Hysterectomy: The big operation

Your doctor has suggested a hysterectomy as a solution to your health problems? Here is everything you need to know about the big operation to help you make a choice!

What is a hysterectomy?

A hysterectomy is often nicknamed « the big operation » because it is a surgical procedure whose purpose is to remove the uterus to treat various health problems women experience over their lifetime. In some cases, depending upon the reason for the operation and your medical history, other organs near the uterus may also be removed to treat your condition properly.

Different types of hysterectomy:
  • Partial hysterectomy: Only the upper part of the uterus is removed. Cervix and other organs are not touched.
  • Complete hysterectomy: The uterus and cervix are removed. Ovaries and fallopian tubes are not touched. This is the most frequent type of hysterectomy performed.
  • Radical hysterectomy: Usually performed in cases of cancer, involves removing the uterus, cervix, upper vagina and supporting tissues of the pelvic lymph nodes.
  • Complete hysterectomy with bilateral salpingo-oophorectomy: The uterus, cervix, fallopian tubes and one or both ovaries are removed.
A survey conducted by Statistics Canada on health in Canadian communities revealed that 19,6 % of women in Quebec aged over 20 have had a hysterectomy.
Conditions that may lead to a hysterectomy

There are several reasons that could explain why your doctor has suggested a hysterectomy. Here is an overview of the most common conditions:

  • The presence of uterine fibroids (myomas): These non-cancerous tumors are common and don’t require treatment, unless they cause unpleasant symptoms. When fibroids grow too large, for example, they can cause bleeding, pelvic pain and pressure during intercourse, pressure on the bladder and even anemia.
  • Endometriosis: This condition causes the tissue lining the uterus to grow outside of the uterus. Symptoms include painful periods, abnormal vaginal bleeding, scarring and infertility.
  • A uterine prolapse: When the tissues that hold the uterus in place become weak, the uterus descends into the vagina, which can lead to urinary incontinence, difficulty emptying the bowels and pelvic pressure. Continuous coughing, physical exertion, hormonal changes, obesity or childbirth usually causes this condition.
  • Pelvic pain with or without bleeding: Depending on the cause of your symptoms, your doctor may present other treatments or fewer invasive strategies to try before suggesting a hysterectomy. That is why it’s important to identify the cause of your symptoms and discuss your options with your doctor.
  • Gynaecological cancers: If you have been diagnosed with a cancer of the endometrium, cervix, ovaries or fallopian tubes, a hysterectomy may be performed to treat 10 to 12 % of these cancers according to the Canadian Women’s Health Network. A hysterectomy prevents the cancer from spreading to other organs.
The operation

Depending on your condition, your doctor will recommend that you have a vaginal hysterectomy or an abdominal hysterectomy.

  • Vaginal hysterectomy: As its name suggests, the uterus is removed through the vagina. This procedure causes less pain and allows you to return to your activities quicker.
  • Abdominal hysterectomy: The surgeon removes your uterus by making a 15 to 20 cm long cut on your abdomen or around your bikini line. This requires a longer recovery period and causes more pain.

In most cases, the operation goes well. However, as with any other surgical procedures, there may be some complications that develop such as infection, bleeding, bruising or in more rare cases, the presence of blood clots. It’s therefore important to monitor your health after the surgery and to contact your doctor if you develop symptoms that worry you such as:

  • Heavy bleeding
  • Fever
  • Urinary incontinence or pain when urinating
  • Swollen wound or pus leaking or draining from the wound
  • Digestive problems like nausea, swelling of the abdomen, difficulty to evacuate gas or vomiting.
  • Difficulty breathing

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