Hysterectomy can be performed which involves the removal of the entire uterus along with the ovaries and Fallopian tubes. The reasons for getting the uterus removed are many. Let’s elaborate on these.
Why is Hysterectomy performed?
The 4 reasons that lead to hysterectomy are enlisted below:
- Uterine cancer: The staging of cervical cancer refers to the extent of the disease. Doctors stage the disease depending upon the size of the tumour and whether it has spread to nearby tissues or other organs.
Stage 0 is not considered invasive. It resides only in the top layer of cells of the cervix. Stage 1a is considered invasive cancer because the microscopic tumour grows through the top layer of cells into the underlying cervical tissue and is three to five millimetres deep by 7 millimetres wide. Stage 1b can again be of two types, the first situation is when they cannot be seen with naked eyes while the other one is visible and has a size range of a few centimetres.
In the 2a stage, the size of the tumour grows further and exceeds the cervix while in case of 2b it invades the outer region of the uterus.
In stage 3a, the tumour spreads even more and distorts the lower region of the vagina. In stage 3b, cancer spreads to the pelvic wall. The lining of the body wall cavity between the hips or it may spread to the uterus. Tubes that carry urine away from the kidneys to the bladder if the flow of urine is blocked, the kidneys can become enlarged and stop working. In stage 4a, the tumour invades nearby pelvic organs, such as the bladder or rectum and may spread to the pelvic lymph node. In stage 4b, cancer spreads past the pelvic lymph nodes to other places in the body, such as the liver, intestines or lungs.
- Uterine Fibroids: Fibroids are the developments on the uterine wall and are benign. Fibroids have varied sizes. They can be extremely small and undetectable by the naked eyes or can spread over the entire uterus. There are various methods to operate out the fibroids, which include laparoscopic approach and the open myomectomy approach. Open myomectomy with Large Fibroids often leads to hysterectomy.
- Endometriosis: The disorder in which the tissue that resembles the lining of the uterus grows in the uterine region. This tissue thickens with time and is shed during the menstrual cycle. But, since this lining of endometriosis is shed outside of the uterus, it stays in the body which can cause irritation and inflammation in the surrounding area.
- Uterine prolapse: Uterine prolapse is a condition in which the uterus faces some displacement because of the weak pelvic floor muscles.
The pelvic organ prolapse is a form of pelvic floor disorder, when the muscles of the pelvic organs get weak, which might cause the bladder to fall into the vagina, the rectum to fall into the vagina or the uterus can protrude through the outside of the vagina, the tip of the vagina can protrude to the outside as well as the bowel can move into the vagina.
One out of two women past the age of 45 can experience some form of perfect organ prolapse. Out of which, only 15 percent seek medical attention. There are a lot of reasons for pelvic organ prolapse. These factors can be ageing, menopause, obesity, pregnancies, pelvic surgeries, if you have hard type labour, i.e., if you lift heavy things, if you have a chronic cough such as asthma or COPD patients.
Apollo Cradle Nehru place hospital is one of the best maternity hospitals and specializes in cases like these. The hospital is known for giving the highest number of natural childbirths.
Even the most complicated procedures are performed with ease, with the assistance of advanced equipment, highly experienced surgeons and skilled technicians. All of these pillars contribute to the success and glory of the hospital.
The Apollo Cradle Nehru place hospital is patient-oriented and makes the patient as the priority. For smooth sailing of its patients, the hospital offers the following services and facilities:
- No Price difference between Normal Delivery & C-Section (Maternity Surgery)
- Specialized Labour and Delivery rooms
- State-of-the-Art Ultrasound Imaging
- Level III NICU
- Ventilator Equipped Ambulances
- Highly Trained Gynecologists and Nurses
- 24X7 Pharmacy
- Range of Maternity Packages
- Surgical ICU
- Apollo Experts
Types of hysterectomy
There are three main ways to perform a hysterectomy, i.e., through the abdomen, through the vagina or by using a laparoscopically-assisted vaginal approach.
For an abdominal hysterectomy, your surgeon will make an incision in your lower abdomen. Next, the abdominal muscles are pulled back in order to expose the uterus. Then the ligaments and tissues that hold the uterus in place are cut and the uterus is removed through the abdominal incision. If the need arrives, the Fallopian tubes and ovaries can also be removed by following the same method.
In this approach, a weighted speculum is inserted into your vagina, to stretch it and hold it open. After this an internal incision is made around the cervix and the ligaments and tissues holding the uterus in place are cut. In the last step, the uterus is slid out through the vagina.
Laparoscopically-assisted vaginal hysterectomy
For a laparoscopically-assisted vaginal hysterectomy, your surgeon will create several small incisions called ports, in your abdomen. Carbon-dioxide gas is then pumped through one of the ports to puff up your abdomen so that its contents can be viewed more easily. Your surgeon will then insert a laparoscope through one of the ports. Images from its camera are projected onto a video monitor in the operating room. Watching on the monitor, your surgeon will slip specialized surgical tools through the other ports and use them to make an incision around the cervix. Then the uterus is cut free from its supporting ligaments and tissues and is passed out through the vagina. Finally, your surgeon will close the incision on your abdomen with some stitches.
In all the three hysterectomy procedures, the top of the vagina is stitched closed and gauze packing is placed in the vagina to avoid excess bleeding.
How is it performed?
When you arrive at the hospital for your surgery, an intravenous line (IV line) will be started. If you are having an abdominal hysterotomy, your pubic and abdominal area may be shaved. Hysterectomies may be done under general or regional anaesthesia. If you are receiving general anaesthesia, you will be asleep for the duration of the procedure and a breathing tube will be temporarily inserted through your mouth and into your throat to help you breathe during the surgery. A catheter will be placed into your bladder to drain your urine during the surgery. A hysterectomy takes about one to three hours.
The procedure is then carried out by any of the three methods of hysterectomy, i.e., through the abdomen, through the vagina or by using a laparoscopically-assisted vaginal approach.
After the procedure is finished, you will be taken to the recovery area for monitoring. The catheter and the gauze packing will be removed before you leave the hospital.
Risks associated with hysterectomy
After, the use of general anaesthesia, complications are quite infrequent. But, still, there are certain risks associated with it which can be allergic reactions, damage to the nerve, etc.
The surgery might cause abnormal bleeding and lead to hemorrhage. In such a case, a blood transfusion might be required.
One other risk factor is damage to the ureter. Besides this, the surgery might damage the abdominal organs like bladder and bowel. Which in turn might lead to other problems such as:
- Incontinence: abnormal frequency of urination.
- Infection: As the bladder is damaged, your body will fail to filter out the impurities and might give rise to infections.
- Thrombosis: In this condition, the veins get clogged and the blood circulation is affected.
- Vaginal problems: You might have an extremely slow and painful recovery from hysterectomy.
Benefits of hysterectomy
If you have been suffering from a uterine cancer of higher stages such that it has completely distorted your uterine region as well as the surrounding area, then there is no other way of eliminating this cancer except for the removal of the entire uterus. Hysterectomy alleviates uterine cancer completely and leaves hardly any room for cancer to come back.
The procedure of hysterectomy is also beneficial when it comes to treating uterine conditions like uterine fibroids, endometriosis or uterine prolapse.
The Apollo cradle Nehru Place hospital offers the preference of all the different types of hysterectomy and has the required equipment and tools for the same.
To get an insight into the facilities, offers and surgeries, you can visit the website www.apollocradle.com of the hospital. Here, you will find reviews of immensely satisfied customers.
The hospital deals with a wide range of cases varying from department to department. The departments present in the hospital, are:
- Fetal medicine and NICU,
- Neonatology, etc.