Frequently Asked Questions
What is Hysterectomy?
Hysterectomy is a medical procedure where the entire uterus [womb] or partial uterus is removed surgically. In this, either complete uterus or complete cervix or a partial part of the uterus is removed. Sometimes depending on the condition of patient health, the top part of the vagina or ovaries or fallopian tubes or tissues on the sides of the uterus may also be removed by your surgeon.
Hysterectomy is mainly of four types and they are
- Total hysterectomy: In this type of hysterectomy only uterus and cervix are removed without removing fallopian tubes and ovaries.
- Subtotal hysterectomy: Here, the uterus is removed surgically. Cervix, fallopian tubes, and ovaries are left in their positions.
- Total hysterectomy with bilateral salpingo-oophorectomy: Here along with the uterus, cervix, fallopian tubes, and ovaries are removed surgically.
- Radical hysterectomy: This is the type of hysterectomy where the uterus, fallopian tubes, ovaries are removed surgically along with some parts of the vagina, lymph glands, fatty tissue, and surrounding tissues. This is performed in the women who are having uterus, ovaries, cervix or fallopian tubes cancer.
Hysterectomy is performed by an experienced surgeon. It can be performed in three ways and they are
- Laparoscopic hysterectomy: In this uterus is removed by making several small cuts in the abdomen.
- Vaginal hysterectomy: Here a cut is made at the top of the vagina and the uterus is removed.
- Abdominal hysterectomy: The uterus is removed by making an incision or cut in the lower abdominal region.
What are the advantages of Hysterectomy?
- It can improve the quality of life.
- It reduces abnormal bleeding and pains.
- Hysterectomy prevents cervix, ovarian and uterine cancer.
- It helps in treating the uterine prolapse and other health conditions such as uterine fibroids.
- It treats severe pelvic inflammatory disease [PID].
What are the indications for Hysterectomy?
Hysterectomy can be indicated in the following conditions
- Uterine fibroids [Non-cancerous tumors in the wall of the uterus]
- Uterine prolapse [Where uterine slips into the vagina from its original position]
- Endometriosis even after surgery or medical treatment
- Chronic pelvic pain
- Persistent severe vaginal bleeding
- Uterine cancer
- Cervix or ovaries cancer
- Adenomyosis [a medical condition where the inner lining of the uterus enters into the muscle of the uterus]
What is the preparation required for Hysterectomy?
Before surgery, your doctor may do the following tests and they are
- Blood and urine tests
- MRI scan
- Ct scan
- X-ray of kidneys and abdomen
- D & C test [Dilation and Curettage test]
- Ultrasound of pelvic
Other preparation instructions for a Hysterectomy are
- Eat a light meal before the night of surgery.
- Should not smoke or drink before the surgery.
- Tell your present and past medical history to your doctor.
- You may be asked to stop taking some medications up to a week prior to the surgery.
- You may be advised to take enemas to clean out the intestines.
- You should ask your doctor regarding all the risks, complications and benefits of having a hysterectomy.
What are the steps involved in Hysterectomy?
Steps involved in Hysterectomy varies from one to another type of surgery performed by your surgeon.
Whatever the type of surgery, anesthesia is given to the patient by an IV to block the pain and make the patient sleep throughout the surgery.
- An incision is made in the lower abdomen region to expose the blood vessels and tissues that surround the uterus.
- Next, the tissue is cut, and blood vessels will be tied off to prevent the blood loss.
- Later, the uterus is removed and if the patient is suffering from uterine cancer or cervix cancer, then the ovaries, fallopian tubes, cervix, surroundings tissues, and lymph glands may also be removed.
- After removing the uterus or other reproductive parts, the abdominal wall will be sewed back together.
- Then the skin is closed with the help of either stitches or staples.
- If the cervix is also removed, then the stitches will be kept on the top of the vagina.
- In a vaginal hysterectomy, no incision will be made by your surgeon.
- Here, the vagina is stretched and will be kept open with the help of surgical instruments.
- Then the connecting blood vessels will be tied off.
- Later, the uterus and cervix will be removed by your surgeon.
- After removal of the uterus and cervix, stitches are made on the top of the vagina.
[NOTE: With each procedure, sterile gauze [vaginal packaging] is placed in the vagina and will be removed after 1-2 days of surgery.]
What is the post-procedure care/recovery care for Hysterectomy?
After the surgery, you will be receiving the following care in the hospital.
- Walk for a short distance on the night of the surgery.
- IV will be removed if you are eating and drinking well enough.
- You will be wearing special boots to prevent the blood clots in the legs.
- To urinate well, you may have a catheter in the bladder.
After discharge from the hospital, you will be provided with some instructions by your doctor and they are
- Take rest and avoid heavy lifting for at least 2 weeks.
- If there is severe pain, then consume pain killers which were prescribed by your doctor.
- Do not have sex for at least 6 weeks.
- Ask your doctor when you can start back your exercises.
If you suffer from any of the following symptoms make a call to your doctor for further instructions
- Infection with fever and chills.
- Redness, swelling, any discharge from the site of infection
- Vomiting or nausea that is not controlled by medications
- Shortness of breath
- Heavy bleeding
- Pain during urination
- Swelling and redness in the leg
Who can perform this [Right specialist type for Hysterectomy]?
Hysterectomy can be performed by
- An experienced Gynaecologist with extra training in hysterectomy surgery.
- Any MD [Doctor of medicine] with several years of experience in hysterectomy.
What is the cost of hysterectomy?
Cost of Hysterectomy may vary according to
- Admission fee
- Doctor fee
- Age of the patient
- The type of surgery planned to be performed
- Type of hospital
- The health condition of the patient
- The room that you opted for
Minimum cost for Hysterectomy in Bangalore Starts from Rs.25,000
Average cost for Hysterectomy in Bangalore is approximately Rs.76,250
Maximum amount to be paid for Hysterectomy in Bangalore can rise up to Rs.1,50,000
Is Hysterectomy a major surgery or minor surgery?
Hysterectomy is a major surgical method as it requires longer recovery time and after this surgery, you will no longer have menstrual periods and cannot become pregnant.
Minimum and maximum age required for Hysterectomy?
Women with an age 18 years and above can go for hysterectomy. Mostly, girls with a severe health condition that affects the reproductive system such as ovarian cancer, and fibroid etc. and women with menopausal complications can undergo this procedure. So, technically there is no age limit.
What is the eligibility criteria for Hysterectomy?
- Women whose age is above 18 years.
- Women suffering from ovarian cancer, cervix cancer, and uterus cancer etc.
- Women with a certain size of the uterus are eligible for vaginal hysterectomy.
- Women who want to decrease the chance of developing ovarian cancer.
What is the ineligibility criteria for Hysterectomy?
Women whose age is below 18 years old.
- If the medical treatment works in improving the conditions like fibroids, and endometriosis etc. in women, then they are not eligible.
- Women with a weak health condition and poor immune system.
- Women who don't want to lose the uterus.
- Women who want to conceive.
What are the risks and complications associated with Hysterectomy?
Every procedure has its own risks and complications besides its benefits. Risks and complications associated with hysterectomy are the followings
- Blood clots
- Severe pain
- Urinary tract infection
- Severe infection
- Tissue or nerve damage
- Breathing or heart problems that are related to anesthesia
- Damage to surrounding organs like bladder or rectum
- Vaginal prolapse may occur
How long does it take to complete Hysterectomy?
Typically, Hysterectomy takes 1-3 hours to complete the procedure.
What is the recovery time?
Recovery time may vary from one type of Hysterectomy to another type of Hysterectomy.
- An abdominal hysterectomy takes 6-8 weeks of recovery time.
- A vaginal hysterectomy takes about 3 to 4 weeks of a recovery period.
What is the success rate of Hysterectomy?
The success rate of Hysterectomy depends on the following factors
- Age of women
- The health condition of the patient
- Type of hysterectomy performed by the surgeon
Generally, the success rate of Hysterectomy is 92.1% to 96%.
Is Hysterectomy painful?
During the surgery, anesthesia is given to you and hence there will be no pain. However, after completion of the surgery or during the recovery time, you may suffer from mild to moderate pain for up to a week. In such cases, if the pain is severe, some pain killers or pain medications will be given to you by your doctor.
Is Hysterectomy Permanent?
After undergoing any type of hysterectomy, you will be no longer have your periods and cannot get pregnant or cannot conceive. These are lifelong or permanent effects.
What are the long-term results of Hysterectomy?
- Reduced sexual drive
- May cause depression as they have lost the uterus and not able to give birth
- Pain during sex
- Dryness of the vagina
- Organ prolapse may occur
Can Hysterectomy be detected in the future?
Hysterectomy is done by either vaginal or abdominal. So, if hysterectomy is done by abdominal, then there may be a presence of scars over the lower abdominal area. However, hysterectomy can be detected in the future by any doctor who examines your reproductive organs or can be detected through scanning.
What are the options if Hysterectomy fails or not successful?
Hysterectomy can fail due to several factors like the patient's health condition, age, and severity of the disease, etc. But, most of the failed hysterectomies are due to stenosis of either external or internal cervical ostium. For overcoming this stenosis and for a successful second hysterectomy, the following options are available
- Dilating the cervix with vaginal misoprostol
- Using mechanical dilators like Sims sounds and Hegar dilators
- Hygroscopic dilation
- Ultrasound guidance with a trans-abdominal probe
What are the alternatives for Hysterectomy?
Alternatives for Hysterectomy depends on the condition for which an individual prefers this. However, some of the alternatives for hysterectomy are
- Hormone therapy
- Uterine artery embolization [uterine fibroid embolization]
- Focused ultrasound surgery
- Endometrial ablation [Uterine balloon therapy]
- Pessary placement
- Medical treatment by NSAIDs, oral contraceptives etc.