Hysterectomy types – What are the options?

Hysterectomy

A hysterectomy is an operation through which some of the female reproductive system is removed. A hysterectomy may be performed as a vaginal hysterectomy, a laparoscopic hysterectomy or an abdominal hysterectomy. A hysterectomy may be conducted when there is need of a total abdominal hysterectomy. Different hysterectomy operations may remove different parts of the reproductive system. Some of the different hysterectomy procedures include sub-total or partial hysterectomy, hysterectomy with ovarian conservation, hysterectomy with oophorectomy, radical or Wertheim’s hysterectomy.

When is a Hysterectomy Recommended?

A hysterectomy is recommended when a women has health problems related to her reproductive organs. Some cases where a hysterectomy may be recommended include fibroids, heavy bleeding, endometriosis, prolapse, cancer and uncontrolled bleeding after having a baby.

Preparation for a Hysterectomy

Different hysterectomy operations are performed in different ways. How the hysterectomy is done will depend on the type of hysterectomy operation being conducted. There are three main options for hysterectomy surgery; abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy.

  • An abdominal hysterectomy is done when there is need for extensive exploration of the reproductive system, when the uterus is enlarged or on women who have never had children or who are obese. It can be done with a vertical incision (which involves a cut from the naval to the public hairline) or by a bikini line cut (which is a horizontal incision above the pubic hairline). After the incision has been made, the surgeon will explore the reproductive system and remove the organs that need to be removed.
  • A vaginal hysterectomy involves an incision in the upper portion of the vagina. The uterus is then removed through the vagina.
  • A laparoscopic hysterectomy involves making three or four small cuts in the abdomen. A laparoscope is inserted through the incisions into the abdominal cavity. The organs are then viewed on a screen and other incisions are made as necessary.

Types of Hysterectomy Surgery

There are also different types of hysterectomy surgery, according to the different organs that are removed. Here are some of the main types of hysterectomy surgery that may be performed.

  • Sub-total or partial hysterectomy. This operation removes the Fallopian tubes and the upper two-thirds of the uterus. The cervix is preserved.
  • Hysterectomy with ovarian conservation. This operation removes the Fallopian tubes, uterus and the cervix, but preserves the ovaries. This operation is also known as a total hysterectomy.
  • Hysterectomy with oophorectomy. This operation removes the Fallopian tubes, uterus and cervix and one or both sets of the ovaries.
  • Radical or Wertheim’s hysterectomy. This operation removes the Fallopian tubes, uterus, cervix, ovaries, lymph nodes and the upper portion of the vagina. This operation is usually used for cancer cases.

After Hysterectomy

Hysterectomy recovery will depend on the method of the hysterectomy and the type of hysterectomy performed. A vaginal hysterectomy will require less recovery time after hysterectomy than a total abdominal hysterectomy. Women with an abdominal hysterectomy generally take around eight weeks before they can resume normal activities. They will need to stay in hospital from two to five days, depending on the type of operation performed.

Side effects of a hysterectomy can include:

  • Feeling nauseous from the general anaesthetic;
  • Pain and discomfort in the abdominal region;
  • Vaginal discharge or bleeding.

During the recovery period, women need to avoid heavy lifting, bending at the waist, pressure on the wound, active activities and sexual penetration. A post-operative check-up will take place about six weeks after the operation. Some pre-menopausal women who have a hysterectomy may need to take hormone replacement therapy.

 

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