Hysterectomy Procedure in South Africa
Hysterectomy is surgical procedure (operation) performed to remove the uterus (or womb).
Hysterectomy is very common surgery around the world and about one in five women will have a hysterectomy by the age of 55. The number of hysterectomies are going down because of new treatments available to manage conditions that previously could only be cured with a hysterectomy.
What are the conditions that may require hysterectomy?
- Cancer of the womb or ovaries or cervix will almost certainly need a hysterectomy
- Abnormal uterine bleeding such as irregular bleeding or very heavy menstrual bleeding that we fail to cure with other methods such as tablets, ablation.
- Adenomyosis or endometriosis of the womb when the cells from the lining of the womb (endometrium) grow inside of the tummy and cause enormous pains during the menstrual periods as well as very heavy bleeding
- Uterine fibroids which are large in size (more than 12 weeks) or fibroids which cause pain and bleeding. Fibroids are growth usually non-cancerous on the uterus. They are very common and in majority of women do not cause any symptoms, but when women start experiencing pain or bleeding I will suggest treatment. Usually I can remove fibroids and the hysterectomy is unnecessary, but women who do not plan to have more children and have very large fibroids hysterectomy may be the safest option. After assessing each case I will discuss all the options available and recommend the most appropriate one in my opinion.
How long in the hospital stay after hysterectomy?
You usually come to the hospital on the day of surgery and go home following day after laparoscopic and vaginal hysterectomy and in 2-3 days after abdominal hysterectomy
How long is the recovery after hysterectomy?
It usually takes up to 6 weeks to fully recover from surgery, however, the recovery is much quicker after laparoscopic and vaginal hysterectomy. Women usually experience some pain, which is controlled with tablets. Constipation is common. Some women have difficulties passing urine, which is usually temporary.
What is important during recovery period?
You should rest initially and increase your physical activity gradually. You can walk the following day after hysterectomy, but should avoid heavy lifting and heavy physical activity for 4-6 weeks. You should also avoid having sex and inserting anything in the vagina for 6 weeks after hysterectomy.
Do women develop menopause after having hysterectomy?
No, hysterectomy does not lead to menopause unless ovaries are removed
Does sexual satisfaction change following hysterectomy?
Women do not need uterus to experience orgasm so sexual satisfaction generally does not change. Some women may find more pleasure in sex because their symptoms of pain or bleeding are gone, others may develop problems because of vaginal dryness especially if the ovaries are removed. Whatever the issue is, I will discuss it with you prior to the operation and we can manage it afterwards.
How is a hysterectomy done?
There are three approaches to performing hysterectomy such as abdominal (Caesarean type and up and down cut on the tummy), laparoscopic (or keyhole surgery where there will be one 1 cm cut in belly button and three 0.5 cm cuts on the sides of tummy) or vaginal (when there is no cut on the tummy at all and the whole operation is done through the vagina). The choice of hysterectomy (abdominal, laparoscopic or vaginal) depends on actual problem, size of the uterus, ability to move uterus, other conditions that woman may have, her medical condition. I can only advise on the type of hysterectomy that is possible in your case after examining you and reviewing all the relevant tests results. Laparoscopic and vaginal hysterectomy do have advantages of quicker recovery.
Are the ovaries removed during hysterectomy?
No, usually ovaries are not removed unless they have abnormalities. Nowadays, removing the tubes during hysterectomy is a common practice as it prevents ovarian cancer in the future and it does not have any negative implications
What are the long-term consequences of hysterectomy?
After hysterectomy you will not have periods and you will not be able to fall pregnant or carry the pregnancy
What are the alternatives to hysterectomy?
There are number of alternatives to hysterectomy depending on what the reason for hysterectomy is. For example, abnormal uterine bleeding and adenomyosis can be treated with hormonal tablets (pill or other hormonal tablets), or tablets that decrease blood flow or endometrial ablation (destruction of the lining of the womb with high temperature).
Uterine fibroids can also be treated with all the above and embolization procedure.
Cancer generally requires hysterectomy with minimal alternatives.
What are the risks of hysterectomy?
As any surgical procedure hysterectomy can be complicated by infection, fever, bleeding during and after surgery, injury to bladder, ureter, bowel and large vessels, blood clots in legs and lungs, breathing and heart problems related to anaesthesia and even death. Your individual risk of hysterectomy depends on the reason for hysterectomy, your other medical problems, your previous surgery, your weight.
What are the measures to prevent the complications of hysterectomy?
Every woman undergoing hysterectomy receives antibiotic just the cut is made to prevent infection, has compression stocking and calf compressors as well as a medication to thin the blood after surgery to prevent clots. Women are monitored closely during and after surgery. Any individual risk is discussed before the surgery and dealt appropriately.