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What Are the Different Types of Hysterectomies?

From the Pre-Op Hysterectomy Articles List

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Different types of hysterectomyI'm confused over the different kinds of hysterectomy. Can you help explain them?


Of course! Here you go!

Total Abdominal Hysterectomy

A total hysterectomy is the removal of the entire uterus, including the cervix.

Acronym: TAH

Description of procedure: The doctor makes a cut in the abdominal wall to expose the ligaments and blood vessels around the uterus. The muscles in the abdomen are usually not cut, but spread apart with retractors. The ligaments and blood vessels are separated from the uterus and the blood vessels tied off so they will heal and not bleed. Then, the uterus—with the cervix—is removed by cutting it off at the top of the vagina. The top of the vagina is repaired by being sewn so that a hole is not left. This is called the vaginal cuff.

Indications/contra-indications: This may be the best option for you if you are dealing with the possibility of cancer, have large fibroids, or have never delivered a baby vaginally. It is the most invasive of the surgery types and the one that may involve the longest recovery. There is risk of the incision becoming infected.

Initial Recovery: Expect 6–8 weeks of recovery, with lifting and straining restrictions for the whole period. It is also normal to have a restriction on intercourse for the entire initial recovery period.

Variations on a theme: It is possible your doctor will do a Supra-cervical Abdominal Hysterectomy (SAH), which means that only the main part of the uterus is removed, and the cervix is left in place. In this case, if you also retained your ovaries, you may experience mini periods.

Total Vaginal Hysterectomy

This procedure is the same as for the TAH, except it is performed vaginally.

Acronym: TVH

Description of procedure: The doctor removes the uterus and cervix through a cut in the vagina. As with the TAH, the top of the vagina is repaired by being sewn to form the vaginal cuff.

Indications/contra-indications: This is usually the surgery of choice if you have prolapse, if there is no possibility of cancer, if your uterus is not too enlarged, and if you've delivered vaginally. This type of surgery is not recommended when the surgeon needs to have space to look around, if there is danger of cancer cells or of endometriosis spreading, if your uterus is enlarged beyond a certain size and sometimes if you haven't delivered vaginally. This surgery can entail additional bleeding. Because you don't have an abdominal incision, it is easy to forget you've just had major surgery and you run the risk of thinking that you are further ahead in your recovery than you really are.

Initial Recovery: Expect 6–8 weeks of recovery with lifting and straining restrictions for this whole period. It is also normal to have restrictions on intercourse for the whole of the initial recovery period.

Variations on a theme: It is possible that your doctor will opt to perform a Lapararoscoply Assisted Vaginal Hysterectomy (LAVH). If that is the case, the cervix is still removed.

Laparoscopically Assisted Vaginal Hysterectomy

Acronym: LAVH

Description of procedure: During a LAVH, several small cuts are made in the abdominal wall through which slender metal tubes called "trocars" are inserted providing access for a laparoscope and other small surgical instruments. The laparoscope is like a tiny telescope with a camera attached to it that provides a continuous image which is enlarged and projected onto a television screen.
Just like in a TAH or TVH, the uterus (including the cervix) is detached from the ligaments that attach it to other structures in the pelvis, and removed through a cut at the top of the vagina which is repaired with stitches.

Indications/contra-indications: Not all women are candidates for laparoscopic hysterectomies and the decision to use this method must be made on an individual basis.

Initial Recovery: Expect 4–6 weeks of recovery, with some lifting and straining restrictions that could extend beyond this period. You can expect to have restrictions on sexual activity for most or even all of this initial recovery phase.

Variations on a theme: It is also possible that your doctor will perform a Total Laparascopic Hysterectomy. In this case, the surgery will still be performed entirely laparascopically, but the cervix will be removed.

Another possibility is that your doctor will opt to perform a Laparoscopic Supracervical Hysterectomy (LSH). If that is the case, the cervix will be retained.

Laparoscopic Supracervical Hysterectomy

This procedure is done completely laparoscopically and does not remove the cervix.

Acronym: LSH

Description of procedure: A morcellator is used to cut the uterus into pieces small enough to be suctioned out through tubes which were inserted into the abdomen.

Indications/contra-indications: Not all women are candidates for laparoscopic hysterectomies and the decision to use this method must be made on an individual basis.

Initial Recovery: Expect 2 to 4 weeks of recovery, with some lifting and straining restrictions that could extend beyond this period. You may have restrictions on sexual activity for this initial recovery phase.

Variations on a theme: It is also possible that your doctor will perform a Total Laparoscopic Hysterectomy. In this case, the surgery will still be performed entirely laparoscopically, but the cervix will be removed.

Bilateral Salpingo Oophorectomy

This involves the removal of both ovaries and of both fallopian tubes.

Acronym: BSO

Description of procedure: Sometimes, both ovaries and fallopian tubes are removed at the same time a hysterectomy is done. When both ovaries and both tubes are removed, it is called a bilateral salpingo-oophorectomy which is usually shortened to BSO. (bilateral=both sides, salpingo =the fallopian tubes, oophore =the ovaries, ectomy = removal)

Indications/contra-indications: The removal of ovaries is most often recommended when the ovaries are diseased. Your doctor may also recommend their removal in the case of cancers that are responsive to the hormones produced by the ovaries. If Endometriosis or Adenomyosis is suspected, some doctors will suggest the removal of ovaries. Removal of ovaries will put you into surgical menopause.

Initial Recovery: Your recovery will be based on the type of hysterectomy you had.

Variations on a theme: Sometimes only the left or right ovary & tube are removed, and this is referred to as RSO or LSO

Anterior and Posterior Repair

This involves repairing the vaginal wall in order to either correct existing prolapses or to prevent further prolapses.

Acronym: A&P Repair

Indications/contra-indications: These repairs are usually only done when the vaginal wall has either been damaged or atrophied. These repairs are usually accompanied with extra stitches and tightening of the vaginal area in order to strengthen the area. This may cause problems during penetration but will also prevent further prolapses.

Initial Recovery: Initial recovery is the same as for a TVH or TAH. Lifting and straining restrictions are usually prolonged for several weeks after the 6–8 weeks initial repair. There is often a permanent weight restriction for lifting as once you've had a prolapse you are vulnerable to further prolapses.

Variations on a theme: Sometimes there is only a need for Anterior repairs or for Posterior repairs.



This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

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HysterSisters Doctor Directory
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9725667760
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Middleburg Hts OH 44149
440-816-5390
Samuel Wheatley, M.D.
627 Jefferson St
Whiteville NC 28472
910-642-3294
Linda Nicoll, M.D.
NYU Faculty Practice GYN
NYU Trinity Center - 111 Broadway 2nd Floor
New York NY 10006
2122639700
Beverly Love, M.D.
46 Sgt. Prentiss Dr.
Natchez MS 39120
601-442-3701
Robert Castle, M.D.
3650 Joseph Siewick Dr. #203
Fairfax VA 22033
703-391-1500

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July 23,2014

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