Remove the uterus
Synonym: hysterectomy (from the Greek "hyster" = uterus and "ectomy" = excision)
The uterus plays an important role in the body of a young woman, and it is in the uterus itself that the child grows up during pregnancy. Your mucous membrane is controlled by hormones from the appendages (ovaries). The ovaries control the menstrual period and enable pregnancy through the formation of egg cells. After menopause, however, the uterus loses its function and is more important as an “organ of identity” for women.
Depending on the disease, it may be necessary to remove the uterus. This can be the case due to benign or malignant diseases. Also, hysterectomy is not the same as hysterectomy, because there are different options for the operation, as well as removal with or without ovaries.
The Hysterectomy (also called hysterectomy in medicine) is a surgical procedure in which the uterus and possibly also the "Attachment images“, Ie ovaries, are removed. There are various surgical techniques for this, including:
- removal through the vagina (vaginal hyterectomy, during which the ovaries cannot be removed).
- A rather "gentle" method, there are no visible scars, pain is less than with an abdominal incision and the patient recovers quite quickly.
- removal by a laparoscopy (laparoscopic hysterectomy),
- Also a very small operation, where only a few small incisions are made on the abdomen and the uterus is removed with instruments, so-called "keyhole surgery".
- the removal of the uterus through the combination of the two possibilities mentioned above ("laparoscopically assisted vaginal hysterectomy" LAVH)
- the possibility of an abdominal incision (laparotomy). Usually used for cancer or when the ovaries have to be removed. A horizontal incision a few centimeters in size is usually made on the lower abdomen. The advantage of this variant is the large field of vision for the surgeon. However, this procedure causes more pain for women and it takes longer for the patient to be fit again.
Depending on the illness, your gynecologist will recommend one of these types of surgery.
After the operation, you should not exert yourself for a while. In the first four weeks you can go for a walk to get your circulation going or to keep it going, if you feel fit enough. Depending on the surgical method, you can start exercising again after 2-3 months. It is best to discuss how best to proceed with the attending physician. Information on special training units after a hysterectomy can be found here: Abdominal muscle training after a womb removal
There are many reasons to remove the uterus. But not every reason is a “must”. Often also can operated organ-preserving become. Urgent reasons for surgical removal of the uterus are:
- Bleeding, especially heavy bleeding that cannot be controlled, such as after giving birth
- Cancer of the uterus (depending on the type of cancer, radiation therapy or chemotherapy is insufficient or can be easily treated with them)
- Likewise cancer of the ovaries (also here a decision is made according to stage)
- severe inflammation of the uterus
There are also reasons to remove the uterus that are not "must". This includes:
- benign tumors of the uterus, such as the very common fibroids
- Adhesions in the lower abdomen
- Menstrual disorders (frequent or heavy menstrual bleeding)
- very painful menstrual bleeding, such as in endometriosis (the lining of the uterus outside of the uterus)
- Uterus or uterus subsidence after birth
- Prolapse of the uterus
Depending on the disease, the patient's individual risk must be taken into account; the patient's age and condition also play a role.
Consequences of the removal of the uterus
After the uterus has been removed, patients have:
- no period
- can afterwards no longer pregnant become
- come to the earlier Menopause
After removing the uterus with ovaries, there are also the following aspects:
- the Menopause enter quite quickly after the ovaries are removed
- the Osteoporosis risk increases due to the lack of estrogen
There can be complications during the surgery, including injury to nearby organs such as the intestines, bladder, ureters, and ovaries.
Bleeding can also occur during and after the operation; if it becomes very severe, it can be treated with donor blood or blood-like solutions (called colloids).
Sometimes urinary tract infections also occur after the operation, which are usually easy to treat with antibiotics. Urinary incontinence occurs less frequently.
Also read the article on the topic: Pain after removal of the uterus