Hysterectomy is a procedure where the uterus (womb) of woman is removed in different ways. In fact, there exits different types of Hysterectomy surgeries where only upper part of Uterus is removed or entire Uterus and cervix are removed or in extreme cases entire Uterus, Cerfix, Fallopian tubes, vagina and ovaries are removed.
The reason depends on the problem diagnosed by your urologist or urogynecologist. Though your doctor just mentions hysterectomy, it is better to ask him/her about what type of hysterectomy is he/she/they going to perform and what parts of your body are going to be removed.
Types of Hysterectomy
Supracervical or Subtotal Hysterectomy
When does your urogynecologist recommend sub total hysterectomy?
Common reasons for subtotal hysterectomy are:
- Having heavy or painful periods which could not be controlled by other treatments. (Drugs / Medicines / Change of diet etc)
- Fibroids – A condition where the muscle of the uterus over grows.
Once performed, most of the women will not have any more periods.
Alternatives to subtotal hysterectomy:
Once you present to your specialist with your problems, he/she may suggest you some of the options to get rid of the problems, however, if nothing improves after these alternatives and the medicines prescribed, subtotal hysterectomy decision will be taken.
Such options include:
- Pelvic Floor Exercises
- Heavy periods may be controlled by variety of hormonal and non-hormonal oral medications.
- Other alternative for heavy bleeding during periods is using an implant, Intra Uterine System (IUS) or a conservative surgery, where only the lining of the womb is removed.
- For fibroids, only the over grown portion will be removed with a surgery called ‘Myomectomy’.
When does your gynecologist recommend you to go for Total Hysterectomy?
- Cancer – If you are diagnosed to have cancer of the uterus or cervix, total hysterectomy may be the best option. Depending on what stage your cancer is, other treatments such as radiation or chemotherapy may be advised.
- Fibroids – The only permanent solution for fibroids problem is – total hysterectomy wherein the womb / uterus is completely removed.
- Endometriosis – A condition where the tissue that lines the inside of the uterus starts growing outside the uterus to the ovaries, fallopian tubes or other organs. Removal of uterus, cervix, fallopian tubes and ovaries may be the best option in such condition.
- Uterine Prolapse – When the uterus descends into the vagina because of the muscles that hold the uterus in it’s place become weak. This can lead to urinary incontinence, pelvic pressure or difficulty with bowel movements.
- Abnormal Viginal Bleeding
- Chronic Pelvic Pain – When unbearable pelvic pain arises out of the uterus, Total Hysterectomy may be the only option.
This operation is done to treat some cancers of the cervix and some cancers of the endometrium (uterus) that have spread to the cervix. The surgeon takes out the uterus and the tissue fibers / ligaments that hold the uterus in place. The cervix and as much as 2 inches of the vagina around the cervix will also be removed.
Once the cervix and a part of the vagina is removed, the surgeon stitches the upper part of the vagina. During healing, some fluids may drain from the vagina and that is normal. Once the vagina seals with scar tissues inside the body, it becomes a closed channel. It doesn’t become an open tunnel from the vagina into the pelvis as some may fear.