What is a hysterectomy?
A hysterectomy is an operation to remove the uterus. It is possible to remove the ovaries if you have a vaginal hysterectomy but they will more than likely be left alone (see figure 1).
The common reasons for having a vaginal hysterectomy include uterine prolapse, heavy periods and fibroids.
What are the benefits of this surgery?
A hysterectomy may cure or improve your symptoms. You will no longer have periods.
Are there any alternatives to surgery?
Symptoms of a uterine prolapse may be improved by doing pelvic floor exercises.
Heavy periods can be treated using oral medications, a hormonal coil in the uterus, or by removing only the lining of the womb.
Depending on the size and position of fibroids, medication can be taken to try to control the symptoms. Other treatments include surgery to remove the fibroids only or uterine artery embolisation to reduce the blood flow to the fibroids.
What does the operation involve?
A vaginal hysterectomy is usually performed under a general anaesthetic. The operation usually takes about three-quarters of an hour.
Your gynaecologist will make a cut around the cervix at the top of the vagina so they can remove your womb and cervix.
Usually they will stitch the support ligaments of your womb to the top of your vagina to reduce the risk of a future prolapse.
What complications can happen?
General complications of any operation:
- Sickness or feeling sick
- Blood clots
Specific complications of this operation:
- Damage to internal organs
- Conversion to an abdominal hysterectomy
- Developing a haematoma
- Long-term problems
- Continued pain
- Menopause, even if your ovaries are not removed
How soon will I recover?
You will be able to go home after one to four days.
For the first two weeks at home you should rest and continue to do the exercises that you were shown in hospital. You can usually go back to work after six to eight weeks.
After three months you should be feeling more or less back to normal.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.
A hysterectomy is a major operation usually recommended after simpler treatments have failed.
Paying for your operation
Vaginal hysterectomy costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
Author: Mr Jeremy Hawe MBChB MRCOG
Illustrations: LifeART image copyright 2007 Lippincott Williams & Wilkins. All rights reserved.
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