Hysterectomy – Scared & Terrified !!! No Need To Be Scared

Keyhole Hysterectomy – Less Pain, Bleeding & Speedy Recovery, The Best Treatment Option

God has made both man and woman, but the almighty has given special powers to Women. Women are the only creation of God who can give birth to a new creation. She is the one who keeps you in her womb for about 9 months, bears the pain and still does not ask for anything extra ordinary, but only what she deserves and that is respect. The womb is the main and the only organ in a woman’s body to welcome in a new life, nurture and sustain that life. Hence every woman is very attached to this special organ that’s very close to every women’s heart.

When the doctors talk about hysterectomy, it’s very natural for women to feel scared and sad as its removal of the womb. But today, medical science has advanced so much that now womb transplants are already happening in the western countries. Now, women need not be terrified and scared when they hear hysterectomy surgery as now laparoscopic (keyhole) hysterectomy which is a minimally invasive surgical technique under general anaesthesia to remove the uterus (womb) has replaced traditional open hysterectomy (cut in the abdomen) method.

Unlike traditional open surgery that causes a longer abdominal incision, this laparoscopic keyhole procedure involves small incisions, usually in the belly button and lower abdomen. Surgeon inserts a laparoscope through these incisions and specialized surgical tools. The camera provides a high-definition, magnified view of the internal organs on a monitor, allowing the surgeon to perform the operation with precision. The uterus is detached from its connecting tissues and blood vessels and then removed either in small pieces through the incisions or, if small enough, intact through the vagina.

 Hysterectomy is performed for various medical reasons, often as a last resort when other treatments have failed or aren’t viable. The primary reasons include:

• Uterine fibroid, a noncancerous growth in your uterus, resulting in heavy menstrual bleeding, pain, or other complications
• Endometriosis, a painful condition, where tissue similar to the lining inside of your uterus starts growing outside it, causing severe pain and menstrual irregularities.
• Uterine prolapse, a condition, when uterus descends into or protrudes out of the vagina, often leading to urinary and bowel issues and pelvic pressure.
• Heavy or prolonged menstrual bleeding may lead to anaemia and severe discomfort.
• Adenomyosis is a condition when the inner lining of your uterus breaks through the muscle wall of the uterus, causing pain and heavy periods.
• Cancer or pre-cancer is the cancer of the uterus, cervix, endometrium, or ovaries, where removal of the uterus is part of the treatment strategy.
• Chronic pelvic pain can be sometimes due to various uterine conditions.

Dr Hrushikesh Vaidya, Medical Director and Chairman Horizon Group of Hospitals said “The main benefit of a laparoscopic hysterectomy is that it provides a quicker recovery compared to an open hysterectomy. This is because there is usually less pain, less bleeding, less risk of infection and an overall reduction in complications with a laparoscopic hysterectomy. Hence, most patients go home within 24 hours of the surgery. The patients are fully recovered in two to three weeks’ time. In comparison, an open hysterectomy requires two to four days at the hospital and full recovery usually takes anywhere between four to eight weeks”.

Dr Hrushikesh Vaidya further said “The other main reason for performing a laparoscopic hysterectomy is that with this approach the specialist is able to see inside of the abdomen very clearly, enabling the treatment of other pathologies. Patients who have had previous surgeries, patients who have scar tissue or adhesions, or patients who have endometriosis – with a laparoscopic hysterectomy, all of this can be seen and therefore treated at the same time”.

 Dr Manali Shilotri Leading Gynaecologist and Consultant Horizon Prime Hospitals said “When it comes to a hysterectomy, the procedure is performed for a variety of reasons, including heavy menstrual bleeding, pelvic pain, pre-cancerous changes, prolapse and uterine fibroids. The best treatment for all of these conditions could, in fact, be a laparoscopic hysterectomy. Choosing a laparoscopic hysterectomy over an open hysterectomy reduces the chances of complications in terms of hospital stay and post-operative pain. For patients who have a high BMI,  the risks of wound infection and blood clots are also reduced if a laparoscopic hysterectomy is performed”.

 Dr Manali Shilotri further added “However, laparoscopic hysterectomy may not be suitable for all cases, especially in certain cancers or very large uteri, where open surgery might be necessary. The decision to opt for laparoscopic hysterectomy depends on the patient’s medical condition, the size of the uterus, and the surgeon’s expertise.”

Different Types of Hysterectomy

Hysterectomy is performed for various medical reasons and comes in different types, each suited to specific conditions and patient needs. The primary types are:

• Total Hysterectomy : This is the most common type, where both the uterus and the cervix are removed. It’s often performed for uterine fibroids, abnormal bleeding, or uterine cancer.
• Partial Hysterectomy : In this procedure, only the upper part of the uterus is removed, leaving the cervix intact. It may be chosen to reduce surgical risk or to maintain some aspects of sexual function.
• Radical Hysterectomy : Primarily used in cancer treatment, this involves removing the entire uterus, cervix, the tissue found round the cervix, and the upper portion of the vagina. It’s a more extensive procedure, typically reserved for cancer cases.
• Hysterectomy with Bilateral Salpingo-Oophorectomy : This includes the removal of the uterus, both of your ovaries, and fallopian tubes. It’s often performed when there’s a risk of ovarian cancer or other gynaecological issues.
• Laparoscopic Hysterectomy : A minimally invasive approach where the uterus is surgically removed making small incisions in the abdomen, using a laparoscope. This method has a shorter recovery time and less post-operative pain.
• Vaginal Hysterectomy : The uterus is taken out through an incision made in the vagina. This approach is rather invasive than a normal abdominal hysterectomy and is often used for conditions like uterine prolapse.

Each type of hysterectomy has its indications, benefits, and risks. The choice depends on the medical condition, the patient’s overall health, future fertility desires, and personal preferences, often after thorough consultation with your gynaecologist.

Up to 600,000 women undergo a hysterectomy (the surgical removal of the uterus and sometimes other reproductive organs) every year in the United States, according to the Centre for Disease Control and Prevention. And in India, 1 in 10 women undergo hysterectomy.

Minor and Relatively common complications include

• Having small scars.
• Feeling a bit of pain after the operation.
• Sometimes, feeling pain in the tip where the tummy has been inflated with gas. However, this usually goes away after 24 hours.
• The wounds getting infected. However, antibiotics are provided and the skin is cleaned, so this risk is small.
• Developing a haematoma, which is a bit of bleeding underneath the skin. However, this usually resolves by itself.
• Major but usually very rare complications (about 1 in 1000) include needing a blood transfusion.
• Damaging structures inside the tummy, such as the bladder, the bowels, the ureters, or a blood vessel.
• Developing blood clotsin the legs and the lungs after the operation. However, this risk is lower if a laparoscopic hysterectomy is performed because patients regain their mobility more quickly.

Dr Manali Shiltori said “From the early onset of menopause to loss of sex drive, there are a lot of horror stories online about the side effects of hysterectomies – but is any of it true? Despite being one of the most common surgeries performed on women after C-sections, the procedure is often not well understood by patients, and many women believe myths about the procedure that influence their approach to it. It can be scary to look at information online. There’s a lot of misinformation and certain experiences may be exacerbated disproportionately around surgeries of any kind, including hysterectomies”.

Myths and Misconceptions

• Hysterectomy means the end of femininity : The most common misconception about Hysterectomy is that it signifies the loss of femininity. However, femininity is not defined by reproductive organs. A hysterectomy does not diminish a woman’s identity or womanhood in any way.
• All hysterectomies lead to menopause : Contrary to a popular belief, not all hysterectomies result in menopause. The type of hysterectomy performed determines whether menopause occurs. A total hysterectomy, which involves removing the uterus and cervix, may lead to menopause only if the ovaries are also removed. However, a hysterectomy that preserves the ovaries allows the hormonal function to continue, preventing immediate menopause.

• Hysterectomy is a high-risk surgery : Advancements in medical technology and surgical techniques have significantly reduced the risks associated with hysterectomy. While all surgeries carry some level of risk, hysterectomy is generally considered safe when performed by a skilled surgeon in a suitable healthcare facility. Complications are rare, and most women recover well following the procedure.

• Hysterectomy negatively impacts sexual function : Concerns about the impact of hysterectomy on sexual function are common but largely unfounded. While some women may experience changes in sexual desire or function following hysterectomy, many others report improvements in their sexual health and well-being.

• Hysterectomy is only for older women : Hysterectomy may be recommended for women of various ages, depending on their medical conditions and health needs. While it’s more common among older women, younger women may also undergo hysterectomy for reasons such as severe endometriosis, fibroids, or cancer.

• Recovery is lengthy and difficult : Recovery from hysterectomy varies from woman to woman and depends on factors such as the type of surgery performed, overall health, and individual healing capacity. While some women may experience a relatively smooth recovery with minimal discomfort, others may require more time and support. Following post-operative instructions, staying active, and seeking support from loved ones can facilitate a smoother recovery process.

• Hysterectomy Causes Weight Gain : Having a hysterectomy doesn’t cause people to gain weight. However some women do gain weight during the recovery period because they aren’t moving as much as they would otherwise be moving.

• Hysterectomies Make you age faster : Hysterectomy does not directly effect on the body’s ageing process but it can be emotionally challenging for some women to have their uterus, cervix or ovaries removed.

Knowing what a hysterectomy could mean for your future emotional and physical health and whether you need a hysterectomy at all is essential before undergoing the procedure. As a result, dispelling these myths and staying informed about hysterectomies is essential before you undergo one.

Dr Hrushikesh Vaidya concluded by saying “The first thing a woman should ask prior to proceeding with a surgical procedure in the form of a hysterectomy is whether there is any other management she can utilize to address whatever issues she’s having”.