Laparoscopy-Assisted Vaginal Hysterectomy: Meaning & Side Effects

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Laparoscopy-Assisted Vaginal Hysterectomy: Meaning & Side Effects


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What is laparoscopy-assisted vaginal hysterectomy?

This is a minimally invasive surgical procedure using a laparoscope to remove the uterus and/or fallopian tubes and ovaries through the vagina. 

A laparoscope is a thin tube with an attached telescope and a light source, which is used to light up and view the inside of the pelvic structure and the abdomen. 

It allows the doctor to examine the insides clearly and find the cause of symptoms such as abdominal pain, pelvic pain, or swelling of the abdomen or pelvic region.

Depending on the patient’s condition, the surgery can take anywhere from 60 minutes to 90 minutes.

How is laparoscopy-assisted vaginal hysterectomy performed?

Laparoscopy-assisted vaginal hysterectomy procedure involves the following steps: 

  • At the outset, the anesthetist administers general anesthesia depending on your overall health condition.
  • Once the anesthesia takes effect, the doctor makes an incision (approximately 1 inch) right at the top of the vagina.
  • He inserts a laparoscope (miniature camera) through a small abdominal incision to view the uterus and surrounding organs.
  • Using laparoscopic tools, electro-coagulation or a laser, the surgeon detaches the uterus from the ligaments that attach it to other pelvic structures. Adhesions are also freed and, if the tubes and ovaries are to be removed, they are detached from their ligaments and blood supply.
  • The doctor then removes all the parts along with the uterus, through an incision made in the vagina.
    Please Note:If the uterus is enlarged, the surgeon may cut it into smaller pieces and remove it in sections.
  • He then sutures the incisions and puts strips of tape on them which you may need to keep for a week.

Am I eligible for a laparoscopy-assisted vaginal hysterectomy?

You are eligible for a laparoscopy-assisted vaginal hysterectomy if you suffer from:

  • Cancerous tumor within the uterus
  • Large fibroids (non-cancerous growths in the uterus)
  • Chronic and excessive bleeding (menorrhagia)
  • Uterine prolapse (A uterus that has dropped down into the vagina and is causing a problem)
  • Endometriosis
  • Adenomyosis (thickening of the uterus)
  • Chronic uterine infection
  • Severe pain associated with menopause
  • Abnormal vaginal bleeding that has not been controlled with other treatments
  • Precancerous or cancerous cells on the cervix (opening to the womb) or in the uterus
  • Pelvic pain that has not been controlled with other treatments

Please Note: Eligibility criteria for various medical procedures differs from patient to patient and depends on their general health, medical history, and medical conditions. Please consult a doctor to know more about your eligibility or ineligibility for any medical procedure. 

What risks will I face while undergoing laparoscopy-assisted vaginal hysterectomy procedure?

The risks involved with laparoscopy-assisted vaginal hysterectomy include:

  • Pain
  • Heavy bleeding may occur in some patients
  • Palpitations and Myocardial infarction (in older patients)
  • Pain during sexual intercourse
  • Infections

What are the disadvantages of laparoscopy-assisted vaginal hysterectomy? 

Laparoscopy-assisted vaginal hysterectomy includes some disadvantages such as:

  • If the doctor is unable to remove a very large uterus or areas of endometriosis, adenomyosis, or scar tissue (adhesions), he may have to switch to abdominal surgery.
  • This procedure consumes more time.

What are the complications of laparoscopy-assisted vaginal hysterectomy? 

Some complications of laparoscopy-assisted vaginal hysterectomy include:

  • Intestinal injury
  • Urinary tract injury
  • Ureteral injury
  • Bladder injury
  • Abdominal wall injury
  • Vascular injury or injury to major blood vessels
  • Sepsis
  • Pelvic abscess
  • Perito­nitis
  • Inadvertently created fistula during surgery, which can cause urinary incontinence or urinary leakage
  • Stress urinary incontinence
  • Risks are higher in women who are obese or who have diabetes or high blood pressure.
  • Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum.

What are the side effects of undergoing a laparoscopy-assisted vaginal hysterectomy? 

The side effects of laparoscopy-assisted vaginal hysterectomy include:

  • Possible loss of sexual desire (conversely some women may experience a drastic improvement in their sex life)
  • Occasional spotting or pink discharge for up to about 6 weeks.

How will I benefit from undergoing a laparoscopy-assisted vaginal hysterectomy procedure?

Some benefits of laparoscopy-assisted vaginal hysterectomy are:

  • the doctor is clearly able to examine your pelvic organs, thanks to the laparoscope, and is able to remove the cysts, scar tissue (adhesions), and fibroids. The areas of infection too can be identified.
  • a shorter stay in the hospital and less recovery time
  • less pain during recovery
  • smaller scars on the abdomen compared to longer scar caused during abdominal hysterectomy

What are my alternatives to laparoscopy-assisted vaginal hysterectomy?

The alternatives to laparoscopy-assisted vaginal hysterectomy include:

  • Medical/hormonal management
  • Hysteroscopy
  • Laparoscopic Myomectomy
  • Endometrial Ablation
  • MRI–guided focused ultrasound (MRgFUS)
  • Uterine artery embolization (UAE)
  • Abdominal hysterectomy

What are the pre-procedure guidelines I should follow for a laparoscopy-assisted vaginal hysterectomy? 

Preparation for a laparoscopy-assisted vaginal hysterectomy typically involves several steps:

  • Physical examination to determine the overall health condition
  • Pelvic exam
  • Blood and urine tests
  • Complete medical history discussion with your surgeon
  • You will be advised to quit smoking, if you smoke, for at least 6 weeks prior to the surgery since smoking can cause problems during the operation, and can also delay the healing process
  • You will be advised to not drink and eat anything at least 12 hours prior to the procedure.
  • Your doctor may prescribe an enema or a laxative to empty your bowels thoroughly before the surgery
  • The doctor may prescribe some medicines prior to the surgery, which can reduce the risk of heavy bleeding during the surgery
  • You need to inform the doctor about any over-the-counter medications, dietary supplements or herbal preparations that you're taking.

What are post-operative guidelines I need to follow after undergoing a laparoscopy-assisted vaginal hysterectomy procedure?

Some of the post-operative guidelines following a laparoscopy-assisted vaginal hysterectomy are:

  • Overnight stay in the hospital for 1 to 2 days. You will be monitored for discomfort, and be given medications to prevent pain and infection.
  • Post the surgery, you should avoid lifting heavy weights or any form of strenuous physical activity for at least upto 6 weeks.
  • You need to avoid tub baths for at least 6 weeks after the surgery.
  • You may have to take a liquid diet temporarily.
  • During the procedure, a catheter will be inserted which will allow the urine to drain from your body. The catheter will be removed the day after surgery.
  • Your incision will be covered with either surgical dressing or glue.
  • You may need to use sanitary napkins since vaginal bleeding may occur after a hysterectomy procedure and last for a few weeks.
  • You may wear sequential compression stockings on your legs until you are able to move around and when lying in bed.
  • After any surgery, constipation is a common problem due to the number of medicines and inactivity. Eating fruits and vegetables rich in fiber content and drinking lots of fluids may help you avoid constipation. And if that is not helpful or if constipation worsens, the doctor may prescribe a stool softener or a laxative.

What is the recovery period after undergoing a laparoscopy-assisted vaginal hysterectomy procedure? 

The recovery period after undergoing laparoscopy-assisted vaginal hysterectomy is usually 1 week – 2 weeks depending on the patient’s overall health conditions.

Are the results of laparoscopy-assisted vaginal hysterectomy permanent? 

There is no definite answer to this question, as the results of the surgery can vary from person to person. Some people may experience complete relief from their symptoms, while others may suffer from side effects. It will be wise to discuss your complete medical history with the doctor, and also get to know the risks involved for you personally, before taking a decision to undergo the procedure. 

How do I know if the laparoscopy-assisted vaginal hysterectomy procedure I underwent is a success? 

Here again, the results vary from person to person. Ideally, if you are free from the earlier painful and discomforting symptoms, then quite obviously, the procedure has been a success for you. If you experience side effects after the procedure for prolonged periods, then you may need to consult with your doctor once again to understand the situation and opt for further treatments.


More Hysterectomy Related Topics 

People interested in this topic also read: 

Hysterectomy Procedures: Types, Costs, & Risks


Types of Hysterectomy


Methods/Techniques of Hysterectomy 

Related Topic

Endometriosis: Symptoms, and Treatment


In the Spotlight- Latest News on Hysterectomy

 Here are some of the latest news on hysterectomy from India and around the world:

References

1. Sheriff ZK, Mohamed EM, Nazem S, Ashraf K, Laparoscopy-Assisted Vaginal Hysterectomy vs Hand Assisted Laparoscopic Hysterectomy. Jaypeejournalscom. 2018. Available at: http://www.jaypeejournals.com/eJournals/ShowText.aspx?ID=9739&Type=FREE&TYP=TOP&IN=_eJournals/images/JPLOGO.gif&IID=745&isPDF=YES. Accessed February 27, 2018.

2. G McCracken J. Comparison of Laparoscopic-assisted Vaginal Hysterectomy, Total Abdominal Hysterectomy, and Vaginal Hysterectomy. PubMed Central (PMC). 2018. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1891794/. Accessed February 27, 2018.

3. Mishra D. LAPAROSCOPIC-ASSISTED VAGINAL HYSTERECTOMY VERSUS TOTAL LAPAROSCOPIC HYSTERECTOMY. Laparoscopyhospitalcom. 2018. Available at: https://www.laparoscopyhospital.com/Laparoscopic%20assisted%20vaginal%20Hysterectomy%20versus%20total%20laparoscopic%20hysterectomy.html. Accessed February 27, 2018.


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Questions answered by trusted doctors

Verified User
Hysterectomy operation
I'm 20 years old , and I'm fed up of my menses.they are painful . i wanna do hysterectomy operation .But don't want to tell my parents about this.They won't allow me but the problem I'm suffering they cannot understand .
Dr. Astha Agarwal
Gynecologist, Ghaziabad
If u r hvng painful menstruation it could be due to endometriosis.
U need to do an ultrasound pelvis first to find the cause.
Also its not certain that hysterectomy will cure your pain.
There are lots of other medication n method that cn b used for pain reduction
Verified User
Vaginal bleeding after hysterectomy
Its been 20 days of total hysterectomy,but there is a vaginal bleeding even after taking tranexa,is it normal? all the reports are normal, the external as well the internal sutures are fine..what is the reason behind bleeding?
Dr. Neha Goyal
Reproductive Endocrinologist (Infertilty), Ahmedabad
Its mostly infection
Ask your doctor to take swab for culture
Mild bleeding is common due to suture dissolving
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Did you know?

India's rate of hysterectomy is much lower than western countries

More than 22,000 Indian women aged between 15 and 49 out of 700,000 surveyed had undergone a hysterectomy, government data shows.

Reports of unnecessary hysterectomies in India are troubling

Women especially of poor and illiterate backgrounds are conned into surgeries mostly by quacks masquerading as doctors. Women who were seeking treatment for minor ailments were suggested hysterectomies and were also told their uterus is of use once they have babies, which is outrageously wrong and even harmful information.

Hysterectomies are mainly performed in the private sector

Two-thirds of the hysterectomies performed in India were done in the private sector and half of the women who underwent the procedure never went to school.

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