Hysterectomy: Types and its Complications

Liliana Chemello^*
*Correspondence: Liliana Chemello, Department of Medicine, University of Padova, Padua, Italy, Email:

Introduction

Hysterectomy is a surgery to remove a woman's uterus (also known as a womb). The uterus is where the baby grows when a woman is pregnant. During surgery the entire uterus is usually removed. Fallopian tubes and ovaries are removed by your doctor. After a hysterectomy, you no longer have periods of menstruation and you cannot get pregnant. During a hysterectomy the anaesthesiologist will give you any:

• General anaesthesia in which you will not wake up during the procedure; or

• Local anaesthesia (also called epidural or spinal anaesthesia) where medications are placed near the nerves in your lower back to "block" pain while staying awake.

Recovery from hysterectomy takes time. Most women stay in the hospital for one to two days after surgery. Some doctors may send you home on the day of your surgery. Some women stay longer in the hospital, usually when a hysterectomy is performed because of cancer [1-5].

Description

Your doctor will probably tell you to get up and leave as soon as possible after your hysterectomy surgery. However, you may need to urinate in a tiny catheter for a day or two after your surgery.

You should get plenty of rest and do not lift heavy objects for four to six weeks after surgery. At that point, you should be able to take a bath. How long it takes you to recover will be depend on your surgery and your health before surgery. Hysterectomy can be performed in many ways. It will depend on your medical history and the reason for your surgery.

Types

Abdominal hysterectomy: Your doctor makes a cut, usually in the area below your abdomen.

Vaginal hysterectomy: During vaginal hysterectomy surgery, the uterus and cervix are removed with a cut made at the top of the vagina. Special surgical instruments are inserted into the vagina to remove the uterus from the arteries holding it in place.

After removal of the uterus and cervix, the cut will be sewn. The operation usually takes about an hour to complete. Vaginal hysterectomy can be performed using:

• General anaesthetic: Where the person will be unconscious during the procedure

• Local anaesthetic: Where you'll be awake, but will not feel any pain

• Spinal anaesthetic: Where you'll be numb from the waist down

Hysterectomy of the vagina is often preferred to hysterectomy of the abdomen as it is less invasive and involves a short stay in the hospital. Recovery time is often faster.

Conclusion

Laparoscopic hysterectomy

A laparoscope is a thin, light tube with a small camera that allows your doctor to see your pelvic organs. Laparoscopic surgery is when a doctor makes very small incisions to insert a laparoscope and surgical instruments inside you. During laparoscopic hysterectomy surgery the uterus is removed with small incisions made in your abdomen or vagina.

Robotic surgery

Your doctor directs the robot arm to perform surgery using small incisions in your lower abdomen, such as a laparoscopic hysterectomy.

Complications

As with any surgery, problems are less likely to occur. Problems may include:

• Blood clots

• Severe infection

• Bleeding

• Intestinal obstruction

• Torn internal stitches

• Damage to the urinary tract

• Problems related to anaesthesia

References

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4. Kjerulff, Kristen H., Patricia W. Langenberg, and Paul D. Stolley. "Effectiveness of hysterectomy." Obstet Gynecol 95 (2000): 319-326.

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5. Merrill, Ray M. "Hysterectomy surveillance in the United States, 1997 through 2005." Med Sci Monit 14 (2008): CR24-31.

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