Hysterectomy (for benign conditions) is used to treat menstrual
problems, fibroids and chronic pelvic pain caused by
endometriosis and pelvic inflammatory disease (PID).
A total hysterectomy involves removal of the uterus and the
cervix. The vagina is closed over at the top and remains
the normal length.
A subtotal hysterectomy involves removal of the
uterus only. The cervix is left intact and the vagina
remains the normal length. This operation is performed only
if a woman wishes to keep her cervix or if there are
technical difficulties with the operation.
The operation is performed under a general anaesthetic and
takes about 1 hour.
During the operation, a catheter will be passed up
the urethra into the bladder to drain off the urine. A
plastic tube may also be inserted into the wound to remove
any slight bleeding. These tubes will be left in place for
12-24 hours.
Although there will be some discomfort following
surgery, this will be controlled with pain killers.
The average length of stay in hospital is 2-3 days
and normal activities can be resumed within 4-6 weeks.
There should be no problems with sexual
intercourse following the operation.
A hysterectomy can be used to treat menstrual problems in
women approaching the menopause.
Bilateral salpingo-oophorectomy, which is removal of the
ovaries, is carried out to prevent the risk of ovarian
cancer in the future and the formation of scar tissue which
may cause long-term pain.
The two procedures are carried out in one operation, which
involves the removal of the uterus, Fallopian tubes, cervix
and ovaries. The vagina is closed over at the top and
remains the normal length.
The operation is performed under a general anaesthetic and
takes about 1 hour.
During the operation, a catheter will be passed up
the urethra into the bladder to drain off the urine. A
plastic tube may also be inserted into the wound to remove
any slight bleeding. These tubes will be left in place for
12-24 hours.
Although there will be some discomfort following
surgery, this will be controlled with pain killers.
The average length of stay in hospital is 2-3 days
and normal activities can be resumed within 4-6 weeks.
Hormone replacement therapy (HRT) may be prescribed to
replace the ovarian hormones, depending upon the age of the
patient.
There should be no problems with sexual
intercourse following the operation.
Myomectomy involves the removal of uterine fibroids. The
uterus, cervix, Fallopian tubes, ovaries and vagina all
remain intact.
Fibroids are lumps which form in the wall of the
uterus. They can cause heavy menstrual bleeding and
are occasionally painful, especially in pregnancy.
Fibroids occur for no apparent reason, and are almost
always non-cancerous.
The operation is performed under a general anaesthetic, and
the time taken wili depend on the number and size of the
fibroids to be removed, but is usually 1-2 hours.
During the operation, a catheter may be passed up
the urethra into the bladder to draln off the urine. A
plastic tube may also be inserted into the wound to remove
any slight bleeding. These tubes will be left in place for
24-48 hours.
There is a small chance that a hysterectomy may be needed,
if any bleeding cannot be stopped.
Patients may develop a temperature immediately after the
operation, but this is quite normal. Although there will be
some discomfort following surgery, this will be controlled
with pain killers. Vaginal bleeding may also occur, but is
usually light.
The average length of stay in hospital is 2-3 days
and normal activities can be resumed within 4-6 weeks.
There should be no problems with sexual
intercourse following the operation.
Endometrial ablation is an alternative to hysterectomy as a
treatment for menstrual bleeding problems. The procedure
involves stripping the lining of the uterus so that the
tissue which produces the menstrual bleeding is destroyed
or 'ablated'.
Hormonal drugs may need to be taken for a perIod before the
operation in order to 'thin' the lining of the uterus, and
make the operation easier and more successful.
The operation is performed under a general anaesthetic and
takes about 30 minutes to 1 hour.
The cervix is dilated to allow a fibre-optic
'telescope' called an hysteroscope to be inserted into the
uterus, so that the lining can be seen.
The tissue lining the uterus can then be destroyed by
a laser, or stripped away using a hot, wire loop called
a resectoscope or a heated revolving ball.
After the operation, pain killers may be necessary and some
light bleeding may occur.
The average hospital stay is 6 hours and normal activities
can usually be resumed in 2-3 days.
Menstrual periods may not be entirely abolished following
this procedure: 25% of women have no periods; 40-50% have
acceptable periods; and 25% find the operation unhelpful in
the long term.
