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HYSTERECTOMY- A DECISION NOT TO BE MADE LIGHTLY
A hysterectomy is an operation to remove the uterus or womb from a woman.
Having a hysterectomy is major surgery. Deciding to have a hysterectomy should only be made after being given adequate information about why, how and what the consequences may be. It is important that each woman thinks about how she feels about losing her uterus or womb.
A total hysterectomy means that the whole of the uterus including the body of the uterus and the cervix are removed. A total hysterectomy does not mean to remove the ovaries. Occasionally a subtotal hysterectomy is performed where the cervix is retained because the woman's cervix is very sensitive to touch and plays a role in her sexual arousal.
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Why is a hysterectomy performed?
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Cancer of the cervix, uterus, ovaries or tubes*
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Uncontrollable continuous uterine bleeding - rare*
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Heavy or persistent bleeding - various causes, some included in list
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Severe chronic pelvic pain - various causes included in list
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Endometriosis - severe
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Pelvic Inflammatory disease ie chronic infections of tubes & pelvis
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Fibroids particularly if there are multiple (many) fibroids, the uterus is large or fibroids are growing rapidly
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Adenomyosis - endometriosis in uterine muscle
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Uterine prolapse
*emergency must do at once |
There are three ways a hysterectomy may be performed:
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Abdominal technique with an incision either across the lower abdomen or an up and down midline incision
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Vaginal - where the procedure is performed completely through the vagina
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Laparoscopic or laparoscopic and vaginal - performed through key-hole surgery either completely or in combination with the vaginal approach
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THE FEMALE REPRODUCTIVE SYSTEM
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The decision as to which method of hysterectomy is most appropriate depends on:
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The reason for hysterectomy
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The facilities/equipment available in the local/regional hospital
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The skill in laparoscopic hysterectomy or your local hospital may not have the required laparoscopic equipment
If a woman is unsure of whether to have a hysterectomy or not she should seek a second opinion. Sometimes it is appropriate to take time over making the decision except when there is cancer or uncontrollable life-threatening bleeding. For most women hysterectomy relieves their symptoms and improves their quality of life. Often women say, "I wish I had done this years ago". However, a small number of women take time to recover following hysterectomy.
This may be for many reasons. Some of which may be due to:
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Complications following the operation such as infection or bleeding prolonging recovery
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Adjusting to the loss of her uterus and end of her ability to have a child particularly if childless
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Concern about her femininity and sexuality particularly if the ovaries were also removed
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Becoming menopausal if the ovaries were also removed before the periods had stopped
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Feeling unhappy about how she was treated by her doctor and/or the hospital staff
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If a woman is struggling with her feelings and well being she should seek help from a qualified practitioner.
DECIDING TO HAVE A HYSTERECTOMY
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Questions to have answered by your doctor: |
Why is your hysterectomy necessary? |
What is/are the reason/s to do it? |
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How will it be done? |
What type of hysterectomy is recommended? |
Is it necessary to take out the ovaries as well? |
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How long will the operation take and how long will I be in hospital? |
What are the potential complications of this operation? |
Are there tests needed to be performed before the operation including: will a blood transfusion be necessary? |
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How long after the operation do I need to recover and how long will I need to be off work? |
What can I expect postoperatively? |
Are there any other options instead of hysterectomy? |
Conclusions
Hysterectomy has become a much safer operation because of modern anaesthesia and analgesia and improved techniques. Hysterectomy is still a necessary operation for the indications outlined. Each woman should find out as much as she can about hysterectomy before making a decision and she should also explore what having a hysterectomy means to her.
YOUNG AND EXPERIENCING MENOPAUSE?
In August 2002 The Jean Hailes Foundation ran a seminar on early menopause that led to an overwhelming response from the public.
More information about early menopause can be found by at www.earlymenopause.org.a
Breakfast Partnership - A Winner For Women's Health
Eighteen months ago The Jean Hailes Foundation formed an exciting joint venture with leading food company Uncle Tobys, that saw the development of a breakfast cereal specifically targeting the nutritional requirements of women 40+, called HealthwiseTM.
According to Janet Michelmore, Director of The Jean Hailes Foundation, the creation of HealthwiseTM for women 40+ was a logical result of the shared vision between The Jean Hailes Foundation and Uncle Tobys.
The link between exercise and diet, especially for women as they age, is extremely important. "Specifically, more emphasis needs to be placed on a diet low in saturated fat, with more breads, cereals, fruits and vegetables and more calcium-rich foods, as well as maintaining a healthy body weight by balancing food intake and regular physical activity", says Associate Professor Susan Davis, who is Research Director at The Jean Hailes Foundation.
"Our partnership with Uncle Tobys has proven to be a winner with women 40+ who know they are eating a breakfast cereal put together using scientific nutritional input from our researchers", says Janet Michelmore. "The way forward in the future for The Jean Hailes Foundation is to work with leading successful, innovative businesses who share a commitment for improving women's health ".
The Jean Hailes Foundation magazine is designed to be informative and educational. It is not intended that The Jean Hailes Foundation magazine provide specific medical advice or replace advice from your health professional. The Jean Hailes Foundation does not accept any liability to any person for the information or advice (or the use of information or advice) which is provided in this magazine or incorporated into it by reference. Information is provided on the basis that all persons reading the magazine undertake responsibility for assessing the relevance and accuracy of its content.
© The Jean Hailes Foundation. Apart from fair dealing for the purposes of private study, research, criticism or review, as permitted under copyright legislation, no part may be reproduced or reused for any commercial purposes.
Note: This article is an archive. Whilst the Jean Hailes Foundation for Women’s Health has made every effort to ensure this information was accurate at the time of publication, the article content has not been updated since the date listed below.
Content updated June, 2002
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