Hysterectomy : Uterus removal surgery
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The uterus has an essential role in the reproductive function in women since it is at the level of the mucous membrane that the embryo and then the fetus will be fixed and developed during pregnancy. Hysterectomy is a surgical procedure to remove all or part of the uterus, and sometimes its appendages (ovaries and fallopian tubes). Because the uterus is inseparable from motherhood, hysterectomy is practiced in very specific situations, after careful consideration by the patient.
Nearly 20,000 hysterectomies are performed because of the presence of one or more fibroids. Fibroma is a non-cancerous tumor, the severity of which is highly variable. But beware, not all fibroids do not involve such a procedure. It is especially considered when the fibroids are too big, poorly positioned and when the drug treatments are not effective. The other major indication of hysterectomy is significant bleeding, especially in case of adenomyosis or internal endometriosis.
This is an abnormality of the junction between the endometrium (lining the uterus) and the myometrium (uterine wall muscle), which allows endometrial cells to infiltrate the myometrium. In rare cases, hysterectomy is used to stop the spread of endometriosis to other organs when they are already very affected. Finally, other pathologies such as gynecological cancers or the descent of organs can justify such an intervention.
Other gynecological procedures:
The price of a Hysterectomy in Tunisia coupled with a week of recovery or vacation in a 5 stars hotel is at least % cheaper than the sole procedure in Europe and for the same medical quality.
Types of Hysterectomy
There are different types of hysterectomy: During total hysterectomy, the uterus and cervix are removed. Total hysterectomy is also called simple hysterectomy.
During the subtotal hysterectomy, the uterus is removed but the cervix is left in place. Radical hysterectomy removes the uterus, cervix, the uppermost part of the vagina just below the cervix, and the surrounding ligaments that support the uterus.
It is often the case that lymph nodes in the pelvis that are nearby are also removed as part of the staging process.
How is Uterus removal surgery performed?
The intervention can be performed under general or loco-regional anesthesia (epidural or spinal anesthesia), depending on the surgical technique used. We can say that generally, the surgery lasts between 40 and 90 minutes. Today, three techniques exist for the uterus removal. The choice of technique is based on the size of the uterus, its mobility but also the operative indication. In fact, the surgeon can proceed by laparotomy, abdominal hysterectomy, that is to say by opening the abdomen. This is the oldest technique. It leaves a scar permanently. An incision is made in the abdomen, usually at the upper limit of pubic hair. This method is especially used in cases of large uterus. Besides, the surgeon can also use laparoscopy, a less invasive technique that involves introducing a camera and instruments with small incisions of 5 to 10 mm are made in the abdomen to inject into the abdominal cavity CO2 gas and to introduce surgical instruments.
Moreover, the surgeon can perform a coelio-vaginal hysterectomy; Laparoscopy and vaginal mean are combined. The surgeon chooses the most appropriate method according to the type of hysterectomy, the size of the uterus, the age and the morphology of the patient. Finally, and this is the technique increasingly used, the surgeon can remove the uterus by natural means, that is to say vaginal hysterectomy. The uterus is removed by an incision located at the bottom of the vagina. This technique is indicated in case of small to medium-sized uterus, externalized genital prolapse and benign pathology
Scars related to hysterectomy intervention
The abdominal hysterectomy is performed by an opening of the abdomen and leaves a transverse scar most often, or median sub-umbilical. However, if the hysterectomy is practiced by natural means, that is to say by the vagina, it leaves no apparent scar.
Post operative effects and recovery after female uterus removal surgery
The hospitalization lasts 3 to 6 days. Analgesics are administered by the venous mean during the first days, then by oral mean. Moreover, anticoagulant injections are also performed to prevent phlebitis. It is usually possible to get up the day after the procedure. Besides, vaginal bleeding is normal in the days following the hysterectomy procedure. Furthermore, the threads or staples are removed after 1 week on average. The patient must stop working for 2 to 4 weeks, depending on the type of hysterectomy. During the recovery period, sports, heavy loads, sex, baths and wearing a tampon are forbidden. Moreover, it is important to consult the doctor if the patient feels signs of complication such as heavy vaginal bleeding, fever, abdominal pain or vaginal discomfort, pain in urination, redness or flow of the scar, pain in the calf, difficulty breathing.
Result and outcome after uterus removal surgery
Any hysterectomy surgery leads to a cessation of menstruation, since these correspond to the evacuation of the uterine lining at each cycle in the absence of pregnancy. On the other hand, hysterectomy does not necessarily lead to menopause: it depends on whether the ovaries are preserved or not. Total hysterectomy with salpingo-oophorectomy and radical hysteroctemia effectively cause so-called surgical menopause. In the absence of contraindications, a hormone replacement therapy for menopause can be started right out of hospital to avoid climacteric disorders such as flushing, weight gain, night sweats, irritability, vaginal dryness, low libido, etc. Subtotal and total hysterectomy, known as conservative, do not involve menopause. Indeed, the woman will continue to feel the symptoms of the cycle like sore breasts, mood changing, etc, but without the getting menstrual periods, and will be naturally menopausal.
Advices after hysterectomy surgery
The surgeon will prescribe to the patient medications. In fact, anticoagulants must be taken scrupulously. A blood platelet level check is required during this period; it must be done twice a week. Besides, it is advised not to do thorough vaginal toilet. Moreover, it is recommended to avoid foods that may induce constipation such as chocolate, rice, etc. Furthermore, sexual intercourses are allowed 3 weeks after the hysterectomy procedure, and they must be protected by condoms until complete healing of the vagina.