What is a Vaginal Hysterectomy?
A vaginal hysterectomy is a procedure that removes the uterus through the vagina. This is often done for a variety of gynecological conditions. A vaginal hysterectomy requires less time in a hospital than a traditional hysterectomy. A hysterectomy normally includes removal of the uterus, cervix, ovaries and fallopian tubes, which are all part of the female reproductive system.
Gynelogical Conditions and Risks
There are several problems that a hysterectomy may need to treat, including fibroids, endometriosis, cancer in the reproductive system, uterine prolapse, abnormal vaginal bleeding and chronic pelvic pain. There are normally several treatment options available before a vaginal hysterectomy would be performed. Normally, medication and less invasive surgical procedures are implemented in a treatment plan prior to a vaginal hysterectomy. The possible exception to this is gynecologic cancer.
As with any procedure, there are risks to consider prior to having a vaginal hysterectomy. The risks include blood loss or clots, infection or a reaction to anesthetics used during surgery. Patients who are obese, have high blood pressure, and have diabetes are at higher risk for surgery. In addition to normal surgical risks, the location of the uterus in the pelvis also means that there is a risk of injury to other organs in the pelvic and abdominal area, such as the bowel, bladder and ureters.
If you have endometriosis or pelvic adhesions, the surgeon may need to perform an abdominal hysterectomy. Discuss possible risks with your doctor.
Before, During and After a Vaginal Hysterectomy
If your physician has recommended that you have a vaginal hysterectomy, it is important to gather as much information as possible. Ask your doctor about the procedure, the risks, recovery time and what you should do before. Having all the information in front of you may reduce anxiety and help you make an informed decision. If you are taking medications or vitamins, it is important that your physician be made aware of them before surgery. Even herbs and vitamins can interact with anesthesia and other medication in the hospital. Find out what anesthesia your surgeon will be using. Although general anesthesia is used most often, it is possible to have a regional anesthetic during the procedure. Carefully follow your physician's requirements about fasting before the procedure and arrange for someone to help you at home and assist you during your recovery time.
After you are under anesthesia, your legs are placed in stirrups, as they would for an annual exam. A catheter may be put through the urethra to void the bladder. The vagina is cleaned with a sterile solution prior to surgery. A surgeon will make a small incision inside the vagina. During a vaginal hysterectomy, the surgeon will detach the uterus from the ovaries, fallopian tubes and upper vagina. All the connecting tissue and blood vessels must be separated as well. The uterus is removed via the vagina, and dissolving stitches will be used to reduce bleeding. In what is called a radical hysterectomy, the surgeon may remove the pelvic lymph nodes. This does not happen often.
After the surgery, there will be a blood discharge for several days, which is normal. After a hysterectomy, you will no longer menstruate or be able to become pregnant. If your ovaries and fallopian tubes were removed during the procedure, you will begin menopause after the procedure. Vaginal dryness and hot flashes are common, and your doctor may be able to prescribe medication to reduce symptoms. Most women feel well within a week and recover in one to two weeks. It is important not to lift anything over 20 pounds or have intercourse within six weeks after surgery. You should contact your doctor if your pain worsens or if you become nauseated, start to vomit or bleed more heavily. The emotional effects of having a vaginal hysterectomy differ from patient to patient. It is important to be aware of your feelings and discuss them with your doctor.
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