Total Abdominal Hysterectomy
This is the removal of the uterus and the cervix because together they form the entire uterus.
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 is the best option for you if you are dealing with a cancer possibility, large fibroids, have never delivered a baby vaginally, etc. 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 to 8 weeks of recovery, with lifting and straining restrictions for this whole period. It is also normal to expect to have a restriction on intercourse for the whole of the initial recovery period.
Partial Abdominal Hysterectomy
This is the removal of the top of the uterus, leaving the cervix intact. Together they form the entire uterus.
A Supracervical Abdominal Hysterectomy (SAH) means that only the top portion of the uterus is removed as the cervix is left in place.
Indications/contra-indications: This could be an option for you if you are not dealing with a cancer and have had clear pap smears. Leaving the cervix in place may result in mini-periods as the cervix may contain enough tissue for menstruation. Often the surgeon will cauterize the cervix to keep from mini-periods.
Possible additional surgical procedures performed at the same time:
Bilateral Salpingo and Oophorectomy
This involves the removal of both ovaries and of both tubes.
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 throw you into surgical menopause which may result in hormonal unbalance and might put you at an increased risk for heart disease, some types of breast cancer and might trigger clotting disorders.
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
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