Top Health Tips on Hysterectomy

Laparoscopy, also known as minimally invasive surgery, is a type of surgery that is used to operate the organs inside the abdomen without making big incisions. The surgery is done with the help of a laparoscope, which is a long and thin tube carrying a high-resolution camera at the front and high-intensity light. A laparoscope is connected to a video monitor and then inserted inside the abdomen through the small incision (0.5 cm to 1.5 cm). As the instrument moves inside the abdomen, it sends images to the video monitor, which the surgeons uses as a reference to operate the affected parts.

Laparoscopy is also used as a diagnostic technique to examine the organs of the abdomen or pelvis and this makes it very useful for gynaecologists. This surgical and diagnostic technique plays a significant role in gynaecology as it can help diagnose and treat multiple gynaecological problems with minimum pain and discomfort to the patient. In fact, there is a special instrument called fertiloscope, a type of laparoscope that is modified and made fit for the trans-vaginal application.

Uses of laparoscopy

It helps in diagnosing and curing a host of female infertility problems.
It has proven to be helpful in treating a number of disorders related to the female reproductive organs.
It is a reliable, precise, and cost-effective instrument or technique used by a number of gynaecologists at the first stage of infertility treatment.
It is a sound technique to treat female infertility as it helps to determine whether a patient needs conventional treatment, IVF (in vitro fertilization), or corrective surgery.
Use of laparoscopy in gynaecological problems

Treatment of fibroids of uterus
Treatment of ectopic pregnancy (pregnancy in which the fertilized egg attaches itself outside the uterus)
Treatment of endometriosis (a painful condition in which the tissue lining the inside of the uterus called endometrium begins to grow outside)
Removal of adhesions
Removal of the womb or ovaries
Removal of the lymph nodes during cancer treatment
Removal of ovarian cysts
Diagnosis of cancer of the reproductive organs
Female sterilization (surgery of fallopian tubes to prevent pregnancy)
Detection of tumors or abnormal mass of tissues
Assessment of the effectiveness of the infertility treatment that has been carried out
Advantages of laparoscopy:
Laparoscopy offers many advantages over conventional surgery and diagnosis, including the following:

It is more precise and accurate
It is painless (during surgery as well as a diagnosis)
It minimizes hemorrhage
It allows for shorter recovery time
It ensures reduced risk of infection to the organs
It is cost-effective
It is more helpful for the gynaecologists as they can see the inside of the organs in real-time
Therefore, it is evident that laparoscopy is no less than a boon in gynaecology. Its multiple advantages and high success rate in treating infertility problems in women and other problems related to their reproductive organs make it a great surgical and diagnostic technique. Nevertheless, it is necessary to take the advice of the doctor before undergoing laparoscopic surgery or diagnosis.

Vaginal Vault Prolapse is the condition where the upper portion of the vagina may lose its normal shape and drop or sag down into the vaginal canal or maybe even outside the vagina. This may occur after a hysterectomy or even simultaneously with uterine prolapse.

The treatment of vaginal vault prolapse varies with the severity and extremity of your symptoms. Your health care provider may suggest medications and physical therapy to treat your condition if you feel that the prolapse is not bothersome. However, you might have to undergo surgery later if your symptoms worsen and the prolapse affects your quality of life and hinders functional ability. You must keep in mind that usually more than one area is affected by weakness in your pelvic floor.

The symptoms of Vaginal Vault Prolapse include- backache, pelvic heaviness, bulging mass into or sometimes outside your vagina that hinders normal activities such as walking and sitting, vaginal bleeding and releasing urine involuntarily.

Treatments:

1. Medication
Most of the women with this condition usually go through menopause around the same time. Since the estrogen levels are severely lowered during menopause, it causes vaginal dryness. Discussing estrogen therapy with your health care provider is a must if you wish to remedy your vaginal dryness. Not every woman should take estrogen so it is imperative to talk to a medical expert first. Usually, women are treated with estrogens before they go into surgery.

2. Physical Therapy
Most health care experts recommend pelvic floor exercises as physical therapy using biofeedback so as to strengthen the specific muscles of your pelvic floor. Biofeedback is the use of monitoring devices that contain sensors and are placed either in your rectum, vagina or on your skin. Biofeedback is very important because it tells you the strength of each muscle you are squeezing i.e. contractions, and if you are squeezing the right muscles in order to perform the exercise correctly. Long term usage of biofeedback in physical therapy leads to the strengthening of your muscles and a reduction in your symptoms.

3. Surgery
Corrective surgery may be performed on you by the surgeon either through the abdomen or vagina. If the surgeon is performing the corrective surgery through the vagina, he will use the ligaments which support the uterus to solve the problem.

A surgical procedure in which a woman's uterus is removed is referred to as a hysterectomy. The need for this operation can arise due to various reasons, which include:

1. Development of uterine fibroids that are painful and accompanied by bleeding and other associated symptoms
2. Uterine prolapse, which is characterised by a shifting of the position of the uterus wherein it enters the vaginal canal
3. Ovarian cancer, cervical cancer or endometrial cancer
4. Vaginal bleeding that cannot be characterised as normal
5. Endometriosis
6. Development of a condition in which the uterus thickens known as adenomyosis; and
7. Chronic pain in the pelvic region

In Ayurveda, the uterus is associated with the Pitta dosha (fire element), and is considered to be a storehouse of metabolic fire. In fact, this is the reason why after a hysterectomy is performed, a woman generally loses the zest for life along with her creativity and feels demotivated, depressed, sentimental or lethargic. But Ayurveda can help in regaining your vitality post hysterectomy. Here's how:

The role of Ayurveda in hysterectomy

In Ayurveda, the greatest healer of hysterectomy is the herb Shatavari (asparagus racemosus). This herb is known to balance out the Pitta Dosha, which is associated with the uterus. Not only that, this herb, whose name roughly means "a woman who has a 100 husbands," is extremely vital in reducing stress and in increasing Ojas (or vitality). It also helps in building stamina and increasing strength post-surgery, while helping in maintaining a normal hormonal balance. A woman will also experience an increase in her Sattva (or positivity) with the help of this herb.

However, just after surgery, a woman is advised to have arjuna and turmeric as they are enriched with healing properties. A combination of other herbs along with Shatavari can help in calming the mind and keeping fluctuating emotions in check. These other herbs include saffron, aloe vera, calamus, gotu kola, bhringraj, and brahmi rasayana or jatamansi.

Hysterectomy is a procedure that is used to treat a wide variety of conditions. A partial hysterectomy is performed for the removal of the uterus whereas a myomectomy is performed for the removal of the fibroids. A complete hysterectomy is performed in order to remove the uterus and the cervix. With hysterectomy, there comes some critical and sensitive topic that needs to be discussed with the surgeon. Here is a list of top 10 things that need to be known about hysterectomy:

The sex life concern: Unlike common apprehension, hysterectomy doesn t necessarily mean the end of sex life. In the worst case scenario where the cervix is removed, it takes around 6 weeks before one can resume the sex life.
Hysterectomy can t cure endometriosis: Endometriosis is a condition that is characterised by menstrual cramp, painful intercourse and chronic pain. Hysterectomy is not the first line of treatment for a condition like this. If any doctor has suggested it, it makes sense to take a second opinion.
Hysterectomy doesn t mean menopause: This procedure doesn t mean a menopause or an inability to get pregnant. There are certain other misconceptions such as getting night sweats, hot flashes and menstrual cramp etc. On the contrary, a well-performed procedure will ensure that a person doesn t feel a thing after the surgery.
The loss in ovaries: Depending on the condition of a patient, a doctor might remove the fallopian tube, uterus and ovaries. It necessarily means a sudden loss of oestrogen and progesterone hormone abruptly. Both this hormone are critical for bone and sexual health. It might also lead to menopause, decreased urge in sex and hot flashes during the night. It is therefore very important to discuss each and every aspect of the procedure before the surgery begins.
Hormonal therapy: Since the removal of ovaries is likely to cause physical discomfort to the body, hormonal therapy can come to the rescue of an individual. Hormonal therapy can curtail the risk of blood clot formation, heart diseases, stroke etc.
Explore other non-surgical options: Hysterectomy is not the last word for any uterus or ovary related problems. The goal is to keep the uterus intact. There are certain less evasive procedures to save ovaries and uterus. This is where multiple opinions come handy.
Less invasive options: There exist less invasive surgeries for treatment related to uterus and ovaries. For instance, a robotic hysterectomy causes far less pain as compared to traditional procedure. It also ensures less loss of blood from the system resulting in less weakness.
The morcellation technique: In case a uterus has to be removed, doctors these days use a process known as morcellation. The latter involves making small cuts into various places of the uterus in order to bring it out. The false apprehension of this process causing cancer cells in the body is not true. Only if a patient is suffering from a particular kind of cancer, it might spread to other parts of the body. A doctor has to be consulted to assure such a thing doesn t happen.
Cancer apprehension: For people facing a gene defect such as BRAC1 and BRAC2 hysterectomy can reduce the chance of ovarian cancer by a good 80 percent.
Physiological healing post hysterectomy: Although physical healing takes no more than 6 weeks after the procedure, the emotional healing might take some time. It makes sense to seek professional help for postoperative depression.

If you are looking for effective first-aid remedies, you can opt for homeopathy. A first-aid kit should be a part of every household, containing medicines which serve a variety of medical conditions. For putting up a first-aid homeopathic kit, you need to add around 10 homeopathic medicines to start with as homeopathy is an ideal branch of medicine, which is efficient for a lot of first-aid purposes. Here is a list of the top first-aid medicines, which should be a part of your homeopathic kit:

Arnica- Arnica is the best homeopathic medicine in case of all types of injuries and shocks. It helps in moving blood back into the blood vessels. This medicine is ideal for every injury or pain-related first-aid. It is good for curing strains and sprains, and also essential in case of jet lag and extreme exhaustion.

Aconite- This medicine is used in cases of sudden emotions and intense anxiety. It is effective for all kinds of health issues, which occur after being exposed to cold, windy, and dry weather conditions. This is an ideal first-aid remedy for cough, cold, fever, and chill. Aconite is also used during a panic attack.

Apis- This homeopathic medicine is used in cases of swelling, redness, and heating of the skin along with stinging pain. It is commonly used in case of insect bites and bee stings. It also serves as an emergency medicine in the cases of anaphylactic shock.

Argentum Nitricum- This medicine is an important first-aid remedy, which should be taken in case of anxiety, tension, and fear before some event. It is used when palpitations, diarrhea, burping, and stomach distention are experienced.

Arsenicum Album- This homeopathic first-aid medicine is used in cases of food poisoning accompanied by diarrhea and vomiting. A person tends to feel cold, and is usually afraid of being alone.

Belladonna- Belladonna is a popular homeopathic medicine, which is used in the case of fever. A person s skin becomes hot and red, the pupils get dilated, and a throbbing pain is experienced. It is an effective first-aid remedy for mild sunstrokes and intense, throbbing headaches.

Bellis Perennis- This medicine is specifically used where there is a bruising of soft tissues such as the breast tissue, and other internal organs. The medicine is effective after a fatal injury or blow. It is a good remedy for internal bruising, following a hysterectomy.

It is important for you to consult a homeopathic practitioner or go through several homeopathic books for coming up with an ideal homeopathic first-aid kit, covering all the important medicines.

What is a hysterectomy and why do you need it?

A hysterectomy is a surgical procedure to remove the uterus, which is a muscular organ that carries and nourishes the baby during pregnancy. This surgery may be done to remove all or parts of the uterus; if there are any associated problems in fallopian tubes/ ovaries, they may also be removed simultaneously, during hysterectomy.

Types of hysterectomy procedures

Hysterectomy may be done through surgical cuts in the belly, known as abdominal hysterectomy or through vaginal hysterectomy where the uterus is removed through the vagina. A Majority of the hysterectomy surgeries are done with a laparoscope, due to the advantage of a faster recovery. Which procedure is chosen will depend on why the hysterectomy is being performed along with the medical history of the patient.

Depending on the reason for the surgery, removal of the whole uterus or just parts of it may be required. The types of surgery are:

- Partial hysterectomy is the removal of just the uterus while keeping the cervix in place

- Total hysterectomy is the removal of the uterus and cervix

- Radical hysterectomy is the removal of the uterus, ovaries, fallopian tubes, lymph nodes, cervix and the upper part of the vagina, and is generally only advised in cases of cancer

- Oophorectomy is the removal of ovaries and it may be done with a hysterectomy


Why is it needed?

There may be many reasons to have a hysterectomy and some of them include:

Heavy periods
These may be very uncomfortable and painful, sometimes caused by other diseases. A hysterectomy may be opted for when all other treatments have failed to treat this condition.

Fibroids
They are non-malignant tumors in the uterus that cause constant bleeding, anemia and pelvic pain along with bladder pressure. They may also cause very heavy periods.

Endometriosis
It is a condition where the tissue lining the uterus also grows on the ovaries, fallopian tubes, or pelvic or abdominal organs. It causes severe abdominal pain, heavy periods and sometimes even infertility.

Uterine prolapse
When the tissues and ligaments supporting the uterus become weak, the uterus may slip down from its normal position and descend into the vagina. It can result in urinary incontinence (leakage of urine), pressure in the pelvis and problems in bowel movements.

Cancer of the uterus, ovaries, fallopian tube, cervix or the lining of the uterus (endometrium)
A hysterectomy may be recommended for these types of cancers.

A surgical procedure in which a woman's uterus is removed is referred to as a hysterectomy. The need for this operation can arise due to various reasons, which include:

1. Development of uterine fibroids that are painful and accompanied by bleeding and other associated symptoms
2. Uterine prolapse, which is characterised by a shifting of the position of the uterus wherein it enters the vaginal canal
3. Ovarian cancer, cervical cancer or endometrial cancer
4. Vaginal bleeding that cannot be characterised as normal
5. Endometriosis
6. Development of a condition in which the uterus thickens known as adenomyosis; and
7. Chronic pain in the pelvic region

In Ayurveda, the uterus is associated with the Pitta dosha (fire element), and is considered to be a storehouse of metabolic fire. In fact, this is the reason why after a hysterectomy is performed, a woman generally loses the zest for life along with her creativity and feels demotivated, depressed, sentimental or lethargic. But Ayurveda can help in regaining your vitality post hysterectomy. Here's how:

The role of Ayurveda in hysterectomy

In Ayurveda, there are the greatest healer of hysterectomy. These herbs can balance out the Pitta Dosha, which is associated with the uterus. Not only that, these herbs are extremely vital in reducing stress and in increasing Ojas (or vitality). They help in building stamina and increasing strength post-surgery, while helping in maintaining a normal hormonal balance. A woman will also experience an increase in her Sattva (or positivity) with the help of this herb.

There are some panchkarma therapies like Abhyang, Swedan, Shirodhara, Basti, etc. for getting rid of surgical menopausal symptoms like hot flushes and more.

Laparoscopy is one of the most common procedures for diagnosing and removing endometriosis. Instead of giving a big incision, this procedure of surgery uses lightweight instrument through a small hole or incision. There could be one or more incisions based on the number of instruments that require access inside the body. This procedure involves the use of a camera to ascertain endometriosis as well as treat it in the same sitting. This brings drastic improvement in infertility as well as pain associated with the endometriosis. If a cyst is found in the ovary, laparoscopic surgeon removes it very delicately without causing any harm to the normal ovary, as a part of the Laparoscopic Surgery for Endometriosis.

How does the procedure go?

Eating and drinking should be suspended before 8 hours of the laparoscopic surgery. The doctor takes a call on whether to give a general or local anesthesia. Mostly, General anaesthesia is given during such procedures. A person specialised in Gynecological Endoscopy ( Gynaec Laparoscopic Surgeon) is the best to perform such a procedure.

How is the procedure performed?

The abdomen is first inflated with gas with the help of a needle. It pushes the abdominal wall from the organs to give a clear visibility to a surgeon. The laparoscopic Camera is then pushed through an incision or a set of incisions to examine the internal organ. If the scar tissue or endometriosis needs to be removed, a doctor can use one of the several laparoscopic techniques such as electrocautery, excision etc. Post the surgery, the incision is closed with stitches. The whole procedure usually takes 30-60 minutes depending upon the severity of endometriosis.

Why is laparoscopy done?

If the endometriosis pain has returned after a hormone therapy
If there is a growing endometriotic cyst
If the scar tissue found on the pelvic wall poses a threat on fertility
If the endometriosis interferes with other organs such as the bladder etc.
If the pain during menses ( dysmenorrhoea) refuses to subside
Duration of hospital stay:
Operations such as these are usually conducted at the outpatient facility owing to their less risky nature. A patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalisation may also be required. One can successfully return to normal work within 1 week of the surgery.

Post-surgical recovery: Once the laparoscopy is done, the next steps of treatment are decided based on the patient's age and severity of endometriosis. Few hormonal medicines are advised according to the desire for fertility etc. If a patient is over and above 35 years of age, the risk of miscarriages double. Since the quality of egg declines by the year, it makes sense to undergo infertility treatment such as the in vitro fertilization, intake of fertility drugs, insemination etc. If, however, the patient is below 35 years of age, makes sense to conceive naturally first and consult a doctor simultaneously. A routine check-up post-laparoscopic surgery on alternate six months for a year will keep any risks at bay.

A surgical procedure in which a woman's uterus is removed is referred to as a hysterectomy. The need for this operation can arise due to various reasons, which include:

1. Development of uterine fibroids that are painful and accompanied by bleeding and other associated symptoms

2. Uterine prolapse, which is characterised by a shifting of the position of the uterus wherein it enters the vaginal canal

3. Ovarian cancer, cervical cancer or endometrial cancer

4. Vaginal bleeding that cannot be characterised as normal

5. Endometriosis

6. Development of a condition in which the uterus thickens known as adenomyosis; and

7. Chronic pain in the pelvic region

In Ayurveda, the uterus is associated with the Pitta dosha (fire element), and is considered to be a storehouse of metabolic fire. In fact, this is the reason why after a hysterectomy is performed, a woman generally loses the zest for life along with her creativity and feels demotivated, depressed, sentimental or lethargic. But Ayurveda can help in regaining your vitality post hysterectomy. Here's how:

The role of Ayurveda in hysterectomy

In Ayurveda, the greatest healer of hysterectomy is the herb Shatavari (asparagus racemosus). This herb is known to balance out the Pitta Dosha, which is associated with the uterus. Not only that, this herb, whose name roughly means "a woman who has a 100 husbands," is extremely vital in reducing stress and in increasing Ojas (or vitality). It also helps in building stamina and increasing strength post-surgery, while helping in maintaining a normal hormonal balance. A woman will also experience an increase in her Sattva (or positivity) with the help of this herb.

However, just after surgery, a woman is advised to have arjuna and turmeric as they are enriched with healing properties. A combination of other herbs along with Shatavari can help in calming the mind and keeping fluctuating emotions in check. These other herbs include saffron, aloe vera, calamus, gotu kola, bhringraj, and brahmi rasayana or jatamansi.

A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen.
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have.
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewellery.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38 C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.