The hysterectomy: pros and cons

GYNOISSUES

By NADINE WILSON All Woman writer wilsonn@jamaicaobserver.com

Monday, November 19, 2012

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A hysterectomy is one those medical options you don't necessarily want to choose unless you must. But if done properly, this surgery could offer you relief from the pain and discomfort that accompanies a myriad of health issues facing women today.


The procedure involves the removal of either all or a part of uterus (womb). A hysterectomy is usually offered to patients dealing with uterine fibroids, endometriosis, chronic pelvic pain, cancer of the uterus, cervix or ovaries, and abnormal vaginal bleeding.


"It must be stressed that a hysterectomy does not include the removal of the ovaries. It is believed that they are one and the same but they are not," explained obstetrician/gynaecologist Dr Charles Rockhead.


For a partial or subtotal hysterectomy, a surgeon would remove only the upper part of the uterus, which means that the cervix would be kept in place.


A total hysterectomy would result in the complete removal of the uterus and cervix, while a radical hysterectomy, which is mostly done for cancer patients, would see the surgeon removing these, plus the tissue on the sides of the uterus, cervix, and the top part of the vagina.


The most common surgery done by doctors is usually the open hysterectomy where the doctor makes a small incision across the belly and removes the uterus through this opening. This would leave a small scar and would require a few days for after-surgery healing.


With new technologies, doctors are finding less invasive methods to remove the uterus, which leaves no scars and takes very little recovery time. One of these options is the vaginal hysterectomy, where a light source with a high definition camera is passed through the vagina to allow the surgeon to work and watch what they are doing on a TV monitor at the same time


According to Dr Rockhead, most pelvic surgeries are done through the vagina thanks to improvement in technologies over the years.


"Ninety-five per cent of hysterectomies are done through the vagina and about four per cent through the laparoscope," he said. "These equipment are very precise and are much smaller than the ones normally used."


The vaginal hysterectomy is less painful, and generally does not cause external scarring.


"Some operations take literally 10 minutes," Dr Rockhead said. "Women can go home immediately after and be back to work in two weeks."


Even with new technologies, a hysterectomy should only be done as a last resort, especially if you are in your childbearing age. This is because like most surgeries, the operation comes with some side effects, such as the inability to conceive afterwards. It could also result in early menopause even if your ovaries were not removed, and there is also a risk of infection and possible complications from anaesthesia.


But while there are risks, there are several benefits to doing a hysterectomy. It has helped to improve the quality of life for many women by helping to relieve pain, heavy bleeding and other chronic conditions and discomfort.


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