Hysterectomy: definition, procedure, risks, etc. • hello healthy

Definition

What is a hysterectomy?

Hysterectomy is a medical procedure to remove the uterus (uterus) and cervix (cervix). The uterus or uterus is the reproductive organ where the baby develops during pregnancy.

While the cervix or cervix is ​​the part under the uterus, which connects the uterus to the vagina. The cervix is ​​usually the passage for the baby to pass from the uterus to the vagina during the birth process.

There are various reasons underlying this hysterectomy procedure, one of which is as a treatment for cancer.

Types of cancer that can use the hysterectomy procedure are cervical cancer (cervix) and uterine cancer.

In certain cases, this surgical removal of the uterus and cervix can be done in conjunction with the removal of the ovaries (ovaries) and fallopian tubes (oviduct). The ovaries or ovaries are reproductive organs whose job is to produce the female hormone estrogen.

Meanwhile, the oviduct or fallopian tube is a channel that connects the ovaries with the uterus. These two reproductive organs are not always removed during surgery to remove the uterus and cervix (cervix).

In some other conditions, the ovaries or ovaries can be left without removal. This depends on the medical condition you are experiencing, as well as the type of hysterectomy surgery performed.

When do I need to have hysterectomy surgery?

Hysterectomy surgery generally needs to be done when you have certain health problems, especially those related to the reproductive organs.

Here are some of the reasons a hysterectomy (removal of the uterus) needs to be done:

1. Heavy bleeding

Heavy vaginal bleeding can occur due to hormonal disorders in the body, or other conditions such as infections, fibroids, or cancer.

Hysterectomy is one of the options available to treat abnormal vaginal bleeding, especially if other treatments have not worked.

2. Adenomyosis

Another health condition that can be treated with hysterectomy is adenomyosis. Adenomyosis is a condition in which the tissue lining the uterus (endometrium) grows inside the muscle wall of the uterus.

3. Fibroids

When a fibrous tumor is found growing around the uterus, it is called a fibroid. These tumors are generally benign, but have the potential to cause pain and bleeding in the vagina.

If it is classified as severe, the doctor may recommend a hysterectomy procedure as an alternative.

4. Endometriosis

Endometriosis is an overgrowth of endometrial cells which can also be treated with removal of the uterus or hysterectomy. Severe forms of endometriosis can cause pain, infertility, and disruption of the menstrual cycle.

5. Uterine prolapse (descending peranakan)

Descending of the uterus occurs when the position of the uterus shifts due to weakening of the tissues and ligaments that support the uterus. According to the Mayo Clinic, uterine prolapse has the potential to cause incontinence, pressure in the pelvis, or even difficulty passing stools.

If it is severe enough, this condition needs to be treated with a hysterectomy.

6. Cancer

Cervical cancer, uterine cancer, ovarian cancer, and endometrial cancer are people at a higher risk of having a hysterectomy.

Surgical removal of the uterus is highly recommended if cancer cells have spread and have reached an advanced stage.

7. Pelvic inflammatory disease / pelvic inflammatory disease (PID)

PID is an infection of the female reproductive system that can actually be treated with antibiotics. However, the hysterectomy option will be recommended if the infection has spread too far and caused damage to the reproductive organs.

8. Placenta accreta

In some cases, the placenta in a newborn cannot be separated, it even goes too deep into the uterine wall.

This condition is called placenta accreta. One of the alternatives used to treat this condition is hysterectomy to save the lives of mothers and babies.

By doing this procedure to remove the uterus and cervix, it is hoped that it can cure or at least relieve the symptoms of the disease that you have been experiencing.

What are the types of hysterectomy surgery?

Hysterectomy not only consists of one type, but there are several types that will be tailored to the needs and conditions of your body.

The differences between each type of hysterectomy procedure are as follows:

Partial (partial) hysterectomy

Partial hysterectomy is a surgical procedure that removes a portion of the uterus. In this procedure, the cervix or cervix is ​​not removed.

Total hysterectomy (simple)

Total hysterectomy is a procedure to remove all parts of the uterus, both the body of the uterus to the cervix (cervix). However, this procedure does not involve the removal of structures or tissues next to the uterus called the parametria and uterine ligaments.

This uterine and cervical removal procedure can be used to treat problems with the uterus and cervix. In addition, total hysterectomy is also a surgical procedure that does not involve removing the ovaries (ovaries) and fallopian tubes (oviduct).

Some of the procedures that are usually performed in a total hysterectomy are as follows:

• Abdominal (abdominal) hysterectomy. This procedure removes both the uterus and cervix by making a surgical incision in the abdominal area.
• Vaginal hysterectomy. This procedure is done by removing the uterus and cervix through the vagina. During the procedure, the doctor will remove the uterus from the ovaries (ovaries), fallopian tubes, and upper vagina. Blood vessels and connective tissue that support the uterus will also be released first before taking the uterus.
• Laparoscopic hysterectomy (laparoscopic hysterectomy). This hysterectomy procedure is the removal of the uterus using a laparoscopic instrument, which is a kind of tube equipped with a telescope or a small medical camera at the end. Laparoscopy generally does not involve major surgery because it relies on special tools. The doctor can then make an incision and take the target tissue through it with the help of a tube and camera, without the need to make a large wound in the abdomen.
• Laparoscopic vaginal hysterectomy (laparoscopic-assisted vaginal hysterectomy). This hysterectomy procedure is the surgical removal of the uterus, cervix (uterus), ovaries, and fallopian tubes. However, this procedure is performed by making an incision in the vagina using the aid of a laparoscopy.

Hysterectomy with Salpingo-Oophorectomy

Hysterectomy with Salpingo-Oophorectomy is a procedure performed by removing the uterus (uterus) along with one or both ovaries and fallopian tubes at once.

If both ovaries (ovaries) are removed, you may need hormone replacement therapy.

Radical hysterectomy

A radical hysterectomy is a surgical procedure that removes the entire uterus (uterus), cervix (cervix), the side tissues of the uterus (parametria and uterine ligaments). The top of the vagina is also lifted about 1 centimeter (cm).

While the ovaries (ovaries) and fallopian tubes can or may not be removed, depending on the underlying medical reasons. There are more tissues and organs removed in the radical hysterectomy process, than in a total hysterectomy (simple).

Radical removal of the uterus and cervix is ​​usually done by incising the abdomen, otherwise known as open surgery (open surgery).

Some of the procedures that are usually performed in a radical hysterectomy are:

• Laparoscopic assisted radical vaginal hysterectomy (laparoscopic-assisted radical vaginal hysterectomy). This procedure combines the radical method with the removal of lymph nodes in the pelvis.
• Laparoscopic assisted radical abdominal hysterectomy. The surgical process is almost the same as the radical laparoscopic vaginal method, but it is performed on the abdomen (abdominal).

Precautions & warnings

What should I know before having a hysterectomy?

It is normal for you to feel anxious before having surgery to remove the uterus. Try to get important information before you go through it so you can prepare yourself.

Some of the things that may happen after you have had uterine removal surgery include:

Menstrual disorders

Disorders of menstruation are one of the things that might happen. You can experience premature menopause.

This condition will usually depend on whether this surgical procedure involves removing the ovaries (ovaries) or not

If the ovaries are taken, the body will automatically no longer produce sex hormones. This condition causes menopause to occur faster than it should be.

Meanwhile, if you have surgery to remove the uterus or cervix but without removing the ovaries, menstruation usually returns to normal afterwards.

Possibility to get pregnant

Another thing you need to know is the possibility of you getting pregnant after having surgery to remove the uterus and cervix (cervix).

When the uterus or uterus is removed, of course there will be no more place for the baby to grow later in the pregnancy process.

Indirectly, your chances of getting pregnant after undergoing this procedure are gone.

On the other hand, don't forget to gather as much information as possible regarding the process and recovery of this surgical removal of the uterus and cervix.

You can raise any doubts and questions that you want to know about this surgical procedure so that you are more sure to do it.

Process

What should I do before having surgery?

Make sure you tell your doctor about any medications you may be taking regularly.

The reason is, several types of drugs may affect the operation process later.

Also tell the allergies you have and your health condition.

Some surgical procedures may require you to fast first. Therefore, it is important to always follow the doctor's instructions regarding when you should start fasting before surgery.

In addition, you will also be given clear guidelines before undergoing pre-surgery, including what foods and drinks can be consumed prior to surgery.

In general, you may be asked to fast for approximately 6 hours before the operation begins. At least one day before surgery, doctors usually recommend that you take a shower using a special soap given by the doctor to reduce the risk of infection.

If you plan to clean the vagina (vaginal douching) or rectum (enema), consult further with your doctor.

Before a hysterectomy is performed, the doctor can give drugs through an intravenous (intraven) which aims to minimize the risk of postoperative infection.

Right before the hysterectomy surgery is performed, the doctor will insert a catheter into the bladder.

This is to ensure that your bladder is empty when the operation is performed. Next, the doctor and medical team will clean the area of ​​your body that will be operated on.

How does the uterine removal process take place?

The hysterectomy procedure is usually performed under general anesthesia, which will put you fast asleep during the operation. In some conditions, surgical removal of the uterus and cervix (cervix) may also be performed under local anesthesia.

Unlike general anesthesia, local anesthesia will only cause numbness from the waist to the feet. That way, you will still be conscious during the operation, but will not feel the pain.

This procedure will take about 1-2 hours depending on the conditions and the level of difficulty during the operation.

First of all, the doctor will make an incision in the abdomen, upper part of the vagina, or the area around the cervix so that it can lift your uterus and cervix.

The area of ​​the body to be incised, be it the abdomen (stomach) or vagina, will be adjusted according to the type of hysterectomy you are undergoing. When finished, the doctor will sew the other reproductive organs around the uterus, to the top of the vagina.

The goal is to avoid the possibility of dropping these organs in the future. As an illustration, the following is the procedure for removing the uterus and cervix according to the method of doing it:

Abdominal (abdominal) hysterectomy

Abdominal hysterectomy is a procedure to remove the uterus and cervix (cervix) by making a large incision in the abdomen.

There are two types of incisions that a doctor can make, namely:

• A vertical incision, starting from the middle of the abdomen or below the navel, and extending just above the pubic bone.
• Horizontal incision. It lies about 1 inch above the pubic bone and extends to the side.

The type of incision is determined by a variety of factors, such as the cause of your hysterectomy. The size of the uterus and the presence of scars if you have had surgery on the stomach before are also factors of consideration.

Vaginal hysterectomy

Vaginal hysterectomy is a procedure to remove the uterus and cervix (cervix) by making a small incision in the vagina. There are no visible incision scars as the operation is performed in the vagina.

In some cases of uterine cancer, the doctor may not completely remove the uterus. The uterus will be cut into smaller pieces and then removed in sections.

Laparoscopic hysterectomy

Laparoscopic hysterectomy is performed by inserting a small instrument called a laparoscope. A laparoscope is a long and thin tube, which is equipped with a camera on the front.

This instrument is inserted into the body by making about 3-4 very small incisions in the abdomen. The small incision size usually doesn't cause scars after surgery.

When the doctor has seen your uterus through the monitor, the uterus will be cut into small pieces and removed one by one.

What should I do after the procedure?

After completing the hysterectomy surgery, you will usually be treated intensively in the hospital for about 2-5 days.

Doctors and the medical team will usually monitor your condition and complaints, and provide pain relievers and infection prevention drugs if needed.

The doctor will also wrap the vagina with gauze to control bleeding after surgery to remove the uterus and cervix.

The gauze will only be removed by the doctor a few days after the operation.

You may still experience a little bit of brown bleeding or discharge from the vagina for about 10 days. Use a bandage to catch the bleeding.

Immediately notify the doctor if the bleeding you experience is quite a lot, even resembling menstruation or it lasts for a long time. The doctor will later find out the cause and the right treatment for your condition.

When you are allowed to go home, try to keep walking around the house.

Your doctor will also ask you to temporarily limit your activities while you are recovering, such as not driving or lifting heavy objects, pulling heavy objects or having sex.

Generally, the recovery time from abdominal (abdominal) hysterectomy surgery tends to be longer than surgery to remove the uterus or cervix via vaginal and laparoscopy.

Complications

What are the possible complications of hysterectomy surgery?

A hysterectomy is basically a safe surgical procedure. However, there are some side effects in the form of a risk of minor complications that may occur afterward. Consult with your doctor about the risks you might get from this surgical procedure.

Complications from a number of medical procedures such as hysterectomy are generally unexpected reactions to anesthesia, bleeding, or blood clots (deep vein thrombosis DVT). However, these complications are rare.

Other, more specific complications of hysterectomy are:

• Infection of the pelvis or abscess, can occur due to bacterial infection.
• Damage to the structure of the organs around the uterus.
• Fistula or abnormalities in the canal connecting the anal canal to the vagina occur.

Furthermore, the risks of long-term complications from a hysterectomy are:

• Prolapse or dropping of the uterine supporting organs.
• Pain that doesn't go away.
• Adhesion, or the presence of interlocking wound tissue that joins the two surfaces of the organs that should be separated from each other.
• Bladder tract disorders.
• Infertility or not being able to have children.
• Early menopause, especially if part of the ovary is removed.

The risks that may occur after surgical removal of the uterus and cervix (cervix) does not mean that this procedure is unsafe. Consult with your doctor beforehand, so that the doctor can help minimize these risks.

Hello Health Group does not provide medical advice, diagnosis or treatment.