Vaginal Hysterectomy: Treatment, Procedure and Risks

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What Is Vaginal Hysterectomy?

Vaginal Hysterectomy is a procedure of using a surgical method to remove the uterus from the vagina. During the Vaginal Hysterectomy, the surgeon removes the uterus from the fallopian tube, ovaries and upper vagina. The connecting tissues that support the uterus and the blood vessels are also detached before removing the uterus.

This surgical procedure involves low cost, shorter time in hospital. It also involves a shorter recovery period, unlike abdominal hysterectomy that needs an incision in your lower abdomen. Sometimes vaginal hysterectomy may not be possible due to your shape and size of your uterus. In these cases you may be advised to go for abdominal hysterectomy.

Why Vaginal Hysterectomy Is Done?

Vaginal Hysterectomy is done to cause various gyenic problems. A person can cure their following gynaecological problems through this surgical process:

  • Abnormal uterine bleeding: If a person is suffering from menorrhagia in which there occurs extensive uterine bleeding then, it can lead to anaemia or fatigue. Menorrhagia is referred to a state when bleeding lasts for more than normal, i.e.7 days. Metrorrhagia can also occur to the women suffering from Menorrhagia wherein an irregular uterine bleeding occurs. Metrorrhagia occurs when bleeding or spotting occurs on the days other than the expected menstrual period.
  • Fibroids: Fibroids is a state to stretching up of pelvis supporting tissues or weakening of ligaments. This causes the uterus to droop into the vagina. It causes pelvic pressure, urine leakage or difficult bowel movements. Removing uterus may help in repairing the supportive tissues thus, aiding the symptoms.
  • Adenomyosis: Adenomyosis occurs when the tissues that generally line up the uterus grows into the walls of uterus. This results in heavy painful periods due to enlargement of the uterus.
  • Endometriosis: This occurs when tissues that generally line up the uterus grows outside the uterus.
  • Gynaecological cancer: If you’re suffering from uterus, ovaries or cervical cancer. Then your doctor may recommend you to go for Hysterectomy. Abdominal Hysterectomy treats this kind of cancer but sometimes Vaginal Hysterectomy may also cure it.
  • Chronic Pelvic pain: If you’re sure that your pain is caused because of your uterine condition Vagina Hysterectomy may work for you as a last resort. As diagnosing the exact cause of pelvic pain may be critical before going through the surgical procedure.

What Preoperative Planning and Evaluations Are Required?

The surgeon and women decide whether the fallopian tubes or/and the ovaries should be detached and if estrogen replacement therapy should be done.

  • Removal of ovaries: A hysterectomy doesn’t always require removal of ovaries. The decision to remove it depends on several other factors. If the ovaries are removed at the time of hysterectomy then fallopian tubes are also detached.
  • Removal of fallopian tubes: It possible to remove the fallopian tubes keeping the ovaries with the hysterectomy. This may decrease the chances of one type of ovarian cancer and thus conserving the hormone production of the ovaries. Sometimes due to the scar tissues, it is not possible to remove the fallopian tube. This factor may increase the risk of removal.
  • Estrogen therapy: This therapy is recommended for the women who went through the ovary removal process. This therapy may also be used by women who have not reached the age of menopause. This may reduce the risk of night sweats, hot flashes and bone density loss that usually happens when ovaries are removed. Women who keep their ovaries may 8not need ET after hysterectomy.
  • Preoperative testing: Physical examination, chest x-ray, electrocardiogram and blood testing is included in preoperative testing. These tests depend on the age and other medical conditions of the patient.

How Should You Prepare for the Surgery?

  • Gather relevant information: Ask your doctor or surgeon regarding your queries. Try to get clear with all the information you are required to know.
  • Follow your doctor’s or surgeon’s instructions carefully: Ask your doctor if you should take your usual medicines before the hysterectomy. Make sure to tell him/her about your dietary supplements, other medications or any other herbal preparations that you might be taking.
  • Arrange for help: Ask someone to help you at your home. As many patients recover soon after Vaginal Hysterectomy but still it takes time, so you may require some help.
  • Discuss anaesthesia: Discuss with your doctor the anaesthesia you’ll be given, whether it is general anaesthesia or regional anaesthesia. During the surgery regional anaesthesia blocks the feel of the lower half of your body. While with general anaesthesia you’ll fall asleep at the time of surgery.

How It Is Done?

Vaginal hysterectomy is generally done in the hospital and takes 1-2 hours. The procedure may take longer time if other procedures are also done like, treatment of prolapse. First of all, the patient is given general anaesthesia or sedation for not making them feel the pain. Blood pressure, heart rate, respiration and blood loss are closely observed before surgery.  After successful completion of the surgery, the patients are taken to the post-anaesthesia unit also known as the recovery room. In the recovery room, they are monitored while they woke up. Many patients are allowed to go home the same day while some may get admitted in the hospital.

What Can You Expect During the Surgical Procedure?

Don’t forget to ask your doctor what to expect after and during the Vaginal Hysterectomy. To perform the surgery your surgeon may make an incision into your vagina to get your uterus out. Then, he separates your uterus from ovaries, fallopian tubes and connective tissues by tightly holding the uterine blood vessels using a long instrument. After removal of your uterus from your vaginal opening absorbable stitches are made in order to control bleeding inside the pelvis.

How You May Feel Emotionally and Physically After the Surgery?

After the surgery, you may be discharged and may go home normally. However, you may be prescribed some medicines. You may also need to wear sanitary pads as it is normal sometimes to have bloody vaginal discharge after the surgery.

Recovery, after Vaginal Hysterectomy takes is less painful and time-consuming as compared to another abdominal hysterectomy. However, a full recovery may take 3-4 weeks. Don’t have vaginal intercourse or lift more than 20 pounds until 6 weeks of surgery. Contact your doctor if you’re observing vaginal pain or any other side effects. You may feel relieved after Vaginal Hysterectomy as you may no longer have to bear with heavy vaginal bleeding or pelvic pain. However, you might feel tensed or get into depression especially you’re hoping or have planned a pregnancy.

Risk and Results After Vaginal Hysterectomy

Even though Vaginal Hysterectomy is safe. It may include the following risks:

  • Heavy bleeding
  • Adverse reaction to anaesthesia
  • Blood clots in the lungs or legs
  • Infection
  • Damage to surrounding organs
  • Constipation
  • Urinary retention
  • Early menopause

After Vaginal Hysterectomy you’ll no longer be able to get pregnant or have periods. If you have not reached your menopause but got your ovaries removed, you’ll soon get menopause. But if you’re ovaries weren’t removed during the surgery then you may bleed normally until you reach your natural menopause.

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