Every year, more than 600,000 women undergo a hysterectomy making it the second-most common significant operation performed on females inside the United States. Some progressive doctors claim that up to 90% of hysterectomy surgeries are unnecessary, more conservative estimates put that number between 20–30%. Either way, that is a lot of women that may be having unnecessary surgeries
A hysterectomy for noncancerous reasons is usually considered only after all other approaches have been tried without success. Women are recommended to consider an elective hysterectomy for quite a few reasons. Many women will consider it when they suffer from intense bleeding and other options have tried and failed. Fibroids, chronic pelvic pain, adenomyosis, endometrial polyps, uterine prolapse, and endometriosis causing debilitating pain tend to be a common prompt for women to consider.
For women who do not fall in the elective category, their consideration of surgery is clear-cut. Hysterectomies that merit immediate surgery would include those who have been diagnosed with cancers of the uterus or ovaries. For these women, their condition truly leaves them with few choices.
- Cancers of the Uterus or Ovaries
- Chronic Pelvic Pin
- Endometrial Polyps
- Intense Bleeding
Surgeons are able to consider different surgical techniques for a women’s surgery depending on the experience with a particular technique, the women’s health status, and the reason behind it. The surgical technique for the surgery will determine risks, scars, and the recovery period.
The two surgical approaches would be an open surgery, also known as traditional or abdominal, or a MIP (minimally invasive) surgery.
An open surgery is the most commonly used technique accounts for more than 65% of surgeries. During an open surgery, the uterus is removed through the abdomen. The surgical incision varies in length from six to eight inches long and either up-and-down, from the navel to the pubic bone or side-to-side, across the pubic hairline. After healing, there is a visible scar from this incision. This procedure is necessary that include the fallopian tubes being removed, when the uterus is enlarged, or when endometriosis or cancer has spread to the pelvic cavity. The recovery period for an open hysterectomy involves three days or more of hospital stay.
A MIP could be one of several technical approaches: vaginal, laparoscopic-assisted vaginal, laparoscopic, or a robot-assisted laparoscopic.
Vaginal Hysterectomy: The surgeon makes a cut in the vagina and removes the uterus through this incision. The procedure is commonly used in cases of uterine prolapse. No external incisions are made; therefore there is no visible scarring.
Laparoscopic-assisted Vaginal Hysterectomy: With the aid of a laparoscope, a thin, flexible tube containing a video camera, thin tubes are inserted through tiny incisions in the abdomen near the navel. The uterus is then removed in sections through the laparoscope tube or through the vagina. In a robot-assisted laparoscopic hysterectomy, the doctor inserts the laparoscope and other instruments and then uses a computer station to control the instruments.
Laparoscopic hysterectomy: Through the use of a laparoscope, which is a tube with a lighted camera, and surgical tools inserted through several small cuts made in the belly or, in the case of a single site laparoscopic procedure, one small cut made in the belly button. The surgeon performs the hysterectomy from outside the body, viewing the operation on a video screen.
Robot-assisted laparoscopic hysterectomy: This procedure is similar to a laparoscopic hysterectomy, with the surgeon using a sophisticated robotic system of surgical tools from outside the body. Advanced technology allows the surgeon to use natural wrist movements and view the hysterectomy on a three-dimensional screen.
This is a low-risk surgery. Most women who undergo a hysterectomy have no serious problems or complications from the surgery. However, as with any surgery, there might be complications for a small minority of women. Surgical risks are higher in women who are obese or who have diabetes or high blood pressure. Those complications include:
- Blood Clots
- Continued Heavy Bleeding
- Fistula Formation (an abnormal connection that forms between the vagina and bladder)
- Pain During Intercourse
- Urinary Incontinence
- Vaginal Prolapse (part of the vagina coming out of the body)
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