Hysterectomy

Having a hysterectomy (the removal of all or part of the reproductive organs) is a decision that no woman takes lightly.

Dr Ljiljana understands that this type of surgery is a big step to take in a woman’s life, therefore if a hysterectomy is recommended due to a painful condition or a diagnosis of a serious illness she is there to guide you through the process. Your concerns are important to her, so she will answer any questions you have and help you to feel comfortable.

There are a number of reasons why a hysterectomy might be recommended, they include the following conditions:

• Cancer of the ovaries, uterus, cervix or fallopian tubes.
• Continuous, uncontrollable bleeding from the uterus.
• Endometriosis (uterine cells are found on surrounding organs and tissue, causing severe pain and heavy bleeding).
• Persistent heavy bleeding.
• Pelvic Inflammatory Disease (often caused by infections in the reproductive organs or pelvic area).
• Chronic severe pelvic pain caused by endometriosis, adenomyosis or infection.
• Adenomyosis (a condition where uterine cells grow in the muscle layer of the uterus, causing painful heavy bleeding).
• Fibroids that are increasing in number or size and cause pain.

If you decide to go ahead with a hysterectomy, you will undergo one of the following surgeries:

• Vaginal Hysterectomy

This surgery involves making an incision in the upper part of the vagina and the uterus is removed through the incision. For non-cancerous conditions, this is often the preferred method due to shorter recovery times, less pain and no visible scarring.

• Laparoscopic Hysterectomy

A laparoscopic hysterectomy is often performed for fibroids, painful or heavy periods, severe pelvic pain, or as part of a cancer treatment. This procedure involves making up to four small incisions in the abdomen. A laparoscope (a thin tube with a light and camera) inserted into one of the incisions enables the surgeon to see the reproductive organs on a screen, while the other incisions enable access for surgical instruments to perform the procedure. Dr Ljiljana is experienced in laparoscopic procedures and can advise if this is the best option for you.

• Abdominal Hysterectomy

This is a more extensive surgery that involves opening the abdomen horizontally across the pubic hair line. Occasionally a vertical incision is also required. This type of surgery is usually performed for extensive fibroids, endometriosis or cancer.

There are several types of hysterectomy surgery and the type of operation you have will depend on your condition.

The different types of hysterectomy surgery include:

• Hysterectomy with Ovarian Conservation

Sometimes known as a total hysterectomy, this involves the removal of the uterus, fallopian tubes and the cervix, while the ovaries remain intact. This option is often used to treat bleeding disorders and is one of the most common hysterectomy surgeries.

• Partial or Sub-total Hysterectomy

This involves the removal of the upper two-thirds of the uterus along with the fallopian tubes, while the cervix remains intact. This surgery is less common in Australia than other hysterectomy surgeries.

• Hysterectomy with Oophorectomy

In this surgery, one or both ovaries are removed along with the uterus. It is often performed in cases of ovarian cancer or where the risk of ovarian cancer is considered high enough to justify the possible complications and side effects of the surgery. This treatment is likely to cause early menopause in pre-menopausal women.

• Radical or Wertheim’s Hysterectomy

A radical hysterectomy involves the removal of the uterus, fallopian tubes, ovaries, surrounding lymph nodes and the upper section of the vagina. The most common reason for this type of surgery is cancer of the reproductive organs.

The length of time for the surgery varies with the type of surgery and the condition. However, if all goes to plan, an abdominal or vaginal procedure should take 1 – 1 1/2 hours, and a laparoscopic procedure may last up to 1 hour 45 minutes.

After surgery you can expect:

• Pain around the surgery site (you will be given pain relief medication while you are in hospital).
• Wind pain for several days afterwards.
• A hospital stay of 2-4 days.
• Staff will encourage you to start taking short walks while you are in hospital.
• You will have a catheter for the first 24 hours, unless you suffered bladder trauma during surgery and it needs to stay in longer.
• You need to allow several weeks’ recovery time after your surgery. Dr Ljiljana will advise you on a post-surgery recovery plan.

No surgery is without risk and complications can occur after a hysterectomy. Many are rare but should be considered when you are planning for surgery. Some of the potential complications include:

• An allergic reaction to the anaesthetic.
• Problems with urination.
• Nausea or vomiting caused by the anaesthetic or medication.
• Internal haemorrhage (bleeding).
• Internal scar tissue.
• Haematoma beneath the stitches (an abnormal bulge caused by a build-up of blood).
• Fistula (an abnormal space between internal organs or structures).
• Injury to the bladder, ureters or the bowel.
• Continuous pelvic pain.
• Unresolved feelings of grief or loss.

Dr Ljiljana is committed to achieving the best outcome for your condition, so you can focus on your recovery with the knowledge that you will be looked after.

If you require further information about having a hysterectomy, and would like to book an appointment, please contact us over the phone or use the contact form in the Contact Us section of our website. Dr Ljiljana, can answer your questions and discuss any concerns you might have.