What is a hysterectomy?
Hysterectomy is a surgery to remove the uterus. Hysterectomy is an operation that is generally performed as an open surgery, but today it can be performed with a closed method (laparoscopic).
What are the reasons for hysterectomy?
Hysterectomy is one of the most frequently performed surgeries in gynecology practice. is one. Some of the reasons for hysterectomy are:
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Myomas (benign tumors developing from the smooth muscle of the uterus)
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Abnormal bleeding (abnormal bleeding resistant to medical treatment )
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Uterine-related pain that lasts a long time and does not respond to treatments
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Endometrial hyperplasia, cervical premalignant lesions
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Uterine prolapse
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Adenomyosis / Endometriosis
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Cancer (uterus, cervix, ovarian cancers)
In addition, hysterectomy is performed along with the ovaries in cases such as ovarian cysts and ovarian cancer at older ages.
What are the types of hysterectomies?
The type of surgery varies depending on the examination findings, the disease causing the surgery, and the doctor's choice.
Abdominal Hysterectomy (removal of the uterus from the abdomen): The size of the uterus in the lower abdomen and the type of surgery performed. Depending on the cause, a horizontal or vertical incision is made. In the abdominal approach, since at least a 10 cm incision is made in tissues such as skin, subcutaneous and fascia to reach the uterus, the healing process requires longer time than other types of hysterectomies. However, it is a good method, especially in large tumors and malignancy (cancer) cases.
Vaginal Hysterectomy (removal of the uterus through the vagina): In this method, there is no incision in the abdomen. Since the incision is in the vagina, recovery time is shorter than abdominal hysterectomy.
Laparoscopic Hysterectomy: Hysterectomy surgery performed with the open method can be performed with the closed method (laparoscopic hysterectomy).
How is laparoscopic hysterectomy performed?
Closed uterus removal surgery (laparoscopic hysterectomy) is performed 5-10mm into the abdominal wall, just like other laparoscopic gynecological surgeries. It is made by drilling 3 holes. Hysterectomy surgery is performed by making one 5mm hole in the belly button and two on the left side of the abdomen, observing the inside of the abdomen with a camera, and placing the necessary instruments to remove the uterus through the holes on the side. If necessary, the ovaries or tubes can be removed during laparoscopic hysterectomy. After the uterus is removed, skin incisions of 5-10 mm in size on the abdominal skin are closed with thin stitches.
What are the possible effects after hysterectomy?
Some long- or short-term mental and physical conditions after hysterectomy may occur.
A menstruating patient experiences two main events after hysterectomy; (a) amenorrhea, (b) inability to become pregnant. If the ovaries are not removed, hormone production will continue, so menopause symptoms such as hot flushes, sweating, and insomnia will not be observed, even if menstruation does not occur. However, if the ovaries are removed before menopause, effects due to the disappearance of hormones (menopause symptoms) are observed. If the patient's age is under 45 and the ovaries are removed along with the hysterectomy, appropriate drug treatments can be prescribed to protect from osteoporosis and prevent menopausal symptoms.
If the ovaries are not removed, the vagina and external sexual organs are not affected by hysterectomy, since hormone secretion will continue. If the ovaries were removed along with the uterus in the pre-menopausal period, vaginal dryness may be a problem during sexual intercourse. Local estrogen or lubricants will prevent dryness and eliminate problems related to sexual life. Most women feel better after hysterectomy because the complaints that caused the surgery disappear. In addition, sexual intercourse after hysterectomy without fear of pregnancy, pain or excessive bleeding makes many women happy.
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