Uterine removal (hysterectomy)

In a hysterectomy, the uterus is entirely or partially removed. This is intended to alleviate discomfort caused by illness or injury to the uterus. Womb removal is a major surgery that can have risks and side effects. It usually comes into question only if other treatments do not help enough. In the case of cancer, it may be necessary to remove the tumor.

For what reasons can the uterus be removed?

The most common occasions for uterine removal are:

  • fibroids
  • Vaginal and uterine depression
  • very strong or painful menstrual bleeding
  • endometriosis
  • Cancers of the uterus, cervix or ovaries

Rarely does a uterus have to be removed immediately?

This may be necessary for unstable bleeding during childbirth, severe injury or infection to avoid serious complications.

Which forms of uterine removal are there?

Depending on which organs and tissues are removed, there are three types of hysterectomy:

Partial removal (supracervical hysterectomy): The uterine body is removed. Cervix, fallopian tubes, and ovaries are preserved.
Total hysterectomy: The uterus is removed including the cervix. Fallopian tubes and ovaries are preserved.
Radical hysterectomy: This involves removing the uterine body and neck, the adjacent portion of the vagina, and portions of the lumbar support – sometimes fallopian tubes, ovaries, and lymph nodes in the pelvis.

How does the procedure work?

There are the following surgical procedures:

Vaginal Hysterectomy: The uterus is removed through the vagina. A belly cut is not necessary.
Laparoscopy: Using small incisions in the abdominal wall, thin tubes are inserted with a camera and surgical instruments. The uterus is crushed in the abdomen and sucked the removed tissue.
Abdominal hysterectomy: The uterus is removed via an abdominal incision.
Most are operated on the vagina or by laparoscopy, as these procedures are less stressful than a large abdominal incision. If possible, intervention over the vagina is often preferred. Vaginal hysterectomy and laparoscopy can also be combined.

The type of surgery depends on the disease and factors such as general health, age and weight of a woman. Since a hysterectomy is always a significant procedure, the operation is performed in the hospital. Usually, you can leave the clinic within a week. Depending on the extent of the system, it takes 3 to 6 weeks to return to normal activities. Sexual intercourse is usually possible again after about six weeks when the surgical wound has healed.

When is a womb removal useful?

Removal of uterus is one of the most common gynecological procedures. However, it is not always necessary. Whether it makes sense depends on the illness or injury and the personal situation of a woman. In case of cancer of the uterus or the ovaries, removal of the uterus is often unavoidable, so that a cure is possible. Also, discomfort from many fibroids can sometimes only be treated by this operation.

Many other causes of discomfort include treatment alternatives, such as medications or minor procedures where the uterus is preserved. It may also make sense to wait for the menopause, as some complaints improve on their own.

It makes sense to find out well in advance of a treatment decision about the advantages and disadvantages of the various options. When in doubt, getting a second medical opinion can help.

What are the risks and consequences of womb removal?

Any surgery may result in injury to vessels, nerves and organs, infection or wound healing disorders. About 5 out of every 100 women are expected to have such complications. Transient pain, constipation, or problems with bladder emptying may occur in the first days after surgery. Also, as with all procedures in the abdominal area, later adhesions can occur, which can lead to pain or intestinal complaints.

After the removal of a womb, it is no longer possible to have children. Also, there is no more menstrual bleeding after the complete replacement. However, if the cervix and ovaries are preserved, mild bleeding may continue.

If the ovaries are removed, the menopause sets in immediately after the operation. Then it can come to complaints such as hot flashes, mood swings, and dry vagina.


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