HEALTHPLAN MAGAZINE

A hysterectomy is a medical procedure that removes the womb (uterus) from the body. There are many reasons why this procedure may take place, and after the procedure, you will be unable to become pregnant.

Why Might I Need a Hysterectomy?

Hysterectomies usually take place when there is an issue or condition that affects the reproductive system. Hysterectomies are considered as an appropriate treatment for a range of conditions if no other surgery or medicine has been effective. Some conditions which may be treated by a hysterectomy include:

• Heavy or irregular menstrual bleeding
• Womb, ovary or cervical cancer
• Fibroids and non-cancerous tumours
• Pelvic pain and uterine prolapse
• Endometriosis and adenomyosis

Is a Hysterectomy Right for Me?

A hysterectomy is a major surgical procedure that requires a long recovery time, and like all surgery, it comes with associated risks.

For many people, a hysterectomy is considered the final option after other methods have been exhausted. A hysterectomy may help to get rid of symptoms such as heavy menstrual bleeding or pain from fibroids, however, there can be complications in the surgery such as haemorrhage, infection and blood clots.

You can no longer become pregnant or have periods after a hysterectomy procedure, which may reduce your reliance on contraceptives, but is also something to consider if having children is important to you. Depending on the type of hysterectomy, you may go through the menopause or you may not.

In regards to sex, a hysterectomy can cause women to feel unfeminine and lose their sex drive, while for others, it may improve as they no longer feel painful symptoms, which can help them to relax and enjoy sex again.

Different Types of Hysterectomy

There are various types of hysterectomy that are used to remove different parts of the reproductive system, depending on your symptoms, you may be offered the following hysterectomies:

• Total hysterectomy – where your womb and cervix are removed.
• Subtotal hysterectomy – where the womb is removed, but the cervix is left which means there is still a risk of cervical cancer and must have cervical screenings.
• Radical hysterectomy – used for cancer treatment, this removes your womb, cervix, fallopian tubes, lymph glands, part of the vagina, ovaries and fatty tissue.
• Total hysterectomy with bilateral salpingo-oophorectomy – where ovaries and fallopian tubes are removed with the womb and cervix.

Preparing for a Hysterectomy

Once you have decided if a hysterectomy is the right cause of action for you, you will then meet your assigned medical professional again for a pre-operative check. Your doctor will then recommend a course of action to ensure you are fully fit for your operation.

As the procedure is done under general anaesthetic, you will have to fast for around six hours before the operation. Depending on your needs your surgeon may ask you to wear compression socks or take anti-clotting medication. Once you are ready for the procedure, you will be requested to sign a consent form.

The Procedure

There are three main ways a hysterectomy may be performed:

• Vaginal – where a small cut is made at the top of the vagina to remove the womb and cervix, it is sealed with dissolvable stitches and leaves no visible scar.
• Abdominal – where a cut is made across the lower part of your abdomen which is then sealed using stitches, staple or glue and covered in a dressing.
• Laparoscopic – where a number of small incisions are made to insert a tiny camera and surgical tools.

Whichever method your surgeon uses, the procedure will take around one hour, and you will usually be asleep throughout the whole operation with a general anaesthetic.

Recovery

It will usually take a couple of months to recover fully from a hysterectomy. Straight after your procedure, you will feel pain, discomfort and tiredness, however, you will be given painkillers by the nurse.

After resting for 24 hours, you will be encouraged to walk to reduce the risk of blood clots. If a catheter has been used, this will be removed so you can pass urine normally after 24 hours. Within the first week, you may see a physiotherapist to improve your mobility and pelvic floor muscle strength. You may see a nurse to remove any stitches used.

Depending on your health and recovery you may be discharged from hospital after just one day, or it could be up to a week. You will then need to recover at home and avoid strenuous exercise. After 4-6 weeks you may need to have a check-up with your doctor, and by eight weeks you should start to feel fully recovered.

Complications

After a hysterectomy, it is common to feel constipated or develop urinary tract infections, both of which can be treated easily. You may also suffer from vaginal bleeding and discharge which can last for up to six weeks after your operation.

If your ovaries are removed during the procedure, then you will feel menopausal, symptoms may include hot flushes, anxiety, sweating and weepiness. For this, you may be offered Hormone Replacement Therapy (HRT) medication.

Some of the other complications experienced include blood clots, deep vein thrombosis or excessive bleeding. The procedure may also cause damage to other organs or cause a pelvic prolapse.

A hysterectomy will feel different for every woman, so there is no fixed time when you will feel ready to go back to work or resume normal duties. Your medical professional will ensure you are on the right path to recovery and will support you throughout the procedure and recovery period.