Abdominal Hysterectomy

What is a Hysterectomy?

The uterus, also called the womb, is the organ in which a baby grows during pregnancy. A hysterectomy is a surgical procedure that involves the removal of the uterus to treat many conditions that affect it.

In certain cases, one or both your ovaries and fallopian tubes may also be removed (total hysterectomy with salpingo-oophorectomy).

What is Abdominal Hysterectomy?

Hysterectomy can be performed through an incision in the vagina (vaginal hysterectomy) or abdomen (abdominal hysterectomy). An abdominal hysterectomy is a surgery performed to remove the uterus through an incision in the lower abdomen.

Indications of Abdominal Hysterectomy

A hysterectomy may be recommended to treat noncancerous growths (fibroids), cancer of the uterus or cervix, endometriosis, uterine prolapse and abnormal vaginal bleeding, heavy, irregular or prolonged periods.

An abdominal hysterectomy is recommended if you are unsuitable for a vaginal hysterectomy either due to an injury to the bladder or ureter or due to other medical complications.

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Pre-surgical Care and Tests before Abdominal Hysterectomy

You may have to undergo the following tests before abdominal hysterectomy:

• Endometrial biopsy, which identifies any abnormality/cancer in the uterus lining
• Cervical screening (Pap test), which identifies any abnormality, especially cancer, in the cervix
• Pelvic ultrasound, which helps to determine the size of the uterine fibroids, ovarian cysts or endometrial polyps

Your vagina will be cleansed and rectum emptied.

Abdominal Hysterectomy Procedure

An abdominal hysterectomy is performed under general anaesthesia. Your surgeon makes an incision in your lower abdomen by one of the below approaches:

1. Vertically, starting from just below your navel to right above your pubic bone
2. Horizontally, about an inch above your pubic bone, along the bikini line

Following this, the uterus is removed alone (partial hysterectomy) or along with the cervix (complete hysterectomy). Following this, your surgeon closes the incision and applies a bandage. The procedure lasts for an hour or two.

Post-surgical Care for Abdominal Hysterectomy

After the surgery, you will be discharged after a day or two. You will be prescribed medicines for pain relief and to prevent any infection. You will be given specific instructions.

• Try to move and walk soon after surgery.
• Avoid lifting anything heavy and refrain from sexual activity for about six weeks after the surgery.
• You may have vaginal bleeding lasting for several days to weeks after your hysterectomy, which is normal. Use sanitary pads for bleeding and discharge from your vagina. However, you may need to consult your surgeon if you experience continuous bleeding or abnormal menstrual flow.

Risk and Complications of Abdominal Hysterectomy

Abdominal Hysterectomy is usually regarded safe. However, it may have certain risks and complications such as:

• Heavy bleeding and/or formation of blood clots
• Infection, unwanted or allergic reactions to anaesthesia
• Damage to your urinary tract, bladder, rectum or other pelvic structures during surgery, which may require further surgical repair
• Death (rarely)

Outcomes of Hysterectomy

Remember, a hysterectomy ends your ability to become pregnant. So, if you wish to conceive, discuss with your doctor about the alternatives to this surgery. In case you have cancer, a hysterectomy might be the only treatment option.

If you undergo a bilateral salpingo-oophorectomy, you may develop a condition called surgical menopause. Surgical menopause leads to permanent end to menses and stops the onset of menopause. Depending on the intensity of the symptoms that arise from bilateral salpingo-oophorectomy, you may require short-term hormonal treatment.