Hysterectomy is the removal of uterus to treat either benign or malignant conditions in women. It is the second most frequently performed surgery after cesarean delivery in women.
Around 600,000 women in the USA have undergone this surgery every year and around 20% of women in the UK have undergone this surgery before the age of 60.
Types of Hysterectomy
Removal of the uterus can be done in three ways, depending on the route to surgery.
Vaginal Hysterectomy: It is more preferred as it involves less pain, quicker recovery time and less post-operative complications. It is especially preferred for women with a small uterus, older in age, and benign conditions without vaginal prolapse.
Abdominal Hysterectomy: It is the most common surgical procedure. However, it is invasive and can cause postoperative complications as pyrexia, UTI, and abdominal trauma.
It needs a slower time for recovery, long hospital stay, and it also needs experts. Also, it may need more blood transfusion and more readmissions.
Laparoscopic Hysterectomy: Although it is a more expensive procedure and needs experienced surgeons, it is a potentially quicker and more efficient procedure and preferred for prolapses.
It is also associated with the least complications as less blood loss than either vaginal or abdominal surgeries and is also more achievable in obese women.
The selection of surgical procedure depends on many factors as physician experience, patient’s age, size of the uterus, physician diagnosis, and BMI of a patient.
Causes of Hysterectomy
There are many causes of uterus removal surgery. They include dysfunctional uterine bleeding (DUB), endometriosis, post-menopausal bleeding (PMB), pelvic pain, prolapse, fibroids, myxomatosis, and cervical intraepithelial neoplasia.
Postoperative Complications
A study showed post-operative complications occurred after Abdominal, Vaginal and Laparoscopic Hysterectomy.
It showed that Abdominal surgery was associated with more postoperative complications. They included: wound erythema, fever, wound infections, urinary tract damage, hemorrhage, UTI, and wound dehiscence.
While Laparoscopic surgery was associated with the least complications and it caused neither UTI nor wound dehiscence.
Vaginal surgery was associated with a high percentage of fever followed by wound erythema. However, it did not cause wound dehiscence.
Quality of Life and Sexuality post Hysterectomy
Another study showed effects on quality of life involving physical and mental health and sexuality after Abdominal and Vaginal surgery. It showed improvement in both the quality of life and sexuality after the surgeries compared to before them.
Although there were statistically significant values of improvement between Abdominal and Vaginal Hysterectomies, it was clinically insignificant.