Vaginal hysterectomy is a procedure in which the uterus is surgically removed through the vagina. A vaginal approach may be used if the uterus is not greatly enlarged, when the uterus is moderately prolapsed or/and if the reason for the surgery is not related to cancer.

Studies have shown that vaginal hysterectomy has fewer complications, requires a shorter hospital stay, and allows a faster recovery compared to removal of the uterus through an abdominal incision (abdominal hysterectomy).

FEMALE ANATOMY:

A brief review of female reproductive anatomy may be of help in understanding hysterectomy.

The uterus is a hollow, pear-shaped muscular organ located in the lower abdomen or pelvis. One end of each fallopian tube opens into the side of the uterus, at the upper end, and the other end of the fallopian tube lies next to an ovary. At its lower end, the uterus narrows and opens into the vagina. The lower end of the uterus is called the cervix. The ovaries lie next to and slightly behind the uterus.

REASONS FOR VAGINAL HYSTERECTOMY:

A hysterectomy may be advised for a number of conditions. For some of these conditions, there may be alternatives to hysterectomy, your doctor would have discussed these options and advised according to your particular situation.

Abnormal uterine bleeding — Excessive uterine bleeding, called menorrhagia, can lead to anemia (low blood iron count), fatigue, and contribute to missing days at work or school. Menorrhagia is generally defined as bleeding that lasts longer than seven days or saturates more than one pad per hour for several hours.

Fibroids — Fibroids (also known as leiomyoma) are noncancerous growths of uterine muscle. Fibroids may become larger during pregnancy, and typically shrink after menopause. They may cause excessive and irregular uterine bleeding.

Pelvic organ prolapse — Pelvic organ prolapse occurs due to stretching and weakening of the pelvic muscles and ligaments. This allows the uterus to fall (or prolapse) into the vagina. It is usually related to pregnancy, vaginal childbirth, genetic factors, chronic constipation, or lifestyle factors (repeated heavy lifting over the lifetime).

Cervical abnormalities — Precancer or carcinoma in situ (CIN 3) of the cervix that does not resolve after other procedures (such as cone biopsy, laser or cryosurgery) may require hysterectomy.

Endometrial hyperplasia — Endometrial hyperplasia is the term used to describe excessive growth of the endometrium (the tissue that lines the uterus). It can sometimes lead to endometrial cancer. Although endometrial hyperplasia can often be treated with medication, a hysterectomy is sometimes needed or preferred to medical therapy.

VAGINAL HYSTERECTOMY PROCEDURE:

Vaginal hysterectomy is performed in a hospital setting, and generally requires one to two hours in the operating room.

Patients are given general or spinal anesthesia plus sedation so that they feel no pain. Heart rate, blood pressure, blood loss, and respiration are closely observed throughout the procedure.

After surgery, patients are transferred to the recovery room so that they can be monitored while waking up.

Most patients will then be transferred to a hospital room and will stay one to two days.

RECOVERY TIME:

Most women stay in hospital for 2-3 days. You will be sent home once you are feeling well and once you are able to pass urine with no problem. It is important to rest after the operation and allow the area to heal.

Generally it is recommended that:

• You restrict activity for 4 weeks.
• After 4weeks do light activities only.
• Avoid heavy lifting for 6 weeks, including shopping bags, washing baskets and children.
• Abstain from sexual activity for 6 weeks.
• Avoid playing sport for 6 weeks.

Please note Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Disclaimer

Dr. Al-Salihi does not accept any liability to any person for the information (or use of such information), which is provided in this fact sheet or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy.