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Hysterectomy

A hysterectomy is a procedure that involves removal of the uterus and cervix. The ovaries are not necessarily removed during a hysterectomy but may be removed after discussion in certain situations. Removal of the uterus and tubes with conservation of the ovaries will stop further menstrual bleeding but retain all hormonal function of the ovaries.

Heavy painful periods, endometriosis, fibroids, cancer, strong family history of cancer, hormonal imbalance and prolapse are the most common reasons for this surgery. The benefits can be:

  • to relieve pain caused by conditions such as endometriosis and adenomyosis
  • to alleviate excessive menstrual bleeding and anaemia
  • to relieve pelvic pressure caused by fibroids
  • as a treatment for certain cancers of the uterus and ovaries.

Most premenopausal women having a hysterectomy for benign reasons e.g. for heavy painful periods, will retain their ovaries (and therefore their normal hormonal function) and as a result do not require hormone replacement. Patients with some cancers and other conditions may require removal of their ovaries at the time of surgery. This will be discussed in detail during your consultation preoperatively.

Laparoscopic hysterectomy is the term used to describe a hysterectomy performed laparoscopically, which involves making three or four small incisions in the abdomen. A laparoscope is an instrument that allows the interior of the abdomen to be viewed and is inserted through one of the incisions into the abdominal cavity. The surgeon can then view the pelvic organs on a video screen and insert surgical instruments through the remaining incisions.

Laparoscopic procedures are advantageous to patients due to a shorter hospital stay, minimal scarring, lower blood loss, and faster recovery time compared to an abdominal (open) hysterectomy. This technique enables any problems such as adhesions to be dealt with immediately and effectively and also a comprehensive check of the entire abdomen at the same time. Most patients are suitable for this procedure.

Your hospital stay will normally involve a stay of one or two nights, and you should be able to return to work in 4-6 weeks or earlier depending on the nature of your work.

In general, hysterectomy is a safe operation, and complications are uncommon. However, some complications can be serious or even life-threatening, and may require further intervention or surgery for rectification. The level of risks varies from one case to another depending on the level of difficulty (patient and pathology-dependent), and the level of experience of the surgeon (operator-dependent). It is important to always discuss the risks and benefits of any operation with your doctor, and look carefully at alternative options to a hysterectomy, before deciding to proceed.

It is important to be aware that the surgeon must be experienced in the procedure to minimize the risks of surgery. Dr Desai and Dr Carswell are experienced laparoscopic surgeons for benign gynaecological conditions and work closely with gynaecological oncologists if there is any suspicion of malignancy.