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Hysterectomy and Surgical Advancements

October 21, 2013

By Anne Stohrer, MD, The Women’s Center

Hysterectomy is the most common surgery among women in the United States, after cesarean section. A hysterectomy is a surgical procedure that removes the woman’s uterus, and sometimes the cervix and/or ovaries and fallopian tubes. There are three types of hysterectomy: partial, total or radical. A partial hysterectomy removes just the upper part of the uterus, leaving the cervix in place while a total hysterectomy removes the whole uterus and cervix. A radical hysterectomy is a total, but also includes removing tissue on both sides of the cervix as well as the upper part of the vagina. The radical procedure is most commonly done when there is cancer present.

You many need a hysterectomy if you have: fibroid tumors; endometriosis; uterine prolapse; abnormal vaginal bleeding; cancer of the uterus, cervix or ovaries; or chronic pelvic pain.

  • Fibroid tumors are non-cancerous tumors that grow in the wall of the uterus. Many woman may experience minor symptoms and require no treatment. However, for some women these fibroids come with prolonged heavy bleeding or pain. Fibroids often shrink after menopause.
  • Endometriosis occurs when the tissue that lines the uterus grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs. Women with endrometriosis may experience severe pain during menstrual periods, chronic pain in the lower back and pelvis, pain during or after sex, bleeding between periods, and other symptoms.
  • Prolapse of the uterus is when a woman’s uterus drops from its usual place down into the vagina. A woman with a prolapsed uterus can expect to experience urinary and bowel problems as well as pelvic pressure.
  • Cancer of the uterus, ovary, cervix or endometrium. If you have cancer of any of these organs, hysterectomy is your best option. Other treatment options can include chemotherapy and radiation. Your doctor will talk with you about the type of cancer you have and how advanced it is.
  • Abnormal vaginal bleeding. Treatments may vary as they depend on the cause. For instance, changes in yourhormone levels, infection, cancer, or fibroids can cause abnormal bleeding. There are a number of medications that can help lighten heavy bleeding, correct irregular bleeding, and relieve pain. These include hormone medications, birth control pills, and nonsteroidal anti-inflammatory medications (NSAIDs). In addition to medication, there are several procedures that you might consider; dilatation and curettage (D & C) or endometrial abulation.
  • Chronic pelvic pain. Surgery is the last to be considered for women who experience chronic pelvic pain as a result of the uterus.

Today, thanks to advancements in equipment and techniques, surgical patients experience less pain, fewer complications and a quicker recovery time. Advancements in hysterectomy surgery for instance, have gone from being performed through large abdominal incisions to being done through very small incisions. Patients used to spend a week in the hospital and have weeks of agony. Now they go home the next day, walking out of the hospital.

Laparoscopic hysterectomy, a surgery performed at Copley, allows the surgeon to perform the procedure from outside the body while viewing the operation on a video screen. The surgery is done using a laparoscope, which is a tube with a lighted camera, and surgical tools inserted through several small cuts made in the belly.

Earlier laparoscopies were done looking directly through an eyepiece. Today fiberoptics and smaller cameras has made it possible to watch the surgery on flatscreen monitors. And the technology continues to advance rapidly.

Copley Hospital has the technology and skill set of its surgical services team to provide these up-to-date gyn surgical procedures. This cutting edge technology allows surgeons to provide better patient care.

As with any surgery there may be ways to treat your health problem without having surgery. You should always speak with your doctor about all of your treatment options.

Dr. Anne Stohrer is an OB/GYN specialist at The Women’s Center, where she provides care for women through every stage of life. Dr. Stohrer, along with Dr. William Ellis and certified nurse midwives Kipp Bovey, Jackie Bromley and Marge Kelso, provide comprehensive menopause care, annual exams and screenings, prenatal and pregnancy care, family planning and treatment of gynecologic conditions and diseases. Learn more online at copleyvt.org/obgyn.