Your doctor has recommended a procedure, vaginal hysterectomy, to remove your uterus.
This video is intended to help you understand this surgical treatment option.
To start let's review some information about your body.
The uterus is in the lowest part of the abdomen, between the hips.
It is where a baby grows in a pregnant woman.
The cervix is the bottom of the uterus and connects it to the vagina.
The cervix is also called the neck of the uterus.
The ovaries and fallopian tubes attach to the top of the uterus.
These structures are all are part of the female reproductive system, and are needed for a
woman to naturally make a baby.
To better understand some of the risks of this surgery, notice that the bladder is directly
in front of the cervix and vagina.
Looking at a side view of the body you can see that the uterus is behind the bladder
and at the top of the vagina.
Ureters, are also next to the uterus.
They are delicate tubes that fill the bladder with urine.
The rectum is behind the vagina, it is the lowest part of your bowel.
A supracervical or partial hysterectomy is surgery to remove the uterus above the cervix.
A total hysterectomy removes the whole uterus and cervix.
After, the ovaries and tubes are held in place by their own ligaments.
Removing an ovary is called an oophorectomy, and removing a tube is called a salpingectomy.
One or both ovaries and tubes can be removed during a hysterectomy procedure.
About 1 of 3 women have had a hysterectomy by age 60.
This number is dropping because of conservative treatment options available today.
Most conditions that can lead to a hysterectomy are not cancer, they include,
painful and/or heavy vaginal bleeding that is disrupting daily life
uterine fibroids, benign tumors of the uterus and
endometriosis, a serious cause of pelvic pain in women.
Non-invasive treatment options that may be recommended for some problems are
watch and wait, also called expectant management,
changes to diet and exercise to improve overall health
and medications to control pain, or to stop or lighten periods.
Less invasive procedures than a hysterectomy may be considered for some problems and include
endometrial ablation to treat heavy periods, a procedure that destroys the lining of the
uterus
uterine artery embolization (say em-bow-liz-A-shun), used to shrink large fibroids
myomectomy to cut out fibroids and save the uterus, and
laparoscopy to look, find and treat the reason for the pain.
Removing one or both of your ovaries and tubes can be planned as part of your procedure if
you have endometriosis, a known cyst or mass on your ovary, or to lower your future risk
of ovarian cancer.
Unplanned removal of a tube and ovary may be necessary during surgery because
an ovary has an unexpected cyst or mass
there are adhesions making it stuck to the uterus
or there is bleeding that makes it impossible to save.
After a hysterectomy pregnancy is not possible
you may have less estrogen, even if you keep your ovaries
you will be in menopause if the ovaries are removed.
There are three types of minimally invasive hysterectomy procedures:
vaginal,...laparoscopic,.... and laparoscopic assisted vaginal hysterectomy also known as
LAVH ( say letters L-A-V-H).
All of these options use smaller incisions, not a classic large incision.
A vaginal hysterectomy removes the uterus and cervix through an incision in the vagina.
There are no skin incisions so recovery can be faster.
There tends to be less bleeding and fewer complications than with other procedures to
remove the uterus.
Sometimes a larger, open incision in your abdomen is needed for unexpected bleeding
or other findings.
If this happens your hospital stay and recovery will be longer than originally planned.
Each way of removing the uterus has its own risks and benefits.
With all minimally invasive surgery the recovery is typically shorter with less pain than if
an open
surgery
is needed.
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