Hysterectomy



What is Hysterectomy?

Hysterectomy means removal of the uterus (womb). This is a common operation, especially in older women, and in many cases it can transform their lives from one of misery, into the way it was when in the heyday of one’s health and vitality. Although some claim too many hysterectomies are done these days, such reports usually come from chauvinist males, and rarely from women, especially those who have successfully undergone this surgery and had a return to normal living.

Growths, either benign (noncancerous) or cancerous ones, are notorious for producing uterine problems. Bleeding anomalies and many other disorders frequently mean the uterus should be removed. Sometimes there is associated disease of the tubes or ovaries, one or both. Depending on the state of these organs, various parts may be removed at the same time.



Surgery is very straightforward. It is usually carried out under a general anesthetic (the patient fully asleep). An incision is made above the pubic bones, the uterus located, and removed. The entire organ is taken away, including the cervix. In years past, the cervix was sometimes left, making it a less difficult operation, but as cancer of the cervix could still occur, it is now the universal recommendation that it be removed with the body of the womb. Sometimes the operation is carried out via the vaginal approach. This gives similar results. In younger women, every effort is made to preserve the ovaries, either fully or partially, for they will continue to produce essential female hormones up until the age of 50 or beyond.

When the operation is over, the lavers of the pelvic wall are stitched together and soon the patient is up and around. Her problems are usually over, recuperation is generally rapid and her health thereafter is usually markedly improved. Gone is the chance of ever reproducing again, but the operation is often carried out after the full family numbers have been achieved, so this is usually no big deal. In my view, hysterectomy is a valuable aid to making the woman feel better, have a greater level of self-esteem, and be filled with more energy and vitality.



Some women fear that it will detract from their love-life and make them a “neuter gender.” This is totally incorrect. In most cases, many women have an appreciated lovemaking capacity, for the causes of their previous pelvic ill health have been removed, and they feel so much better. Pain, discomfort, for whatever reason, also goes. They are still very feminine, still very much a woman. Sensations are frequently improved.

Do not let anyone dissuade you from this surgery, if it is indicated, on account of reduced libido. In most cases, it is simply not true. Most likely you will perform better than ever.



Pelvic Floor Exercises

Many women with incontinence benefit from pelvic floor exercises. Many physiotherapists supervise the exercises. They consist of regular contraction and relaxation of the muscles of the pelvic floor. This may be carried out 50 – 100 times, several times a day.

A suitable time is when standing, maybe washing the dishes, to gently and firmly squeeze the pelvic muscles. This is similar to the action when cutting off’ the urine stream midway. Contract tightly and hold for a few seconds then release. Repeat many times, anywhere from 50 to 100 times. Repeat the whole exercise several times during the day. It strengthens and tones up the muscle fibers.



Some suggest placing the fingers into the vaginal canal. Others suggest placing small balls inside (these are available commercially). Supervision by a trained physiotherapist is recommended. Incontinence Societies These exist in most states, and are conducted by skilled staff with a special interest in the problem. Advice on the various devices and treatment gear available can be given.

Laparoscopic hysterectomy, removal of the womb, is a common operation, especially in older women. Heavy bleeding for no apparent reason is a frequent indication that means no obvious disease can be found. Many women now respond satisfactorily to endometrial ablation, which avoids the need for surgery. However, womb removal is now often carried out with laparoscopy, the VDU screen, several small low pelvic incisions, and an internal camera. The womb is finally delivered through an incision in the upper part of the vagina. It is time consuming, but the patient is often out of hospital much more quickly.