Hysterectomy
What is a hysterectomy?
Hysterectomy is a surgical procedure for removal of uterus. Almost in 33 % percent women have their uterus removed before they reach age of 60 years.
After cesarean operation, hysterectomy is also performed in many cases in the interest of ruling out the growth of a cancer of uterus or cervix.
Hysterectomies are performed on a large scale in cases of fibroids of uterus with symptoms excess menstrual bleeding causing great discomfort all though other non-invasive alternatives are available.
Uterus is a dispensable organ after the child bearing age of the woman. Now a days the medical opinion is to save the uterus because of its role in hormones regulation.
Criticism of Hysterectomy:
There has been lot of criticism about unnecessarily removal of uterus, in conditions, where other alternatives available could have been considered instead of a hysterectomy. Hysterectomy has been resorted to achieve the objective of birth control even without consent of the patients whereas other very safe and effective measures are available.
The most significant drawback of hysterectomy is the loss of fertility of a woman. Some women lose the sexual desire. Women who have been forced to get hysterectomy done have a negative feeling about it.
Indications for Hysterectomy:
With the presence of advanced stage of cancer of uterus, cervix or ovaries, hysterectomy is a life saving measure to prevent metastasis or spread of cancer to other organs of body. Presence of large uterus fibroids is also an indication for performing hysterectomy. Besides in conditions advanced pelvic inflammation, severe complications associated with pregnancy.
A second opinion may be taken, regarding other effective and safe treatments available, before undergoing hysterectomy.
Alternatives to hysterectomy:
During initial stages of cancer of the cervix, ovaries, or uterus, alternative measures can be considered and hysterectomy may be performed, when other measures have failed. Fibroids of uterus also can be first treated with medicines in case of no response hysterectomy is performed as a last resort.
Preoperative Preparation:
Hysterectomy is performed under general anesthesia or local anesthesia depending on the choice of the doctor considering the health and age of the patient. General anesthesia requires patient to be empty stomach overnight and rectal enema in the morning to avoid vomiting on the operation table.
Post Operative Care:
The patient is kept in the hospital for few days changing the dressing and administration of antibiotics and anti inflammatory agents and analgesics to ensure healthy healing of wound. During the stay in the hospital patient is maintained on IV fluids and urination with the help of a catheter. Patients stool are also managed with a bed pan. Patient is advised bed till the wound has completely healed.
During the recovery period lasting a month patient is advised not to lift heavy objects and abstain from sexual intercourse.
Side Effects of a Hysterectomy:
There is possibility of decrease in libido in few patients. Because of uterus contractions are associated with orgasm; it may be missing in some patients after hysterectomy.
Because nerves to the bladder are located near the uterus a nerve damage is possible during hysterectomy and such women develop stress incontinence i.e. urine getting passed out on sneezing, coughing or abdominal pressure. Pelvic muscular exercises help in improving situation.
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