Normal functions of the uterus and ovaries

Deciding whether to have a hysterectomy

Common reasons for recommending a hysterectomy or alternatives

Benefits and risks of each including common physical and emotional effects

Different types of hysterectomies

Hospitalization and recovery

Functions of Uterus:

The Uterus gets it prepared cyclically to receive fertilized ovum called Zygote, which gets implanted in the Uterus and thereafter the uterus provides nutrition to the fetus for its further development and growth till a full term Embryo is formed. At this stage the foetus is fully formed and ready for birth. Uterus helps in the delivery of the baby. It also produces the monthly menstrual flow, or period in situations, when conception in not in a position to take place.

Function of Ovaries:

The ovaries is responsible for Ovum production and secretion of Estrogen & Progesterone Hormones, Regulation of Menstrual cycle taking care of the health and well being of the Person including sexual well being.. The ovaries after puberty and up to menopause cyclically produce matured ovum cyclically on the 13^th day of the Menstrual Cycle under the influence of Estrogen. Once Ovum is released production of Hormone declines and Progesterone Hormone is produced to sustain the pregnancy if taken place.

To Undergo Hysterectomy or Not:

Hysterectomy forms a treatment for a number of diseases and conditions. If there is cancer of the uterus or ovaries or hemorrhage of the uterus, this operation may save your life.

In many cases hysterectomy is procedure of choice rather a necessity. The operation’s objective is to improve the quality of life and relieve unbearable pain, to stop heavy bleeding or other chronic conditions and discomfort with it.

There are other ways of treating or dealing with these problems the decision should be based on first attempting other available options. If the problem still continues only then a hysterectomy should be attempted.

Reasons for a Hysterectomy:

Reasons why hysterectomies may be recommended fall into three categories:

1. To save a  life;
2. To correct serious problems interfering normal functions;
3. To improve the quality of life.

The following describe the more common reasons for recommending hysterectomies.

Cancer of Uterus or Ovary:

In Cancerous situations organs and in some cases adjoining organs and structures are removed in order to stop the spread of this life-threatening disease.

Fibroids:

These are common non-cancerous tumors of the uterus and are the very common reason for performing a hysterectomy. Fibroids grow from the muscular wall of the uterus and made up of muscle and fibrous tissue. Many women after 35 years age get fibroids are asymptomatic.

In some women fibroids cause heavy bleeding, pelvic discomfort and pain and pressure on other organs. These symptoms require treatment as first priority. Hysterectomy is only to be considered after failure of the treatment.

Another alternative is surgical removal of the fibroid.  It is an abdominal surgery which removes the fibroid without removing the uterus

There are advanced new experimental drugs, which temporarily shrink the tumors. These drugs may have serious side effects and are very costly. These treatments may be sufficient or they may offer temporary relief and enable a woman to postpone having a hysterectomy, especially if she still has to bear children.

Some women choose to do nothing since fibroids will often shrink in size as a woman goes through menopause.

Other conditions requiring a hysterectomy include Endometriosis, prolapse of Uterus, Cancer of Cervix, Precancerous uterus, Pelvic adhesions in them.

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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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