More and more women in the United States
are seeking out hysterectomy alternatives each
year. For decades women have been subjected to
hysterectomy on the advice of their doctors
without fully educating themselves on their
options. Studies show that over eight hundred and
twenty four thousand women will have a
hysterectomy in the year 2005. This makes
hysterectomy the most common major surgery
performed in the United States next to caesarian
section operations.
The sad truth of the
matter is that the uterus and pelvic organs are
often considered by physicians to be expendable
once a woman's childbearing years are over. The
pelvic organs are rarely studied outside the realm
of reproduction. Most doctors believe that once a
woman has had her children, the uterus and ovaries
are then useless and can be
removed.
Hysterectomies are usually
performed when a woman develops an abnormal
condition such as endometriosis, fibroid tumors,
ovarian cysts, or cervical dysplasia (abnormal
growth).. Most medical professionals believe that
the best way to rid a woman of these problems is
to perform a partial or total hysterectomy. Many
medical professionals have not even been trained
or educated on the various procedures that can now
serve as perfectly suitable Hysterectomy
Alternatives.
Modern Medicine and Hysterectomy
Alternatives
A hysterectomy is the complete or partial
removal of the uterus and other pelvic organs. A
complete hysterectomy is when the entire uterus as
well as fallopian tubes and ovaries are removed. A
partial hysterectomy is described as the removal
of the body of the Uterus while conserving the
cervix as well as the Ovaries and fallopian tubes.
Most doctors suggest total hysterectomies because
they can then be assured that cancer of the
Ovaries or cervix will not develop.
The
problem is that removal of the Ovaries or female
castration is terribly destructive to a women.
Surgical menopause is abrupt and causes severe
symptoms of estrogen deprivation that even
replacement does not satisfy a women’s hormonal
requirements. The worst news is that ovarian
cancer has been described even after dilateral
oophorectomy.
Many doctors do not
understand why a woman who has pelvic
abnormalities would want to keep her Uterus. They
often feel that women are being sentimental or
superstitious. They do not take into account the
tremendous after effects of a hysterectomy
including immediate menopause and severe bone
density loss. The uterus, fallopian tubes and
ovaries help to regulate hormones throughout a
woman's body. Removal of these organs can result
in complications sometimes more severe than the
reason for the hysterectomy.
This is why it
is important for women to learn all they can about
hysterectomy alternatives.
The
No-Hysterectomy Option
The “No
Hysterectomy Option” empowers women to educate
themselves concerning their reproductive problems,
learn the alternatives and insist on being part of
their health care decisions.
There are
several treatment options now available as
hysterectomy alternatives. More and more surgeons
are being trained for laparoscopic conservative
surgery.
Fibroid
Tumors
Fibroid tumors are benign tumors that grow
on or within the uterus. Fibroids are the most
common indication for hysterectomy in the United
States. Studies show that twenty to fifty percent
of women have fibroids.
Fibroids are made
from firm solid fibrous tissue growing in whorls
and surrounded by a capsule that makes removal of
the tumors fairly routine until the tumors have
grown very large. Removal can become difficult if
the tumors degenerate or are very
vascular.
Most Fibroid Tumors are detected
by pelvic examination, and confirmed by
ultrasound. Fibroids often grow to the size of a
grapefruit while some grow to be only a few
centimeters in diameter. Some small fibroids do
not cause any damage to the uterus or surrounding
organs, however it all depends on location and
numbers of the fibroids.
Causes and
Symptoms of Fibroid Tumors: Uterine fibroids are
caused by a mutation of the gene that controls
smooth muscle development of the uterus. Symptoms
of fibroid tumors vary depending on where in the
uterus they are growing. The most painful symptoms
of fibroids occur when they are growing beneath
the lining of the uterus. These fibroids can cause
excessive bleeding, anemia and extreme pain. Most
fibroids can be removed without the need for a
hysterectomy.
Most women undergo surgery
for fibroid tumors because of the pain and
bleeding they experience. Many women panic when
fibroids cause them to bleed abnormally. This fear
and panic is often what leads them accept
hysterectomy as a solution.
Fibroid tumors
can also cause abdominal pain when they begin to
degenerate within the uterus. This usually happens
when fibroids grow so large that they begin to
lose their blood supply. The loss of blood flow to
the center of the fibroids translates itself as
pain Degenerating Uterine Myomas can cause severe
inflammation and precipitate emergency major
surgery. Uterine Fibroid Tumors are extremely
common among women in the United States. Studies
show that many women who have fibroid tumors in
their uterus are not even aware of it. Fibroid
tumors grow in and around various areas of the
uterus. They vary in shape and size. Usually
complications arise such as bleeding and pelvic
pain due to fibroid tumors that grow underneath
the lining of the uterus.
Most women do not
experience any symptoms of fibroid tumors unless
they have grown extremely large. If a woman has a
large uterine fibroid tumor then her abdomen may
begin to have a pregnant appearance. Tumors that
grow inside the muscle wall of the uterus tend to
cause pain and vaginal bleeding. Many women who
experience abnormally heavy menstrual flow and
very bad menstrual cramps may also have fibroid
tumors growing under the lining of their
uterus.
Many women panic when they hear that they
have Uterine Fibroid Tumors. Many women associate
the word tumor with cancer, however the majority
of fibroid tumors are not cancerous. The chance of
a fibroid tumor being cancerous is less than one
in a thousand. Most fibroid tumors can be left
alone to be monitored every few months. Many of
them shrink or disappear on their
own.
Uterine Fibroid Tumors and
Pregnancy
Fibroids do have a tendency to grow larger
during pregnancy due to the extra hormones being
produced. Sometimes degenerating fibroids can
cause the uterus to contract, resulting in early
childbirth. The complications that a woman may
experience during pregnancy depend on the size of
the tumor and where it is located in the uterus.
Many women have been known to carry babies to term
with no complications at all, however if the
fibroids impact on the cavity of the Uterus they
can obstruct the birth, negatively affect the
placenta and often lead to prematurity.
Fibroid Tumor
Treatments
Myomectomy
The
gold standard for removing Uterine fibroids is
abdominal myomectomy. Modern Gynecologists have
realized that performing minimally invasive
surgery such as laparoscopic myomectomy benefits
their patients and is more than worth the
physician’s extra efforts .Minimally invasive
surgery allows more rapid healing ,less blood loss
and allows patents to return to their routines
much quicker and therefore promotes well being
.
Myolysis
Myolysis is a fairly
new surgical procedure used to shrink uterine
fibroid tumors. The procedure coagulates the blood
vessels serving the tumor cutting off its blood
supply. The procedure is performed using specially
designed 5 cm bipolar needles that are placed into
the uterus during a laparoscopic surgery. The
procedure is designed to treat moderate sized
myomas less than 10 cm. Pre treatment is
recommended for ten to twelve weeks using a GnRh
agonist to preshrink the tumor. These monthly
injections cause the myomas to shrink by reducing
estrogen levels. Once the procedure is performed
it is expected that tumors will be permanently
reduced in size by more that fifty percent.
Side Effects of
Myolysis
Myolysis has very little
side effects on the body, however most doctors
will not perform the surgery on women who wish to
become pregnant later on. There have been
incidences of uterine rupture when women have
attempted to carry babies to term after the
operation. Although the procedure does not affect
women's fertility, pregnancy is not advisable
after the operation.Uterine rupture has also
occurred after myomectomy but it is rare.
Myomectomy is still the gold standard for removal
of fibroids in women desiring
pregnancy.
This operation is one of the
many surgical procedures that serve as
alternatives to partial or total hysterectomies.
The operation is particularly successful on women
who are past their childbearing years.
Preservation of the uterus and ovaries can prevent
multiple complications. This operation is ideal
for women who have already had their children, but
are not ready to lose their pelvic
organs.
Uterine Artery
Embolization
Uterine Artery
Embolization is a technique performed by
interventional Radiologists. A puncture is made in
the Femoral Artery near the groin and a catheter
is placed and threaded into the Aorta and then
back down into the Uterine Artery. Millions of
microscopic plastic particles are placed into the
Artery to cause blockage and thereby subsequent
fibroid death. The problem is that if you Embolize a very large fibroid, the
tissue death causes necroses of the muscle and
severe pain for as long as a month. In addition
there are a myriad of potential complications,
including improper placement of the embolization
catheter. Lastly about 10% of patients have a
communication between the Uteine Artery and the
Ovary. So post procedure menopause is a real
possibility.
Abnormal Uterine
Bleeding
The commonest cause of
Hysterectomy is abnormal uterine bleeding.
However, every women over 40 years of age will
have episodes of abnormal Uterine bleeding. This
abnormality is the result of less than normal
Ovarian function. As a women approaches menopause
, the lack of regular ovulatory function results
in irregular shedding of the Endometrium. If the
examining physician finds a concomitant Uterine
fibroid, then Hysterectomy is the most frequently
called for solution.
The proper approach to
the women with abnormal Uterine bleeding is to
perform Endometrial biopsy as well as Ultrasound
examination to establish the proper diagnosis.
Often the hormonal irregularity can be resolved
with a short course of progesterone.
If
bleeding continues, then Endometrial Ablation can
be performed. This is a procedure in which the
lining of the Uterus is destroyed. There are
various techniques to accomplish this effect.
Ranging from transcervical Endometrial resection
with Roller Ball ablation to the newer techniques,
including Thermal balloon, Microwave, Cryo,
Bipolar technology and finally Hydrothermal
Ablation. Whichever technique the physician
chooses is not as important as his dedication to
performing Hysteroscopic evaluation and attempting
to solve the patient’s problems without resorting
to the alleged FINAL SOLUTION of all women’s
problems ,namely HYSTERECTOMY.
When
abnormal bleeding is associated with Uterine
Fibroids then I often recommend the addition of
Myolysis . Literature review has shown the
efficacy of combining both procedures . These
procedures are reserved for those women who are
post reproductive with Fibroids of 10 cm or less
and a desire to preserve their Uterus.
Pelvic Pain. Many women suffer
from a condition called chronic pelvic pain where
there is no visible reason for a woman to be
experiencing pain.
Doctors used to tell
women that a lot of this pain was psychosomatic or
in their heads. This is not widely believed to be
true anymore. Chronic pain ofthe pelvic organs has
been linked to stress and a tension filled
lifestyle - just like someone may get a neck ache
due to tension. Studies have also shown that women
who have experienced sexual traumas may experience
pelvic pain. More commonly Endometriosis, Uterine
Fibroids and the diagnosis of Interstitial
Cystitis is a cause of persistant pain.
HYSTEROSCOPY.
This technique allows us to look inside the
Uterus by placing a scope into the vagina and
minimally dilating the cervix. The scope is 3mm in
diameter and saline is used to distend the uterus.
we can see tumors, polyps and abnormal tissue. In
order to accurately diagnose the causes of uterine
bleeding hysteroscopy must be performed. Other
techniques such as fluid ultrasonography are
helpful but not as acurate.
Operative
Hysteroscopy
This technique is an advanced form
of hysteroscopy. Using a specialized instrument
called a resctoscope and an electrified loop , we
can resect ( remove) fibroid tumors and also
ablate the lining of the uterus(endometrium).
Resectiong the lining of the endometrium is akin
to digging up a lawn and actually cutting away the
roots of the grass. If the roots are destroyed
completely new grass will not grow. We try to do
the same thing with the resectoscope. That is
destroy the basal lining of the endometrium.
Similarly small fibroid tumors can be removed ina
similar fashion. Combining this technique with
Myolysis allows us to treat many fibroid
conditions that cause heavy bleeding in post
reproductive women who WISH TO PRESERVE THEIR
UTERUS.
Interstitial
Cystitis
This cause of Interstitial Cystitis is not
clear but the condition is often associated with
Endometriosis. The symptoms may be urinary
frequency and urgency but occasionally is limited
to lower abdominal pain. The diagnosis may be made
by history but is confirmed by instillation of a
Potassium Chloride solution which causes no
symptoms in the normal bladder but with ICS the
lining of the bladder is disrupted and severe
discomfort occurs during instillation of Potassium
Chloride. The treatment/solution is dietary as
well as
pharmacological.
Lower Abdominal Pain
Lower abdominal pain can be a symptom of
various different pelvic organ dysfunction. Many
doctors misdiagnose women who complain of
abdominal pain since the symptom can mimic other
disorders having to do with the bowels, digestive
tract, and stomach. This misdiagnosis is
common.
Lower Abdominal Pain can be caused
by a number of conditions in the pelvic cavity
such as fibroid tumors, ovarian cysts and
endometriosis. The pain usually occurs when a
lesion comes in contact with another organ causing
inflammation. Many women who complain of lower
abdominal pain are diagnosed with irritable bowel
syndrome or acid reflux disease. This is because
endometrial lesions can attach to the intestine
causing abdominal pain.
Diagnosing Lower Abdominal
Pain
The most common causes of abdominal pain in
reproductive women include Fibroid
tumors,Endometriosis, Ovarian cysts, Irritable
Bowel syndrome and interstitial Cystitis.Women who
experience chronic abdominal pain could be
suffering from endometriosis. Endometriosis is
often misdiagnosed as irritable bowel syndrome.
This is because the lesions caused by
endometriosis often involve the intestine causing
extreme pain.
Endometriosis is a condition
in which tissue which normally is found inside the
uterus begins to grow in areas outside of the
uterus. Often times endometrial tissue is extruded
out the fallopian tubes during menstruation and
attaches to the back of the uterus. This tissue
responds to hormonal stimulation and during
menstruation weeps and bleeds and causes the
severe Abdominal Pain that many women with
endometriosis experience.
Most women with
endometriosis are told that the only way to get
rid of their abdominal pain and pelvic pain is to
become pregnant or have a hysterectomy.
Unfortunately neither of these solutions are
acceptable to many women. Many women experience
infertility and for most others the pain returns
after pregnancy. Studies also show that almost one
quarter of women who undergo hysterectomy for pain
relief continue to experience pain after
hysterectomy. Endometriosis seems to be an
increasingly common condition among women in the
United States.
Endometrial tissue is the
tissue that grows on the inside of the uterus and
forms the lining of the uterus. If a woman does
not become pregnant, the endometrial lining is
shed each month during her period. Endometriosis
is endometrial tissue growing in other areas of
the uterus and sometimes outside of the
uterus.
Endometrial tissue can grow in or
on the ovaries, the sidewalls of the pelvis and
the bowels. This extra tissue cannot be shed
during a woman's period. Endometrial lesions
inflame various organs in and around the pelvic
cavity causing pelvic pain and abnormal bleeding.
Symptoms of
Endometriosis
The commonest
symptom of Endometriosis is menstrual pain and
cramping. Many women also experience irregular
periods, infertility, stomach pain and upset, and
extremely painful sexual intercourse.
Endometriosis is also often accompanied by fibroid
tumors in the uterus.
Endometrial tissue
is often first discovered during a laparoscopy for
pelvic pain and infertility. The problem with
endometriosis is that it is extremely difficult to
diagnose.
Many women in the United States
are misdiagnosed with everything from irritable
bowel syndrome to stress. Many doctors just chalk
up a woman's complaints of pelvic pain to
premenstrual syndrome and menstrual cramps. The
fact that many women live for years with no
symptoms whatsoever of the dysfunction, makes
endometriosis even harder to detect. Many doctors
have been known to tell women that getting
pregnant is a good way to rid herself of the
dysfunction, however, there is no medical evidence
to back up this theory of different symptoms
depending on where the endometrial tissue is
growing. Many women experience
infertility.
The best method for diagnosis
is by an experienced gynecologist who can perform
a pelvic examination. Since Endometriosis is often
found in the culdesac, the space between the
Uterus and the Rectum, performing a combined
rectal and vaginal examination is crucial to the
diagnosis. Endometriosis symptoms tend to vary
depending on where in the body the endometrial
tissue is growing. Endometriosis is a condition
where the tissue that normally forms the lining of
the uterus begins to grow in other areas of the
pelvic cavity. Since this tissue cannot be shed
during menstruation, it can form lesions and
abrasions on various pelvic and reproductive
organs. These lesions can rub against surrounding
organs causing a variety of problems and
complications in the pelvic
cavity.
Endometriosis Symptoms often
include, abnormally heavy menstrual flow, pelvic
pain, back pain, stomach upset and painful
ovulation. Endometriosis symptoms often mimic
symptoms of irritable bowel syndrome, uterine
fibroids and menstrual cramps. Since endometriosis
is extremely hard to detect many women with
symptoms of the condition are misdiagnosed by
doctors.
Other Endometriosis
Symptoms
Endometriosis is a significant cause of
infertility. This happens when the endometrial
tissue grows in or around the ovaries. Often the
ovaries can become inflamed and develop cysts,
tumors and lesions. Once ovulation ceases, so does
regular menstruation. For this reason, irregular
periods often is accompanied by
endometriosis.
While the cause of endometriosis
is not clear, some experts believe that
endometriosis is caused by retrograde menstrual
blood. This is when the tissue that is shed during
menstruation is somehow forced back into the
pelvic cavity because of spasm in the lower
portions of the
uterus.
Endometriosis
Treatment
There are various forms
of endometriosis treatment available for women.
One of the most common forms of treatment for
endometriosis is hormone therapy. Physicians
prescribe synthetic progestin, birth control
pills, and Danazol or GnRH agonists. These
hormones will make a woman's body temporarily
menopausal. This will cause her uterus to stop
producing endometrial tissue, which will also stop
the growth of tissue outside the uterus. While
hormone therapy helps, it is not one hundred
percent effective.
Many women's bodies have
a low tolerance for synthetic hormones. Synthetic
hormones such as progestin can cause uncomfortable
side effects such as mood swings, nausea, swelling
and even blood clots have been reported. Women who
have experienced complications taking the birth
control pill, for example are not urged to try
hormone therapy as Endometriosis Treatment. Also,
endometriosis is likely to return once a woman
stops taking the hormones. Unfortunately birth
control pills are not very effective in
controlling severe endometriosis, but may help for
young women with severe menstrual
cramps.
New Surgical Endometriosis
Treatment
Hysterectomy is still widely used as a
treatment for endometriosis. Many doctors feel
that removal of the uterus is the most efficient
way of ridding a woman of endometriosis. This does
not represent the modern approach to treating
endometriosis However there are new surgical
procedures that remove endometrial tissue while
leaving the uterus in tact. This procedure is
called pelvicscopic surgery and when done
correctly it has a ninety percent success rate.
Many gynecological surgeons are becoming very
skilled at pelvicscopic or advanced laparoscopic
surgery and can remove endometrial lesions without
any damage to the surrounding
organs.
Ovarian
Tumor
The word tumor comes from
the greek word for swelling. An ovarian tumor is a
solid or cystic swelling that appears in, on or
around the ovaries. Most ovarian tumors are
harmless. Studies show that ninety-eight percent
of ovarian tumors that develop in women before the
age of forty-five are benign. Because of the shift
in hormone balance after menopause, women are more
likely to develop ovarian tumors during or after
menopause.
Symptoms of an Ovarian
Tumor
Most ovarian tumors are CYSTS,and most
ovarian tumors do not have any symptoms at all.
However if a tumor has grown very large, has
twisted, ruptured or broken apart - painful
symptoms may occur. These painful symptoms can
include abnormal vaginal bleeding, menstrual
cramps, general pelvic ache, sharp pelvic pain and
painful sexual intercourse.
Ovarian Mass
An
ovarian mass is any type of ovarian cyst or tumor
that is either benign or malignant. Most ovarian
masses are not harmful since they often consist of
functional ovarian cysts. Often an ovarian mass
can form when many ovarian cysts are clustered
together in close proximity.
The fear of an
Ovarian Mass being cancerous is what causes many
women to have their ovaries removed at the first
sign of an ovarian cyst or mass. This is not
particularly necessary since only one in every
eighty women in the United States are affected by
ovarian cancer. Most doctors examine ovarian
masses through the use of an ultrasound or a
laparoscopic procedure
Symptoms of
an Ovarian Mass
Some ovarian masses can cause pain and
discomfort and in some cases they can be dangerous
to the ovaries if the grow too big. If an ovarian
mass does not shrink or go away within a few
months, it is a good idea to have it removed. This
can be accomplished by laparoscopic
surgery..
Many women become scared when they are told
that they have an ovarian tumor. The fear that
they feel often makes them rush to make decisions
that they normally would not make.
Doctors
often suggest hysterectomies and the removal of
ovaries for women with ovarian tumors. These
procedures are not usually necessary. Laparoscopic
removal can identify the nature of the cyst.
Ovarian
Pain
Ovarian pain can be caused by
a number of different factors, however ovarian
cysts are often the main reasons for women to
suffer from pain in the ovaries. There are several
reasons why ovarian cysts can cause pain in the
ovaries. Some follicular cysts begin to cause
problems when they do not expel their eggs
properly. These follicular cysts can then grow as
large as eight centimeters in diameter. Once an
ovarian cyst gets this big it can be very
painful.
Other ovarian cysts that can cause Ovarian
Pain are called luteal cysts. These are cysts that
form after an egg has been released from its
follicle. During this process, sometimes a small
amount of blood collects in the ovary. This small
puddle of blood can form a cyst after time. Luteal
cysts become painful when they twist, burst or
bleed into the ovaries or pelvic cavity. This pain
can be dull and persistent or sharp and
inconsistent. Bleeding ovarian cysts usually go
away naturally.
Other Causes of
Ovarian Pain
Ovarian pain can also occur if the ovaries
have become swollen for some reason. Usually when
a woman has swollen ovaries, she experiences pain
during ovulation. This is because of the extra
effort it takes for the ovaries to release their
eggs. Cysts, hormonal imbalance, raised body
temperature and an increase in sexual activity can
cause the ovaries to swell. Sometimes women's
ovaries become extra sensitive for no apparent
reason. When ovaries are overly sensitive,
ovulation can often be accompanied by
pain.
If you are experiencing chronic pain
in your ovaries, it's a good idea to ask your
gynecologist for an ultrasound to rule out an
enlarged Ovary. There are several treatments to
help alleviate pain in the ovaries. Many doctors
recommend diet change and taking multivitamin
tablets. For those with chronic pain in their
ovaries or other pelvic organs there are surgical
procedure that can remove cysts, tumors and
endometrial tissue.
Ovarian
Cysts
Another major reason for a woman to be
advised a hysterectomy is the presence of a
significant ovarian cyst greater than 5 cm. There
are various forms of ovarian cysts many of which
are benign or harmless. In fact the ovaries are
designed to produce cysts each month during the
process of ovulation. Most women's ovaries always
contain small cysts that are less than three
centimeters in diameter. When Ovarian cysts become
complex and grow more than 5cm physicians become
concerned about the possibility of cancer.
Hysterectomy is not necessary if the cyst is
benign. The nature of the cyst can be determined
at surgery by frozen section pathological
examination. Most often the laparoscopic approach
is the preferable approach for cyst
removal.
When a woman is ovulating, the
ovaries create small cysts filled with a
nourishing fluid in which the eggs develop. When
an egg is released, these cysts usually burst. The
tissue inside the pelvic cavity then absorbs the
fluids inside them. After the egg is released
another small, more solid cyst forms in the area
where the egg used to be.This structure is called
the corpus luteum, and serves to nourish the
lining of the uterus in preparation for pregnancy.
If pregnancy does not occur then the corpus luteum
would normally degenerate and disappear. These
small Ovarian Cysts are called functional cysts.
They are a completely normal part of the ovulation
process.
Dysfunctional Ovarian
Cysts
Cysts usually become dysfunctional when
they grow larger than four centimeters. There are
various different types of cysts that can develop
in a woman's ovaries. Women tend to have various
different symptoms depending on the size and type
of cysts that they have. Many women who have
abnormally large cysts in their ovaries are not
even aware of it because they have no painful
symptoms.
Complex Ovarian Cysts
Complex
ovarian cysts are potentially dangerous, in that
most malignancies have internal component that
make them complex .One type of benign complex cyst
is an endometrioma which are often referred to as
chocolate cysts.. Endometriomas are usually filled
with old blood that has the appearance of
chocolate syrup..
Hysterectomy
Procedures
The performance of
HYSTERECTOMY should be recommended as a LAST
RESORT. If malignancy exists or if other options
described above have been attempted uncessfully.
There are several different types of hysterectomy
procedures that are commonly performed on women in
the United States.
The most common
procedure is called a total hysterectomy. This is
the operation that removes both the uterus and the
ovaries. This procedure causes a woman to begin
menopause almost immediately after the operation
because of the removal of the ovaries This type of
menopause is called surgical menopause. Because of
the abrupt nature of the Estrogen withdrawl the
menopausal symptoms are severe and immediate.
These organs can be removed through an incision in
the abdomen or the vagina.
A hysterectomy
is a surgical procedure whereby the uterus with or
without the ovaries are removed through an
incision in the abdomen or the vagina. This
procedure is the second most common major
operation performed in the United States next to
cesarean section operation.
Hysterectomy
Alternatives
A hysterectomy is
commonly offered to women who suffer from extreme
menstrual cramps, heavy monthly bleeding, anemia
and severe abnormal pelvic pain. These symptoms
are often caused by fibroid tumors or
endometiosis. Most tumors are harmless, but can
cause severe discomfort . Women who have large
fibroids often have abdomens that look as though
they are pregnant.
What many women are not
told is that there are several different
alternatives to hysterectomies. Many women in the
United States are deciding on less drastic
surgical procedures such as myomectomy.. A
myomectomy can remove fibroid tumors while keeping
the pelvic organs in tact. Before considering
surgery of any kind women should educate
themselves on the many different ways to treat
pelvic organ dysfunction.
Vaginal
Hysterectomy
A vaginal
hysterectomy is a less commonly performed
hysterectomy where the uterus and/or ovaries are
removed through the vagina rather than through an
abdominal incision. While most hysterectomies are
abdominal, some doctors recommend vaginal
hysterectomy when a woman is suffering from
cervical dysplasia. The mode of hysterectomy
depends on the size of the uterus , accompanying
intraabdominal pathology and the skill of the
surgeon to perform advanced vaginal surgery. The
reason why a vaginal hysterectomy is suggested for
cervical dysplasia is because the uterus is
usually of normal size and the procedure is
technically easy to perform.
Vaginal hysterectomies are not suggested
for women who have large fibroid tumors or ovarian
cysts as the uterus must be small enough to pass
through the vaginal canal. Many women who have not
been through childbirth may not have vaginal
canals that are large enough for the
procedure.
Laparoscopic Assisted
Vaginal Hysterectomy
Another form of hysterectomy is called
laparoscopic assisted Vaginal Hysterectomy. This
procedure uses a laparoscopic approach to remove
the upper portions of the uterus, also to allow
the surgeon to survey the entire abdomen and
remove safely intestines that may have adhered to
the uterus in cases of endometriosis. Laparoscopic
approach actually allows the skilled surgeon to
convert a potential abdominal hysterectomy into a
vaginal one. The recovery is shorter and the
patient disability is less.
Partial
Hysterectomy
Partial hysterectomy
refers to the removal of the body of the uterus
leaving the cervix intact. The value of this
procedure is that the nerves and blood vessels
that supply the lower portions of the pelvis and
vagina are preserved.
A not infrequent
sequella of total hysterectomy is actual prolapse
of the vaginal vault in later years. Therefore
when I must of necessity perform Hysterectomy, I
recommend a supracervical or subtotal
hysterectomy. I also believe it is wise to
preserve ovaries whenever possible. Even
postmenopausal women have some function in their
ovaries.
Although a Partial Hysterectomy
can be less shocking to a woman's system than a
total hysterectomy, it can still be accompanied by
rather severe after effects. For example, even
though your ovaries are still intact, the sudden
cessation of menstruation can change the hormone
levels in the body causing menopausal symptoms and
early menopause.
Partial
Hysterectomy Side Effects
When a
uterus is removed, even if the ovaries are left in
tact, the blood flow to the ovaries significantly
decreases making it harder for them to maintain
proper hormone levels. For this reason many women
who may have had low bone density to begin with
can develop are more likely to develop
osteoporosis after the surgical removal of her
uterus.
There are also many sexual side
effects that come from undergoing any kind of
hysterectomy. Many doctors claim that as long as
the ovaries are left in tact, then there is no
reason for a woman to have a decreased libido
after a hysterectomy. However, studies show that
partial hysterectomies can decrease hormone levels
and this, in turn, will decrease a woman's libido.
Many women also say that sex is often painful
after for them after they have undergone the
surgery. This, understandably, can significantly
lower their sex drive.
Hysterectomy
Recovery
Complete hysterectomy
recovery usually takes from four to six weeks for
most women. Women are told to expect to feel
exhausted after the operation and to rest whenever
they feel they need to. Recovery time may vary
depending on the type of hysterectomy that was
performed on you and how healthy you were before
the operation.
Hysterectomy Recovery
Time
For many women, hysterectomy recovery
can become an extremely long process. Laparoscopic
surgery decrease remarkably the recovery time.
Even if laparoscopic assisted techniques are used
,patients can usually return to work in two or
three weeks, depending on their physical shape
prior to surgery. If your ovaries have been
removed you are most likely to begin menopause
immediately. This takes a lot of adjustment on
behalf of your body and means that your recovery
must now include hormone replacement therapy. Many
women experience complications when they begin
taking synthetic hormones since there is just no
comparison to the real thing.
These days
there are many surgical alternatives to
hysterectomy that are far less painful and require
less recovery time. Laparoscopic myomectomy, a
surgical procedure wherein fibroid tumors are
removed by advanced laparoscopic surgery has you
walking out of the hospital the very next day.
Having any or all of your pelvic organs removed
can create a domino effect of health issues. Be
sure you know all of your options before agreeing
to undergo a hysterectomy.
It is important for women to begin to
understand the long lasting after effects a
hysterectomy procedure can have on their body.
Over six hundred thousand hysterectomies are
performed on women each year, many of which may be
INDICATED MEDICALLY BUT ARE NOT NECESSARY.
In the words of a well known retailer “OUR
BEST PATIENT IS AN INFORMED CONSUMER.”
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