Hysterectomy
Definitions and indications:
Hysterectomy is the surgical removal of the uterus. The uterus is a muscular organ located in the pelvis essential in the reproductive function. It's in the uterine cavity that the embryo will be able to develop . Every month, aside from pregnancy, the scaling of the uterine lining generates menstruation. This body is a provider of many diseases of which a hysterectomy may be the treatment. This surgery is often done as a last resort or when drug therapy is ineffective.
Main indications :
-Cancer of the endometrium, cervix, ovaries or fallopian tubes.-Uterine Fibroids: benign cause many gynecological symptoms: menorrhagia (heavy periods), pelvic pain, compression of adjacent structures, dyspareunia (pain during intercourse).-Adenomyosis: the cause of pelvic pain, painful and very heavy, .-Endometriosis: the cause of dyspareunia, dysmenorrhea and pelvic pain.-Genital prolapse-Bleeding complications during childbirthThe different surgical techniques:
There are different techniques depending on the extent of ablation to nearby organs:-Total hysterectomy: Removal of the entire uterus-Sub-total hysterectomy: The uterus is removed but the cervix is left in place.-Radical colpohysterectomy involves removing the uterus, cervix, upper vagina. This technique is indicated mainly in cancers of the endometrium and cervix.-Hysterectomy with associated oophorectomy removal of the uterus with Annexes (fallopian tubes and ovaries). The Oophorectomy is unilateral or bilateral (final menopause).These different techniques are associated with different surgical approaches. The choice of approach depends on the surgeon's experience, anatomical conditions, history of the patient, the indication for surgery but also the wish of the patientAnesthesia is either general or loco-regional (spinal or epidural). The surgical approaches:-Abdominal laparotomy, also called the oral route: an incision of 10-15 cm is made in the abdomen. It is either horizontal (more aesthetic) or a vertical median. This surgical approach is indicated in cases of a large uterus or where it is impossible to pass through the vagina. Hospitalization is 4 to 7 days. Work stoppage for a month.-Vaginal passage: the surgeon goes through natural means, ie through the vagina. There is no abdominal scar. Recovery time is shorter, 2 to 4 days of hospitalization and 2-3 weeks of work stoppage.-The combination between a laparoscopic and vaginal route also existsPossible complications :
-Hematoma-Abscess wall-Heavy bleeding may require blood transfusion-Burning-Compression of a nerve in the lower limbs-Injury to the gastrointestinal tract-Injury to the urinary tract (bladder, ureter)-Even more exceptional :life-threatening or serious sequelaeWhat happens next?:
Your sexuality will not be changed by the intervention. Sexual intercourse may be resumed in one month after surgery. -If you are menopausal before the operation: There will be no particular change later.-If you are not menopausal before the operation: The main sign after a hysterectomy will be no periods and no possibility of pregnancy, which does not mean you're menopausal.-If the ovaries are left in place Their function will persist until natural menopause. You will not have hot flushes or other signs of menopause after the procedure.-If the ovaries are removed the operation will lead to menopause (unless you are already menopausal) and then you can have symptoms such as hot flushes. You can discuss with your doctor about medical treatment replacement.
Victor Hugo