Different Surgical Approaches for Hysterectomies

Eileen Bailey Health Guide
  • Hysterectomies are one of the most common surgeries for women. A radical hysterectomy is the removal of the uterus, cervix and ovaries, while a total hysterectomy refers to the removal of the uterus and cervix. During partial hysterectomies, the upper part of the uterus is removed and the cervix and ovaries remain in place.


    This type of surgery is most often performed because of painful fibroids, but other reasons include abnormal bleeding, endometriosis, pre-cancerous conditions on the ovary or cancer. Your doctor should explain the different types of hysterectomies and recommend one based on your medical condition.

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    Previously, hysterectomies were performed through an incision made in your abdomen. This type of surgery, called an abdominal hysterectomy, is still used, however, there are also newer, less invasive procedures that shorten recovery times. You should talk with your doctor about all of the different surgical procedures before deciding which is best for you.


    Abdominal Hysterectomy


    A 4 to 8 inch incision is made across your abdomen, usually below your belly button, along the bikini line but can also be vertical, from the pubic bone up to the belly button. This type of surgery is often used when the uterus is enlarged, the ovaries and fallopian tubes are also being removed or, in the cases of cancer, when the disease has spread within the pelvic cavity. It allows the surgeon to clearly see into the abdomen. It usually takes 4 to 6 weeks to recover from this type of surgery.


    Vaginal Hysterectomy


    A small incision is made at the top of your vagina. The uterus is removed through this incision and is often done if you have experienced a uterine prolapse, which is when the pelvic cavity cannot support the uterus. This type of surgery does not allow the surgeon to view other organs and determine if there are further problems. The recovery time (usually 3 to 4 weeks) is much shorter than with abdominal hysterectomy and there are no external scars after the surgery.


    Laparoscopic Hysterectomy


    A small incision is made in your abdomen and surgical tools are inserted through this incision to detach and remove the uterus. The surgeon can use a laparoscope to view the uterus and the surrounding organs. Sometimes surgeons will combine the laparoscopic and vaginal procedures, using the incision in the vagina to remove organs and the incision in the abdomen to insert a laparoscope and view the pelvic cavity, this is called laparoscopically assisted vaginal hysterectomy. As with a vaginal hysterectomy, recovery time is much less than from abdominal surgery. Depending on your specific procedure, recovery time may be from 1 week to 4 weeks. You will have a scar from the incision but it is much smaller than the scar from an abdominal hysterectomy.


    Risks


    All surgeries carry certain risks. No matter which type of hysterectomy you and your doctor determine is best, you should be aware of the risks. Some risks include:

    • Infection
    • Hemorrhage
    • Injury to other organs within the pelvic cavity

    If you have not yet reached menopause, you might experience menopausal symptoms after your surgery. This includes hot flashes, mood swings and vaginal dryness. You will no longer have a monthly period. Some women also experience a feeling of loss of sexual identity after having their uterus removed. Be sure to talk to your doctor if you have any of these symptoms. He or she will be able to recommend ways to minimize any discomfort.


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    References:


    “Hysterectomy,” Date Unknown, Staff Writer, John Hopkins Medicine




Published On: June 24, 2014