multiple small incisions in the abdomen to view internal organs during the procedure.
• 3. Robotic hysterectomy : This is an advanced type of laparoscopic hysterectomy in which a robotic arm is guided by the surgeon to do the surgery through a small incision in the lower abdomen.

SIDE EFFECTS AND COMPLICATIONS

After undergoing a hysterectomy, some of the most common side effects and complications that may arise are:

• Vaginal dryness
• Loss of libido
• Difficulty sleeping (insomnia)
• Hot flashes
• Chronic pain
• Blood clots
• Severe infection
• Bleeding
• Constipation
• Torn internal stitches
• Issues related to anesthesia
• Urinary tract infections

It is important to keep in mind that these side effects and complications may vary from person to person and depend on a variety of factors, such as the type of hysterectomy performed, the patient's overall health, and any pre-existing medical conditions they may have. If any of these symptoms persist or worsen, it is important to seek medical attention immediately

BENEFITS OF HYSTERECTOMY

Hysterectomy is a life-saving treatment for cancers of the uterus and cervix. It provides relief from painful medical conditions such as endometriosis and fibroids, and is also recommended as the ultimate cure for adenomyosis. Hysterectomy can improve the quality of life of an individual.

AFTER CARE

To ensure a speedy and smooth recovery after hysterectomy treatment, it is advisable to follow some aftercare tips. Recovery can take almost 5-6 weeks, and the following steps can help:

• Stay active with gentle exercises such as yoga and walking, as this can aid in good blood flow and the healing process. Avoid hard exercises for 5-6 weeks.
• Do not lift heavy weights for 5-6 weeks.
• If you experience emotional trauma post-treatment, try practicing meditation to keep your mind calm and balance your emotions.
• Get enough sleep.
• Eat healthy, light and easily digestible food. Avoid processed and oily foods as they may cause constipation and pain in the abdomen.
• Keep yourself hydrated as dehydration may slow down the healing process.
• Avoid sexual activity for at least a few weeks. Talk to your healthcare provider before having sex again.

TYPES OF PROLAPSE

Vaginal/Pelvic Organ Prolapse : In this condition, the supportive tissues in the pelvic region become weakened, causing the pelvic organs to descend into the vaginal canal. Vaginal vault prolapse is a type of pelvic organ prolapse that occurs when the uterus is no longer present to support the other organs.

Cystocele : This type of prolapse occurs when the supportive tissue between the bladder and vaginal wall becomes weakened, causing the bladder to bulge into the vagina.

Rectocele : In this case, the pelvic tissue that separates the rectum from the vagina weakens and bulges against the back wall of the vagina.

Enterocele : This is a condition where the small intestine drops into the lower pelvic cavity and pushes against the upper part of the vagina.