Abdominal Hysterectomy

1 What is an Abdominal Hysterectomy?

A partial hysterectomy removes just the uterus, and the cervix is left intact. A total hysterectomy removes the uterus and cervix.

At the time of a total hysterectomy, your surgeon may also remove the ovaries and fallopian tubes. An abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen.

Your uterus — or womb — is where a baby grows if you're pregnant. A partial hysterectomy removes just the uterus, leaving the cervix intact. A total hysterectomy removes the uterus and the cervix.

Sometimes a hysterectomy includes removal of one or both ovaries and fallopian tubes, a procedure called a total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me).

A hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses long, thin instruments passed through small abdominal incisions.

An abdominal hysterectomy may be recommended over other types of hysterectomy if:

  • You have a large uterus.
  • Your doctor wants to check other pelvic organs for signs of disease.
  • Your surgeon feels it's in your best interest to have an abdominal hysterectomy.

2 Reasons for Procedure

An Abdominal Hysterectomy may be needed if you have gynaecological cancer, such as cancer of the uterus or cervix.

A hysterectomy is the only certain cure for fibroids. These are benign tumors that often cause

Abdominal hysterectomies are also a solution in cases of endometriosis. In endometriosis, the tissue lining the inside of your uterus (edometrium) grows outside your uterus on your ovaries, oviduct, or other pelvic or abdominal organs.

Decent of the uterus into our vagina can happen when the supporting ligaments and tissues weaken. Uterine prolapse can lead to urinary incontinence, pelvic pressure or difficulty with bowel movements. A hysterectomy may be necessary to treat these conditions.

A hysterectomy may bring relief when the bleeding can't be controlled by other methods in cases of heavy periods, irregular or prolonged each cycle.

Occasionally, surgery is a last resort for women who experience chronic pelvic pain that clearly starts in the uterus.

A hysterectomy ends you hances of ever getting pregnant. If you think you might consider pregnancy in the future, ask our doctor about alternatives to this operation.

During hysterectomy surgery, your doctor may also perform a related procedure that removes both your ovaries and fallopian tubes (bilateral salpingo-oophorectomy). With surgical menopause, menopause symptoms usually begin immediately after the operation. Depending on how much these symptoms affect your quality of life, you may need short-term treatment with hormones.

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3 Potential Risks

Generally, any hysterectomy is safe. However, any major surgery is accompanied by potential risks.

The risks associated with abdominal hysterectomy include:

  • blood clots
  • infection
  • excessive bleeding
  • adverse reaction to the anaesthesia
  • damage to the urinary tract
  • early onset of menopause
  • and rarely death

4 Preparing for your Procedure

It is a normality to feel anxious before a procedure such as an abdominal hysterectomy. However, you can prepare for it in the following ways:

Gathering information

It is advisable to gather all necessary information before surgery. Follow your doctor's instructions about medication. It is very important to find out whether you should make any changes in your medication routine prior to the surgery.

Discuss what type of anaesthesia you will be given

Abdominal hysterectomy requires you to have general anaesthesia, this kind makes you completely unconscious during the procedure.

Plan for hospital stay

The length of the period you stay in the hospital depends on what type of hysterectomy you have and what the doctor recommends. In general, an abdominal hysterectomy requires a hospital stay of at least one to two days. Arrange for assistance. You can only achieve full recovery after several weeks. Your doctor may recommend restricting your activities during your recovery, such as avoiding driving or lifting heavy objects.

5 What to Expect

Here you'll find out more about what you can expect before, during, and after an abdominal hysterectomy.

During an abdominal hysterectomy, your surgeon detaches your uterus to the ovaries and fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it.

The cervix is usually removed (total hysterectomy) but sometimes can be left in place (partial hysterectomy). If important, your surgeon may remove additional pelvic organs and tissue, such as your ovaries and fallopian tubes.

Before the surgery, some test made be done to check for cancer, which should change your surgeon's approach to surgery.

Tests may include:

Cervical cytology (Pap test), this test detects the presence of abdominal cervical cells or cervical cancer,
Another test is known as an endometrial biopsy, this test detects abnormal cells in the uterine lining or endometrial cancer.
Pelvic ultrasound may show the size of uterine fibroids, endometrial polyps or ovarian cysts.
The day and morning prior to the surgery, your doctor will instruct you to shower with soap he or she will provide, this is done to reduce the risk of infection. A preoperative cleansing of your vagina (vaginal douche) or preoperative cleansing or your rectum (enema) may also be done.

Immediately before surgery, you will receive an intravenous antibiotic medication, this done to minimize your risk of infection after the procedure.

During the procedure

A hysterectomy is typically performed under general anaesthesia, so you will be completely unconscious during the operation. The procedure itself general lasts for one to two hours, although you will spend more time beforehand getting ready for it.

To begin the procedure, a member of your surgical team passes a urinary catheter through your urethra to empty your bladder. The catheter remains in place during surgery and for a short time afterward. Your abdomen and vagina are cleaned with a sterile solution before surgery.

To perform the surgery, your surgeon makes an incision into your abdomen, using one of two approaches.

A vertical incision which begins from the middle of your abdomen and extends to just above your put bone.

A horizontal bikini-line incision can also be made, this one lies about two inches above your pubic bone.

The type of incision depends on many factors, including the reason for hysterectomy, the need to explore the abdomen, the size of your uterus and the presence of any scars from prior abdominal surgeries.

After the procedure

After the surgery, you will stay in the recovery room for a few hours. Your health care team will do the following:

  • monitor you for signs of pain,
  • give you medicine for pain and to prevent infection
  • and also to encourage you to get up and walk around soon after surgery

An abdominal hysterectomy usually requires a hospital stay of about two days, but it can be longer. You will need to use sanitary pads for vaginal bleeding and discharge.

It is a normal occurrence to have bloody vaginal discharge for several days to weeks after a hysterectomy. However, it is advisable to let your surgeon know if you have bleeding that is as heavy as a menstrual period or bleeding that is persistent.

The abdominal incision will eventually heal but leave a permanent visible scar.

6 Procedure Results

After the abdominal hysterectomy procedure, as a result, it takes a fair amount of time for you to be able to get back to your daily activities. This period is usually six weeks for most women.

During that time

  • Get plenty of rest
  • don’t lift anything heavy
  • stay active but avoid strenuous activities
  • do not engae in sexual activity
  • and follow yor doctor's recommendations about returning to other normal activities

A hysterecromy changes several aspects of your life. For example:

  • You will no longer have menstraul periods
  • most of the time, you will get relief from the symptoms that made your symptoms necessary
  • you will not be able to become pregnant
  • if you are premenopausal, a hysterectony starts menopause

If you have a partial hysterectomy, your cervix remains in place, so you are still at risk of cervical cancer. You will need regular Pap test to screen for cervical cancer.

If you have a hysterectomy prior to menopauseand you keep your ovaries, you may experience menopause at a younger age than normal.

Other parts of your life will return to normal or even improve once you have recovered from your experience, for instance:

  • If you had a good sex life before the operation, chances are  that you will maintain it afterwards.
  • Some women even experience more sexual pleasure after a hysterectomy.

The relief of symptoms

Symptoms may greatly enhance your quality of life. You may have an improved sense of well-being and a chance to get on with your life. You may, however, fell a sense of loss after a hysterectomy.

Premenopausal women who must have a hysterectomy to treat gynecologic cancer may experience grief and possibly depresion over the loss of fertility. If sadness or negative feelings begin to interfere with your enjoyment of everyday life, talk with your doctor.

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