Uterus Cancer & Hysterectomy
Hysterectomy, one of the major and common surgeries relating to gynaecology is seen as a better option for women who are suffering from uterus related disorders such as uterine bleeding, fibroid growth, heavy bleeding, endometriosis, uterus cancer symptoms etc. The success and satisfaction rate of hysterectomy is much higher compared with other treatments, and this surgery improves physical comfort in women. Hysterectomy has been found to be an effective and cost-effective intervention across a variety of indications.
What is Hysterectomy?
The uterus is an important organ in a woman that cradles & nourishes the unborn baby in a woman. It also the organ to produce monthly menstrual cycle, but when a woman is suffering from as mentioned earlier, uterine bleeding, fibroids, endometriosis or any other uterus disorder. The removal of the uterus through surgical process is known as hysterectomy. A hysterectomy can save life and improve quality of living by giving relief from many serious health problems caused by the uterus.
Menstrual bleeding: The menstrual flow and period can vary from woman to woman & also from cycle to cycle in the same woman. Women menstrual cycle with heavy flow is quite common in many especially after the age of 40. And, if the bleeding is unusually heavy or if there is frequent heavy flow, treatment is required. There may be various reasons for heavy bleeding, the most common are hormonal imbalances & fibroids. Under such circumstances, and depending on the diagnosis and therapy, a hysterectomy may be the best option.
Prolapse: Uterus is supported by Ligaments & muscles, and as a woman ages these may lose their tone, firmness & the uterus may sag down. The uterus is close to the urinary bladder in the front & the rectum behind. When the uterus sags, it may pull the bladder & rectum along with it & cause various health problems. A woman may feel dragging sensation in the pelvic area, problems with emptying or controlling the bladder or the bowel. A hysterectomy with repair of the pelvic floor can be chosen by the patient suffering from this disorder.
Endometriosis: The cells from the lining of the uterus grow like islands outside the uterus – ovary, tubes, and pelvic wall. In this condition, it behaves like the lining & produces the monthly menstrual cycle, this may cause a lot of discomfort & pain. This symptom i.e. endometriosis also causes scarring, adhesions & infertility. Under such condition, medication, pain relief medications & localized surgery are usually recommended, so as to help the patient to get cured from endometriosis and be able to have reproduction system in order. But for those, who have a family, that is complete & response with medication is not satisfactory, hysterectomy may be the best alternative.
Fibroids: Fibroids are the most common tumors in females and usually found during the middle and later reproductive years. A fibroid may start as a single muscle cell in the uterus, but this cell changes into a fibroid tumor cell, grow and also multiply. These may cause heavy and painful menstruation, painful sexual intercourse, greater urinary frequency and urgency. Some fibroids may also interfere with pregnancy in rare cases. There are non-surgical and non-invasive processes available for treating this condition who prefer in place of hysterectomy.
Uterus Cancer: If the patient is diagnosed with cancer, the cancerous uterus needs to be removed to prevent and spread of this life threatening disease.
Pelvic Pain: A common symptom among women, pelvic pain may be associated with heavy bleeding, but there can be other reasons or causes for pelvic pain, which include endometriosis, fibroids, ovarian cysts, infection or scar tissue. Pelvic Pain may not be related to the uterus at all. Therefore, a careful diagnosis is necessary before considering whether to have a hysterectomy or not.
Other reasons for hysterectomy, apart from the above mentioned there are other indications for hysterectomy like an ovarian tumor in a patient who has completed the family, long standing pelvic pain with adhesions which is not responding to the medicines, rupture of the uterus, etc. For many removal of the uterus has helped in living a better life.
Types of Hysterectomy
Radical Hysterectomy: In Radical hysterectomy the uterus is completely removed with the parametrium (ie, round, broad, cardinal, and uterosacral ligaments) and the upper one-third to one-half of the vagina, with the ovaries left intact. If symptoms of cancer are detected, lymph nodes, ovaries and fallopian tubes are also removed to prevent the cancerous growth.
Total Hysterectomy: This surgery involves in removing both the body of the uterus and the cervix, which is the lower part of the uterus. Hysterectomy can be done through the vagina (vaginal hysterectomy); or through a surgical incision in the lower belly (abdominal hysterectomy).
Subtotal Hysterectomy: In this surgery, only the upper part of the uterus is removed, but the cervix is not removed, since many women want to retain the cervix believing that it may affect sexual satisfaction after hysterectomy. Fallopian tubes and ovaries may or may not be removed depending on the condition of the patient. Usually, this procedure is done through the abdomen.
Types of Hysterectomy Surgery
Hysterectomy is performed in many different ways in different treatment centers and hospitals, and more importantly it depends on your health history and the reason for your surgery.
- Abdominal hysterectomy. A 5- to 7-inch incision in the lower part of your belly is cut and the cut may go either up and down, or across your belly, just above your pubic hair.
- Vaginal hysterectomy. The vagina is cut open to enable the doctor to take your uterus out through this incision and the cut is stitched after the removal of the uterus.
- Laparoscopic hysterectomy. In this method, three or four minor incision is done on the belly, and a laparoscope is inserted with other instruments, in which the doctor is able to see the pelvic organs and cut the uterus into smaller pieces, remove them through the incision already done. [Laparoscope is an thin tube instrument with light & small camera that allows the doctor to see the organs.
- Laparoscopically assisted vaginal hysterectomy (LAVH). The uterus is removed through the vagina with the help of laparoscope.
- Robotic surgery. A special machine is used to perform the surgery like laparoscopic surgery. This type of surgery is usually done on patients who have cancer or are obese/overweight and vaginal surgery is not safe.
Recovery period from a hysterectomy:
While the surgery may get over in few hours, recovering from a hysterectomy is a co-related factor for every individual. It depends on the type of hysterectomy performed, age of the patient, health of the patient, post-surgery care etc. Most women stay in the hospital from 1 to 2 days for post-surgery care, some may stay even for a longer period when the hysterectomy is done because of cancer, as part of patient observation process.
In Laparoscopic Hysterectomy and Laparoscopically assisted vaginal hysterectomy, the surgery time is much lesser and recovery time is also faster. In these type of surgeries, patients usually walk-in and walk-out of the hospital after surgery without the need to stay as inpatient. Patients should take care so that stress is not too much and follow hospital/doctor’s advice. In general, patients should get plenty of rest and not lift heavy objects for about 6 weeks after surgery.
