What is a Hysterectomy?

English हिन्दी Bengali

What is the meaning of Hysterectomy?

Hysterectomy is a surgical procedure done to remove a woman’s uterus (womb). The uterus or womb is a pear-shaped organ where a baby grows when a woman is pregnant. The lining of the uterus (called the endometrium) is the source of bleeding during menstruation. Hysterectomy involves the removal of the whole uterus. Sometimes, the procedure may involve the removal of the ovaries (a pair of egg-producing organs), fallopian tubes (a pair of tubes along which the eggs travel from the ovaries to the womb), and/or cervix (the lower end of the uterus which sits on top of the vagina).

Once a woman has a hysterectomy, she will no longer be able to get menstrual periods or get pregnant.

In this article, we will be discussing hysterectomy in detail-

• What are the different types of Hysterectomy?
• What is the purpose of Hysterectomy?
• What is the diagnostic procedure before a Hysterectomy?
• How to prepare for a Hysterectomy?
• What is the procedure of Hysterectomy?
• How to care after Hysterectomy?
• What are the risks of Hysterectomy?
• What is the cost of Hysterectomy in India?

What are the different types of Hysterectomy?

The different types of hysterectomy procedures include:

• Total hysterectomy: A procedure when the uterus and cervix are removed.
• Partial hysterectomy: This procedure involves the removal of the uterus while the cervix is left intact. The removal of the cervix is generally advised as it is a potential site for cancer development. However, if a woman chooses to not have the cervix removed, regular cervical screenings are a must.
• Radical hysterectomy: This is an extensive procedure and involves the removal of the uterus, ovaries, fallopian tubes, upper portion of the vagina, and the associated pelvic lymph nodes and ligaments. This procedure is performed in cases of cancer of the cervix, uterus, ovaries, or fallopian tubes. ( Know more about- What is Labiaplasty? )
• Hysterectomy and bilateral salpingo-oophorectomy: This procedure includes the removal of the uterus, ovaries, and fallopian tubes. This procedure is done in cases of cancer of the uterus or ovaries, or in cases of chronic (long-term) pain due to recurrent infection in the pelvis region (region below the stomach) or recurrent endometriosis (a disorder in which the tissues normally lining the uterus grows outside the uterus). 
• Hysterectomy with prophylactic bilateral salpingectomy: This type of procedure involves removal of the fallopian tubes at the time of hysterectomy. This is because early cases of ovary cancers usually originate in the fallopian tubes.

What is the purpose of Hysterectomy?

Hysterectomy may be performed in the following cases:

• Heavy or abnormal bleeding that cannot be controlled by other treatments
• Extreme pain during menses (dysmenorrhea) that cannot be controlled by other methods 
• Leiomyomas or uterine fibroids (non-cancerous tumors)
• Uterine prolapse (when the uterus gets dropped into the vaginal canal due to muscular weakness), leading to difficulty in bowel movements or urinary incontinence
• Increase in pelvic pain that is related to the uterus and cannot be treated using other methods ( Know more about- What is Ovarian Cyst Removal Surgery? )
• Cervical or uterine cancer ( Know more about- What is Cervical Cancer ? )
• Hyperplasia (increased cell production in the uterine lining)
• Recurrent uterine polyps (a non-cancerous growth attached to the inner wall of the uterus)
• Adenomyosis (when endometrial-like cells grow in the uterus muscles)
• Endometriosis

What is the diagnostic procedure before a Hysterectomy?

• Physical examination: The doctor will examine the patient physically and note down the symptoms. The medical history of the patient is also noted.
• Pelvic exam: The doctor inserts one or two of his gloved fingers into the patient’s vagina to check the female reproductive organs. ( Know more about- What is IVF? )
• Pap test or cervical cytology: This test helps in detecting the presence of any abnormal cervical cells or cancer of the cervix.
• Pelvic ultrasound: Sound waves are used to obtain images of the female reproductive organs using a pelvic ultrasound. This may help in detecting the size of ovarian cysts, uterine fibroids, or endometrial polyps.
• Endometrial biopsy: The doctor removes a sample of the endometrial lining and sends it to the laboratory to check for the presence of any abnormal cells in the lining of the uterus or endometrial cancer.

How to prepare for a Hysterectomy?

• Tell your doctor about any pre-existing medical conditions that you may be having.
• Tell your doctor about any medications, herbs, or supplements that you may be taking.
• The doctor may ask you to stop taking blood-thinners like aspirin and warfarin a few days before the surgery, as these medications can increase your risk of bleeding during and after the procedure.
• You will be instructed to not eat or drink anything at least eight hours before the procedure.
• The day before and on the day of the surgery, you will be instructed to have a bath using a soap prescribed by your doctor to reduce your chances of infection.
• A preoperative cleansing of the vagina by a vaginal douche may be done.
• A preoperative cleansing of the rectum (from where the stool passes) may be done using an enema.
• Just before the procedure, you will be receiving antibiotic medication intravenously (injected directly into the vein) to minimize the chances of infection after the surgery. ( Know more about- What are Females Genital Procedures? )

What is the procedure of Hysterectomy?

The procedure is generally performed under general anesthesia (the patient is put to sleep during the procedure) or epidural anesthesia (medications are injected near the nerves in the lower back to block the pain while you stay awake during the procedure).

There are different ways of carrying out a hysterectomy:

Vaginal hysterectomy:

• The uterus is removed through an incision (cut) made at the top of the vagina. There is no external incision in this procedure.
• Dissolvable sutures (stitches) are given inside the vagina.
• This procedure is most commonly performed in cases of uterine prolapse or other non-cancerous conditions.
• Patient goes home on the same day of the surgery.
• The procedure has few complications and a quick recovery.

Laparoscopic hysterectomy:

• A laparoscope is a thin tube with a camera on one end. It is inserted in the lower abdominal region through a small incision made in the belly button area.
• Surgical tools are inserted inside the abdomen through many other small incisions.
• The uterus is removed in small pieces through the incisions in the abdomen or through the vagina.
• You may be able to go home on the same day or the next day following the surgery.
• The procedure is less painful and has a quicker recovery compared to an abdominal hysterectomy.

Robotic-assisted laparoscopic hysterectomy:

• The surgeon performs a hysterectomy with the help of a robotic machine in this procedure.
• A laparoscope is inserted in the abdomen to view the pelvic area.
• Small surgical tools are then inserted through three to five small incisions made in the belly button area. 
• This is done by robotic arms, which are controlled and monitored by the surgeon.
• The recovery is similar to a laparoscopic hysterectomy procedure.

Abdominal hysterectomy:

• The uterus is removed through a six- to the eight-inch-long incision made in the abdomen.
• The incision is made from the belly button to the public bone or across the top of the public hairline.
• The surgeon closes the incision using stitches or staples after the removal of the uterus.
• This procedure is performed in cases of cancers, enlarged uterus, or when the disease is spreading to the other pelvic organs.
• This procedure requires a hospital stay of two to three days following the procedure and a longer recovery time.

How to care after a Hysterectomy?

• You will be in the hospital for one to two days after the procedure.
• It is normal to have vaginal bleeding for many days or weeks following the procedure
• In case of an abdominal hysterectomy, the incision will gradually heal, but a visible scar will remain on the abdomen.
• It takes approximately six weeks for complete healing following a hysterectomy.
• Take plenty of rest during the recovery period.
• Avoid lifting heavy objects for six weeks after the surgery.
• Avoid strenuous activities for the first six weeks after a hysterectomy.
• Wait for six weeks before resuming any sexual activity.
• Follow the instructions given by your doctor about resuming your daily activities.
• You will no longer have periods or get pregnant after the procedure.
• In the case of premenopausal women, if your ovaries are kept intact, you may experience menopause at an earlier than expected age.
• In case of partial hysterectomy, get regular Pap screening tests for detecting cervical cancer. 
• The symptoms of heavy bleeding and pain are relieved after the procedure, and this will improve your quality of life.

What are the risks of Hysterectomy?

The risks associated with a hysterectomy procedure are:

• Infection
• Blood clot formation
• Excessive bleeding
• Adverse reactions to anesthesia
• Early-onset of menopause even if the ovaries are not removed
• Damage to the bladder, urinary tract, rectum, or other pelvic structures
• Blockage of bowel movements
• Tearing of the internal stitches
• Urinary tract injury

What is the cost of a Hysterectomy in India?

The total cost of hysterectomy in India can range from around INR 1,10,000 to INR 3,70,000. However, many prominent hospital doctors in India specialize in hysterectomy. But the cost varies across different hospitals.

If you are coming from abroad, apart from the cost of a hysterectomy, there will be an additional cost of living in a hotel and the cost of local travel. After surgery, the patient is kept for two days in the hospital and seven days in the hotel for recovery. So, the total cost of hysterectomy in India comes to a total of INR 1,50,000 to INR 4,50,000. 

We hope that we could answer all your questions regarding Hysterectomy through this article.

If you need more information related to hysterectomy, then you can contact a Gynecologist.

We only aim to provide you with information through this article. We do not recommend any medicine or treatment. Only a doctor can give you the best advice and correct treatment plan.