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Wednesday, March 31, 2010

What is hysterectomy?


A hysterectomy is a surgery to remove a woman's uterus or womb. The uterus is where a baby grows when a woman is pregnant. The whole uterus or just part of it may be removed. After a hysterectomy, you no longer have menstrual periods and cannot become pregnant.

During the hysterectomy, your doctor also may remove your fallopian tubes and ovaries. The ovaries produce eggs and hormones. The fallopian tubes carry eggs from the ovaries to the uterus. The cervix is the lower end of the uterus that joins the vagina. These organs are located in a woman’s lower abdomen.


If you have not yet reached menopause and:
1.You keep your ovaries during the hysterectomy, you may enter menopause at an earlier age than most women.
2.Your ovaries are removed during the hysterectomy, you will enter menopause. You can talk with your doctor about ways to manage menopausal symptoms, such as hot flashes and vaginal dryness.


Types of hysterectomy:


1.Partial, subtotal, or supracervical removes just the upper part of the uterus. The cervix is left in place.
2.Total removes the whole uterus and the cervix.
3.Radical removes the whole uterus, the tissue on both sides of the cervix, and the upper part of the vagina. This is done mostly when there is cancer present.

How is a hysterectomy performed?


There are different ways that your doctor can perform a hysterectomy. It will depend on your health history and the reason for your surgery.


Abdominal hysterectomy. This is done through a 5- to 7-inch incision, or cut, in the lower part of your belly. The cut may go either up and down, or across your belly, just above your pubic hair.


Vaginal hysterectomy. This is done through a cut in the vagina. The doctor will take your uterus out through this incision and close it with stitches.


Laparoscopic hysterectomy. A laparoscope is an instrument with a thin, lighted tube and small camera that allows your doctor to see your pelvic organs. Your doctor will make three to four small cuts in your belly and insert the laparoscope and other instruments. He or she will cut your uterus into smaller pieces and remove them through the incisions.
Laparoscopically assisted vaginal hysterectomy (LAVH). Your doctor will remove your uterus through the vagina. The laparoscope is used to guide the procedure.


Robotic surgery. Your doctor uses a special machine to perform the surgery like laparoscopic surgery. It is most often done when a patient has cancer or is very overweight and vaginal surgery is not safe.


Why do women have hysterectomies?


Hysterectomy may be needed if you have:


Cancer of the uterus, ovary, cervix, or endometrium. Hysterectomy may be the best option if you have cancer in these organs. The endometrium is the tissue that lines the uterus. If you have precancerous changes of the cervix, you might be able to have a loop electrosurgical excision procedure (LEEP) to remove the cancerous cells. Other treatment options can include chemotherapy and radiation. Your doctor will talk with you about the type of cancer you have and how advanced it is.

Fibroids are non-cancerous, muscular tumors that grow in the wall of the uterus. Many women with fibroids have only minor symptoms and do not need treatment. Fibroids also often shrink after menopause. In some women, fibroids can cause prolonged heavy bleeding or pain. Fibroids can be treated with medications. There are also procedures to remove the fibroids, such as uterine artery embolization, which blocks the blood supply to the tumors. Without blood, the fibroids shrink over time, which can reduce pain and heavy bleeding. Another procedure called myomectomy removes the tumors while leaving your uterus intact, but there is a risk that the tumors could come back. If medications or procedures to remove the fibroids have not helped, and a woman is either near or past menopause and does not want children, hysterectomy can cure problems from fibroids.


Endometriosis. This health problem occurs when the tissue that lines the uterus grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs. This can cause severe pain during menstrual periods, chronic pain in the lower back and pelvis, pain during or after sex, bleeding between periods, and other symptoms. You might need a hysterectomy when medications or less invasive surgery to remove the spots of endometriosis have not helped.
Prolapse of the uterus. This is when the uterus slips from its usual place down into the vagina. This can lead to urinary and bowel problems and pelvic pressure. These problems might be helped for a time with an object called a vaginal pessary, which is inserted into the vagina to hold the womb in place.


Adenomyosis. In this condition, the tissue that lines the uterus grows inside the walls of the uterus, which can cause severe pain. If other treatments have not helped, a hysterectomy is the only certain cure.


Chronic pelvic pain. Surgery is a last resort for women who have chronic pelvic pain that clearly comes from the uterus. Many forms of pelvic pain are not cured by a hysterectomy, so it could be unnecessary and create new problems.


Abnormal vaginal bleeding. Treatment depends on the cause. Changes in hormone levels, infection, cancer, or fibroids are some things that can cause abnormal bleeding. There are medications that can lighten heavy bleeding, correct irregular bleeding, and relieve pain. These include hormone medications, birth control pills, and nonsteroidal anti-inflammatory medications (NSAIDs). One procedure for abnormal bleeding is dilatation and curettage (D&C), in which the lining and contents of the uterus are removed. Another procedure, endometrial ablation, also removes the lining of your uterus and can help stop heavy, prolonged bleeding. But, it should not be used if you want to become pregnant or if you have gone through menopause.


Very rarely, hysterectomy is needed to control bleeding during a cesarean delivery following rare pregnancy complications but this thing happened to me during my delivery...There are other methods doctors use to control bleeding in most of these cases, but hysterectomy is still needed for some women.
Article were taken from The National Women's health Information Centre, US Department of Health and Human Services..

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