A hysterectomy is a surgical procedure used to remove the uterus. In some cases, the entire uterus is removed and in other cases, the cervix may be left intact (a partial hysterectomy). In a radical hysterectomy, the upper portion of the vagina may also be removed, and in some cases, the ovaries also may be removed in a procedure called an oophorectomy that can be performed at the same time as the hysterectomy. Because a hysterectomy removes the uterus, whenever possible it’s reserved for women who no longer plan to have children.
Hysterectomies can be performed for different reasons, and the underlying reason can also determine if a partial, complete or radical procedure should be performed. Some of the more common reasons for having a hysterectomy include:
While hysterectomy used to require a large incision in the pelvic region, today there are minimally-invasive techniques using very small incisions that can be used in many patients. These procedures use special instruments designed to be used through very small incisions. Some hysterectomies can be performed using incisions in the vaginal wall, using no external incisions. Traditional procedures are often used when cancer is present to ensure all the cancerous tissue is removed. No matter which technique is used, a hysterectomy is performed under general anesthesia.
The recovery process following a hysterectomy can vary depending on the approach used, with traditional procedures (those that use large abdominal incisions) requiring a longer recovery time than those that use minimally-invasive or laparoscopic techniques. A one or two night hospital stay is usually required to ensure the initial stages of healing are underway before being discharged. Once home, patients will need to avoid heavy lifting and strenuous activity for about six weeks. Sexual intercourse will also need to be avoided during this time. Bleeding can be controlled with pads (not tampons) and pain relievers can help relieve discomfort.
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