Hysterectomy is a procedure used to remove the uterus and the cervix. In the Total Abdominal hysterectomy (TAH), the incision is made in the abdomen. The incision is made in the abdominal wall. It is about 5 inches long and reaches the uterus by cutting through the skin and connective tissue. This incision can either be horizontal (known as bikini-line incision running across the top of the pubic bone) or vertical (running from just above the pubic bone to just below the navel).
This procedure is carried out when the surgeon needs to get a complete, unobstructed look of the uterus and surrounding organs. Also, it provides more room for the procedure to be carried out. It is very useful in conditions where cancer is suspected or the patient has large fibroids. However, there are some disadvantages too like more pain, larger scar, and longer recovery time.
Many people get the TAH done along with the Salpingo-Oophorectomy and get their cervix, uterus, fallopian tubes, and ovaries removed in a single surgical procedure. After the surgery, you won’t be getting your menstrual period and you won’t be able to get pregnant.
At the Apollo Cradle Kondapur, we believe in providing the top-class medical facilities to our patients at an affordable price. Our team of doctors and staff has a lot of experience in carrying out hysterectomies and they will make sure that they provide you with the best care.
Who should have this surgery?
There are multiple conditions in which the hysterectomy becomes the only treatment option:
- Gynecologic cancer
This includes the cancer of uterus or cervix. Depending on the type of cancer and which stage it is, your other options might be chemotherapy or radiation.
Total Abdominal Hysterectomy is the only permanent solution for fibroids. Fibroids are benign uterine tumor which, if left untreated, might cause anemia, bladder pressure, pelvic pain, and persistent bleeding. However, many women have minimal symptoms of fibroids and therefore, don’t require any treatment.
In this condition, the endometrium (tissue lining present inside the uterus) starts growing outside the uterus on places like on your ovaries, fallopian tubes or other abdominal or pelvic organs.
- Uterine Prolapse
This is a condition in which the uterus descends into the vagina. This can happen when the supporting tissues and ligaments get weak. This can lead to pelvic pressure, difficulty during bowel movements, and urinary incontinence.
- Abnormal vaginal bleeding
If you have irregular, heavy, and prolonged periods during each cycle and cannot be controlled by other methods, a hysterectomy might be the solution for you.
- Chronic pelvic pain
Occasionally, women feel chronic pain that arises in the uterus and the only solution to that is a hysterectomy. But, before undergoing such a major surgery, carefully evaluate your condition because an unnecessary hysterectomy will just create new problems.
A Total Abdominal Hysterectomy procedure will end your ability to get pregnant. So, if you are thinking of conceiving in the future, this procedure is not for you. Also, after the TAH, you must opt for Hormone Replacement Therapy to help you fight through the sudden deficiency of hormones in your body.
How you prepare
Before the Procedure
It is normal to feel anxious before a surgical procedure. Here is what you can do to feel prepared:
- Get information
Before you schedule an appointment for the surgery, you need to get all the information you can and make an informed your decision. Talk to your healthcare provider regarding the procedure and all the steps involved in it. This will help you get more comfortable.
- Follow the instructions
Make sure that your doctor knows everything about your medication routine. You need to find out if you need to change your usual medication a few days prior to the procedure. This includes over-the-counter medications herbal preparations and dietary supplements
- Type of anesthesia
You need to decide beforehand, what type of anesthesia to use. Normally, in the abdominal hysterectomy, general anesthesia is used so that you can stay unconscious during the procedure.
- Plan the hospital stay
Depending on your condition, the type of hysterectomy, and what your doctor recommends, your stay in a hospital might change. Some women get to leave the same day as the procedure while some others have to stay for at least 1 to 2 days.
- Arrange for help
You will take several weeks to fully recover. You will have to restrict your daily activities. You don’t want to put too much pressure on your body. Don’t drive or lift heavy objects. Ask someone to help you get through the day-to-day activities or hire help.
Before the surgery, you might have to take some tests including:
- Cervical Cytology (Pap test)
This test is used to check abnormal cervical cells or cervical cancer.
- Endometrial Biopsy
This test detects endometrial cancer of abnormal cells present in the uterine lining.
- Pelvic ultrasound
This is done to check the size of the uterine fibroids, ovarian cysts, or endometrial polyps
On the day of the surgery, a shower using a soap given to you by your healthcare provider to reduce the risk of infection. You will receive a preoperative cleansing of your vagina.
During the procedure
A Total Abdominal Hysterectomy is performed under general anesthesia. The procedure lasts about 1 to 2 hours. First, a urinary catheter will be passed through your urethra to empty your bladder. Before the surgery, your vagina and abdomen will be cleaned using a sterile solution.
Now, for the procedure, an incision will be made in your lower abdomen using one of the following approaches:
- A vertical incision
Starting from the middle of your abdomen, this incision extends from below your navel to just above your pubic bone.
- A horizontal bikini-line incision
This incision lies an inch above your pubic bone.
The type of incision made by the surgeon depends on factors like the reason for the hysterectomy, the size of the uterus, need to explore the abdomen, presence of any scars, etc.
After the incision is made, your uterus will be detached from the ovaries, fallopian tubes, upper vagina, blood vessels, and connective tissue. The lower part of the uterus named cervix will be removed too.
After the procedure
After the procedure is completed, you will be kept in the recovery room for a couple of hours. During this time you will be monitored for any signs of pain, encouraged to get up and walk and given medications to reduce pain and prevent infection.
The total abdominal hysterectomy will require at least a stay of about 1 to 2 days. In some cases, the stay can be longer. You will have bloody vaginal drainage for weeks. So, use sanitary pads. If the bleeding is as heavy as the menstrual period, contact your doctor immediately.
The incision from the procedure will heal but there will be a visible scar on your abdomen.
It will take you at least 6 months to fully recover from the procedure. This is what you need to do to carry out the recovery process smoothly:
- Wait at least 6 weeks to resume intercourse
- Don’t lift anything heavy
- Stay active but avoid strenuous exercises
- Get plenty of rest
The TAH will permanently change a few aspects of your life including:
- No menstrual periods
- You won’t be able to get pregnant
- Menopause will start if you had your ovaries removed as well
- If you didn’t have your ovaries removed, you will experience menopause at a younger than average age.