Hysterectomy: Types and its Complications

A hysterectomy is a surgical procedure to remove the womb (uterus). You will no longer be able to get pregnant after the surgery.

Updated: November 3, 2017

A hysterectomy is a surgical procedure to remove the womb (uterus). You will no longer be able to get pregnant after the surgery.
After hysterectomy you will have menopause, a condition when a woman's monthly periods stop, which usually occurs from the ages of to 45 to 55. You will no longer have periods, regardless of your age after hysterectomy.

When a Hysterectomy is Required?

To treat conditions that affect the female reproductive system, hysterectomy is required.
The female reproductive system is made up of the womb (uterus), cervix, vagina , fallopian tubes and ovaries. A hysterectomy is a major operation with a long recovery time and is only considered after alternative, less invasive, treatments have been tried. This can be done when you have health issues such as:

  • non-cancerous tumours (fibroids)
  • long-term pelvic pain
  • ovarian cancer, uterine cancer, cervical cancer or cancer of the fallopian tubes
  • heavy periods

You may have to decide whether to remove your cervix or ovaries along with your uterus in hysterectomy.

Types of hysterectomy:

Depending on how much of your womb and surrounding reproductive system can safely be left in place and why you need the operation, you have various types of hysterectomy.
The most common types of hysterectomy are:

Total Hysterectomy:

this is the most commonly performed surgery where the uterus and cervix are removed.

Subtotal Hysterectomy :

Here the main body of the uterus is removed, leaving the cervix in place.

Total Hysterectomy with Bilateral Salpingo-Oophorectomy :

In this surgery the womb, cervix, fallopian tubes (salpingectomy) and the ovaries (oophorectomy) are removed.

Radical Hysterectomy :

In this case, the womb and surrounding tissues are removed, including the fallopian tubes, part of the vagina, ovaries, lymph glands and fatty tissue.  

There are three ways to perform a hysterectomy:

Vaginal Hysterectomy :

Here the womb is removed through a cut in the top of the vagina.

Abdominal Hysterectomy :

In this procedure the womb is removed through a cut in the lower abdomen.

Laparoscopic Hysterectomy  or keyhole surgery:

Here the womb is removed through several small cuts in the abdomen.

Complications of a Hysterectomy:

As with all types of surgery, a hysterectomy can sometimes lead to complications. Some of the possible complications could be:

Reaction to General anesthetic:

Serious complications can include nerve damage, allergic reaction which is rare because of general anesthetic.

Bleeding:

There is a small risk of heavy bleeding (haemorrhage) after having a hysterectomy. In that case you may need a blood transfusion.

Ureter damage:

The ureter (the tube that urine is passed through) may be damaged during surgery which is very rare.

Bladder or bowel damage:

Damage to abdominal organs such as the bladder or bowel can occur which is again very rare.However any damage during the hysterectomy is possible to repair.

Infection:

There is always a risk of either a wound infection or a urinary tract infection which can be treated with antibiotics.

Thrombosis:

A thrombosis is a blood clot that forms in a vein and interferes with blood circulation and the flow of oxygen around the body. The risk of developing blood clots increases after having surgery. To prevent this you should start moving around as soon as possible after your operation. You may also be given an injection of a blood-thinning medication (anticoagulant) to reduce the risk of clots.

Vaginal problems:

If you have a vaginal hysterectomy, there is a risk of problems at the top of your vagina where the cervix was removed.

Ovary failure:

Your ovaries receive some of their blood supply through the womb, which is removed during the surgery. So even if one or both of your ovaries are left in place during hysterectomy,  they could fail within five years of having surgery.

Early menopause:

You will usually have menopausal symptoms soon after the surgery, if your ovaries were removed. The symptoms include:

  • vaginal dryness
  • disturbed sleep
  • sweating
  • hot flushes

Once you stop ovulating, the menopause is triggered. Because estrogen levels decrease during the menopause, there is an increased risk of developing brittle bones (osteoporosis) which need to be considered if you are under the age of 40. You may need to take additional medication to prevent osteoporosis.
   
It takes about six to eight weeks to fully recover after the surgery. As hysterectomy is a major operation you need time for your abdominal muscles and tissues to heal. Take rest as much as possible during this time and don't lift anything heavy, such as shopping bags.

Surgical menopause:

Regardless of your age, you will go through the menopause immediately after hysterectomy, if your ovaries are removed during surgery. If one or both of your ovaries are left, there is a chance that you will experience the menopause within five years of having hysterectomy.
Hormone replacement therapy (HRT) will be recommended for you if you experience a surgical menopause after having a hysterectomy.


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