Hysterectomy: What To Expect

Every year in the U.S., millions of women undergo a hysterectomy for health and medical reasons. The most common reasons why women have hysterectomies are:

• Unusual or heavy vaginal bleeding caused by fibroids, infections, changes in hormone levels, or cancer.
• Uterine fibroids or other types of noncancerous growths developing on the uterine wall.
• Endometriosis – a condition where tissue thrives abnormally outside the uterus. Tissues eventually engulf the ovaries, causing bleeding and severe pelvic pain between menstrual periods.
• Prolapse of the uterus – in women having multiple vaginal births, muscles supporting the uterus weaken and allow the uterus to sag into the vaginal area. Post-menopausal and obese women are also prone to suffering uterine prolapse.
• Adenomyosis – Thickening of the uterine walls accompanied by heavy bleeding and severe pain may indicate endometrial tissues normally lining the uterus are growing inside uterine walls. Adenomyosis is benign but causes discomfort and periodic anemia in women who bleed profusely during their periods.
• Precancer or cancer of the uterus, cervix or ovaries – if radiation and chemotherapy does not eradicate the cancer of the uterus, a hysterectomy may be the next best treatment option.

Depending on what needs to be removed, women can choose between a laparoscopic hysterectomy or an abdominal hysterectomy.

What Can a Laparoscopic Hysterectomy Spot?

Also referred to as “keyhole” surgery, laparoscopic surgery involves the insertion of a laparoscope through one or two small incisions to view pelvic organs. Equipped with a telescopic camera and lens, a laparoscope allows surgeons to remove small pieces of the uterus through these small incisions. This is in contrast to an abdominal surgery where the surgeon makes a much larger incision and removes the uterus virtually intact. Although both laparoscopic and abdominal hysterectomies require general anesthesia, the length of recovery for laparoscopic hysterectomies is shorter and easier than abdominal hysterectomies.

During a laparoscopic hysterectomy, surgeons may gain insight into medical conditions not yet diagnosed by a woman’s doctor. Learning more about these conditions may also help further define a previous diagnosis made that precipitated a hysterectomy. Problems a hysterectomy may spot include:

• Tumors, tissue masses or ovarian cysts not detected in ultrasounds or other imaging scans
• Confirmation of endometriosis (symptoms can mimic other pelvic diseases)
• Signs of pelvic inflammatory disease
• Fallopian tube obstructions
• Observations regarding the extent of cervical, uterine or ovarian cancer

Tissue biopsies can be taken during laparoscopic surgery if necessary. This procedure is also used to eliminate endometriosis scar tissue, repair uterine or fallopian tube damage, remove ectopic pregnancies, and perform tubal ligations.

Why Do Women Have Hysterectomies After a Pregnancy?

In some cases, women who have suffered from heavy bleeding, painful periods, or other problems before getting pregnant may elect to have a hysterectomy after giving birth. Additionally, infertility is often an issue with women experiencing abnormal periods, fibroids, or endometriosis. Viero Fertility Clinic in Melbourne offers fertility testing and assisted reproductive technologies such as IVF and IUI for women who are unable to get pregnant.

Many women visiting our clinic have had one or more miscarriages due to fibroids, hormonal instability, or adenomyosis. Viero Fertility Clinic provides an outpatient procedure called a hysterosalpingogram (HSG) evaluation that ensures the uterine cavity is structurally capable of carrying a child. An HSG can also determine if the fallopian tubes are not obstructed and if fibroids or polyps may be the cause of miscarriage.

If you are considering a hysterectomy but would like to have fertility testing done or try ART to get pregnant, please contact our clinic today to schedule an appointment with our fertility doctor.