What is the treatment?

The word 'Hysterectomy' is derived from its Greek root 'Hysteria' which means the womb and 'Ektomia' implying to cut out of. A Hysterectomy surgery concerns the surgical removal of a woman's uterus. It can also mean the surgical removal of the uterus, ovaries and the cervix. So technically, a Hysterectomy surgery means that the woman can never be a biological mother again.

This type of a surgery, which is one of the most common gynaecological procedures performed, does become important in certain scenarios. It can either be a total (removal of the uterus along with the cervix) or a partial (removal of the uterus but not the cervix).

A Hysterectomy surgery can be carried out for the following reasons: uterine fibroids (the common non-cancerous growths on the uterus muscles), uterine prolapse (a benign condition wherein the uterus drops into the vagina from its usual spot), endometriosis (a condition characterized by the growth of the uterus lining tissues outside the uterus), cancer and hyperplasia ( thickening of the uterus lining resulting in bleeding).

Other reasons include pelvic pain that is chronic, chronic PID (Pelvic Inflammatory Disease) and heavy, persistent bleeding.

How is the treatment done?

A Hysterectomy Surgery usually takes about two hours at the maximum. General anesthesia is administered after which, an IV catheter will be inserted to supply medications and other fluids.

The process of hysterectomy depends on the type of the surgery. In the case of abdominal hysterectomy, first, an incision (either transverse or vertical) of about 7 inches is made in the lower abdomen. The supportive tissues and the blood vessels around the uterus are excised and then the uterus is taken out through the incision. Finally, the incision is closed. A major advantage of this type is that hysterectomy can be performed even if there is scarring or presence of large fibroids. In the case of vaginal hysterectomy, an incision is made around the top of the woman's vagina. After the ligaments, fallopian tubes and the blood vessels are cut off, the uterus is taken out through the vagina. The advantage here is that scarring is minimal with almost no operative pain. The patient can resume normal activities within a month. However, the chances of complications are more in the case of a vaginal hysterectomy. In the case of Laparoscopically assisted vaginal Hysterectomy, the same procedure is followed with a laparoscope assisting the doctor.

Who is eligible for the treatment? (When is the treatment done?)

The Hysterectomy surgery is opted for only if other methods haven't been able to provide results. The most common eligibility criteria include:

• Heavy periods: Often caused by the presence of fibroids, heavy periods can pose other problems such as menstrual cramps, irritability and nausea.

• Uterine prolapse: This is characterized by the uterus dropping into the vagina as a result of the weakening of the supportive ligaments and tissues.

• Pelvic pain: This can be because of endometriosis, adenomyosis, incomplete treatment of PIDs and/or fibroids.

• Cervical or ovarian cancer

Who is not eligible for the treatment?

There are no non-eligibility criteria as such, however:

• The woman should talk it out with the doctor regarding her sex life post hysterectomy as a woman's libido could take a beating and also suffer from sexual dysfunction.

• Also, if the woman is running a temperature, the surgery should not be carried out.

Are there any side effects?

The possible side effects include:

• Damage to the surrounding organs

• Problems related to anesthesia, such as heart or breathing problems

• Formation of blood clots in the lungs or legs

• Heavy bleeding

• Infections

• Premature menopause in case the ovaries have been removed as well

• Pain during engaging in sexual intercourse

What are the post-treatment guidelines?

The basic post-operative guidelines are:

• The woman should avoid lifting any heavy weight post surgery.

• The woman must also avoid bathing in tubs for a period of about 5-6 weeks post surgery.

How long does it take to recover?

For an abdominal hysterectomy, complete recovery can take about a month to 8 weeks. However, for vaginal/laparoscopically assisted vaginal hysterectomies, the downtime is much shorter; about 1-2 weeks.

Are the results of the treatment permanent?

Yes, a Hysterectomy surgery offers a permanent solution to the treatment of fibroids.

What are the alternatives to the treatment?

Some of the alternatives to Hysterectomy include embolization, endometrial ablation, and myomectomy.