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Vaginal Hysterectomy

Surgeons may remove one or both ovaries along with fallopian tubes & uterus during vaginal hysterectomy surgery. Ovaries are source of both female hormones estrogen & progesterone which are critical for both bone & sexual health. Therefore, losing both ovaries abruptly will effectively translate to a condition called surgical menopause. Sudden loss of female hormones will also cause stronger symptoms of menopause like loss of sex drive & hot flashes. Emotional trauma following hysterectomy for some women may take much longer to heal when compared to physical recovery. Having a sense of loss or feeling down after undergoing hysterectomy is normal. However, keep a check on postoperative depression & seek professional help when needed to deal with symptoms like loss of appetite, insomnia & hopeless feelings.

Vaginal Hysterectomy

What is Vaginal Hysterectomy?

Vaginal hysterectomy is a surgical procedure designed to remove uterus through vaginal opening. Surgeons typically detach uterus from ovaries, fallopian tubes & upper vagina including supporting blood vessels & connective tissue during vaginal hysterectomy procedure. Surgically detached tissues including uterus is then removed through vagina. Vaginal hysterectomy involves shorter stay in hospital alongside lower costs & faster recovery than traditional abdominal hysterectomy where an incision is made for the purpose of surgery in lower abdomen. However, in case uterus is enlarged vaginal hysterectomy may not be possible & doctors may recommend other surgical options like abdominal hysterectomy. Hysterectomy also often involves removal of cervix as well as uterus. All organs involved in hysterectomy procedure are part of the female reproductive system located within pelvis.

Why Undergo Hysterectomy?

Vaginal hysterectomy effectively treats a variety of Different Gynecologic Problems. With possible exception of cancer, hysterectomy is just one of the many treatment options for these gynecologic conditions. Doctors may often recommend Hormonal Therapy or some other less invasive gynecologic procedure which is successful in managing symptoms & may not even consider hysterectomy as treatment for these medical conditions. However, patients must understand that it is not possible to become pregnant following hysterectomy. Therefore explore other treatment options in case you are less than completely sure.

  • FibroidsHysterectomies are often performed to permanently treat Fibroids which are benign tumors in uterus which can cause pelvic pain, anemia, persistent bleeding, bladder pressure & pain during intercourse. Patients with large fibroids may often need abdominal hysterectomy surgery which can remove uterus through incision in lower abdomen.
  • EndometriosisThis occurs when tissue lining uterus grows outside of uterus & involves fallopian tubes, ovaries & other organs as well. Most women suffering endometriosis undergo abdominal hysterectomy, but vaginal hysterectomy is also possible in some cases.
  • Gynecologic CancerDoctors will often recommend hysterectomy to treat cancer of uterus, Ovarian Cancer, endometrium or cervix. Most often abdominal hysterectomy is performed as ovarian cancer treatment, but vaginal hysterectomy may be most appropriate procedure for women having cervical cancer or endometrial cancer.
  • Uterine ProlapseUterus can sag or lower into vagina when supporting tissues & ligaments of pelvic region weaken or stretch out causing pelvic pressure, urinary incontinence or difficulty with movement of bowels. Removal of uterus through hysterectomy & repair of pelvic relaxation often relieves these symptoms.
  • Abnormal Vaginal BleedingWhen less invasive surgical procedures or medications fail to control irregular & heavy or very long periods, hysterectomy can be an effective solution.
  • Chronic Pelvic PainHysterectomy may help as a last resort for women having chronic pelvic pain which is clearly caused by uterine conditions. However, chronic pelvic pain has several causes; therefore accurate diagnosis of cause is critical before employing hysterectomy for chronic pelvic pain.

Types of Hysterectomies

All hysterectomies involve removal of uterus, but the type of surgical procedure employed depends upon the condition which is required to be treated.

  • Partial or Supracervical HysterectomyThe upper portion of uterus is removed while leaving cervix intact in partial hysterectomy.
  • Complete or Total HysterectomyThis procedure involves removal of both uterus & cervix. Total hysterectomy is the most common type of hysterectomy procedure performed.
  • Hysterectomy with Bilateral Salpingo-OophorectomyThis type of hysterectomy procedure involves removal of uterus, ovaries, fallopian tubes & cervix.
  • Radical HysterectomyThis is the most extensive type of hysterectomy surgical procedure involving removal of uterus, ovaries, fallopian tubes, cervix, upper vagina, lymph nodes & some surrounding tissue.

Preparing for Hysterectomy

It is normal for women to feel anxious about their hysterectomy surgery.

  • Gather InformationGet all information required to feel confident about hysterectomy prior to undergoing surgery. Ask as many questions as you want & learn more about the procedure involvement of steps during operation. This should make you feel more comfortable.
  • Follow Surgeon’s Instructions about MedicationsCheck with the doctor if you should be changing usual medication routine in days leading up to hysterectomy surgery. Let surgeons know about over-the-counter medications, herbal preparations & dietary supplements you are taking.
  • Discuss Type of AnesthesiaWhile most patients prefer general anesthesia which keeps them unconscious during the surgical procedure, regional anesthesia which is called the ‘Epidural Block’ ot ‘Spinal Block’ may also be an eligible option. Regional anesthesia can also be an ideal option blocking sensation in lower half of the body for women undergoing vaginal hysterectomy.
  • Arrange for HelpPatients are likely to recover sooner after vaginal hysterectomy than abdominal hysterectomy; Even then they would need someone back home to help out during the first 7 – 10 days at least.

Vaginal Hysterectomy Procedure

Patients should talk to surgeons about what they can expect during & after vaginal hysterectomy procedure including physical & emotional experiences. Patients will be asleep during the course of surgery under the influence of general anesthesia. Alternately, choosing regional anesthesia with medication will only make them drowsy & may remain awake during surgery without feeling any pain. Patients will lie in back position quite similar to when Pap smear test was taken. A urinary catheter may also be inserted so as to empty the bladder. Team accompanying the surgeon will clean the surgical site with sterile solution prior to surgery.

Surgical Steps During Vaginal Hysterectomy

  • Surgeons will make an incision inside vagina so as to get to the uterus.
  • Surgeons will subsequently clamp uterine blood vessels & separate uterus from connective tissue, fallopian tubes & ovaries using long instruments.
  • Uterus is detached & removed through vaginal opening.
  • Absorbable stitches are utilized so as to control any bleeding inside pelvis.
  • With exception in cases of suspected uterine cancer, surgeons may often cut enlarged uterus into small pieces & remove in sections. This is called Morcellation.

Robotic or Laparoscopic Vaginal Hysterectomy

Many women are good candidates for Robotic Hysterectomy or Laparoscopically Assisted Vaginal Hysterectomy (LAVH). Both these procedures allow surgeons to remove uterus vaginally while observing pelvic organs through a slender viewing instrument called laparoscope. Most of the procedure is performed by surgeons from these small abdominal incisions aided by thin & long surgical instruments inserted through incisions. Surgeons will finally remove uterus through an incision within the vagina. Surgeons will most often recommend robotic hysterectomy or LAVH for women having scar tissue on pelvic organs due to endometriosis or prior surgeries.

Hysterectomy Risks & Complications

Vaginal hysterectomy is largely safe. Surgical risks are however higher among women who are obese & have high blood pressure. Risk of injury to adjacent pelvic & other abdominal organs during vaginal hysterectomy include ureters, bladder or bowels. Moreover, severe scar tissue or endometriosis may force surgeons to switch from vaginal hysterectomy to abdominal hysterectomy during the procedure. Therefore, check with the surgeon about this possibility.

Common Risks of Vaginal Hysterectomy Include

  • Infection
  • Heavy Bleeding
  • Blood Clots in Lungs or Legs
  • Damage to Surrounding Organs
  • Adverse Reaction to Anesthesia

Recovery From Hysterectomy

Patients will be shifted to a recovery room for a few hours following completion of vaginal hysterectomy. They may have to stay a day or two in hospital, or even longer in some cases. Patients will be given medications for pain & to prevent infection after hysterectomy surgery. Associated healthcare team will encourage patients to get up & move as soon as possible during recovery period. It is normal to have bloody discharge from vagina for many days to weeks after hysterectomy & patients will therefore need to wear sanitary pads.

Physical Experience Following Hysterectomy

Recovery following vaginal hysterectomy is much shorter & far less painful than compared to abdominal hysterectomy. However, full recovery may take between 3 – 4 weeks of time. Do not lift anything heavy over 9.1 kg or indulge in vaginal intercourse until 6 weeks following surgery even if you feel normal. Make it a point to contact the surgeon in case pain worsens or you develop nausea, vomiting or bleeding which is heavier than normal menstrual periods.

Emotional Experience Following Hysterectomy

Many women feel an improvement in mood & increased sense of well being following hysterectomy. Patients seem relieved to experience no signs & symptoms like pelvic pain or heavy bleeding. Most women also find no change in sexual function following hysterectomy. Some women also experience heightened sexual satisfaction during intercourse after hysterectomy. This could be because they no longer fear pregnancy of feeling of pain during intercourse. However, some women feel sense of grief & loss following hysterectomy, which is also normal as they experience depression due to loss of fertility, especially in younger patients who were hoping for future pregnancies. It would be sensible to talk to surgeons when women experience sadness or negative feelings which begin to interfere with enjoyment of everyday living.

Hysterectomy Results

Women will no longer have menstrual periods or be able to get pregnant following hysterectomy. Patients who have had ovaries removed will begin menopause almost immediately following hysterectomy. Many women experience symptoms like vaginal dryness, night sweats & hot flashes. In cases where treatments are required, doctors will recommend medications so as to ease these symptoms. However, for patients whose ovaries were not removed during surgery & had periods prior to hysterectomy will continue producing eggs & hormones until they reach menopause.

Hysterectomy Surgery in India

India is a rapidly emerging as a leading global medical tourism destination proving high quality affordable healthcare solutions including gynecological treatments like hysterectomy for international patients from all around the world. Surgeons in India are some of the best oncologists & gynecologists capable of performing advanced complex procedures for a variety of medical problems faced by women. IndianMedTrip is one of the fastest growing healthcare tourism companies in South Asia offering a wide spectrum of low cost medical treatments. Associated with top surgeons & best accredited hospitals, IndianMedTrip consultants will ensure a hassle-free comfortable experience right from the first telephonic conversation to arrival, treatment, recuperation & successful farewell.

 

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