HYSTERECTOMY

Fahad zakwan

Hysterectomy

•Usually performed by a gynecologist

•Uterus is removed

•Other reproductive organs may be removed

•No longer able to have a baby

•Periods will stop

Indications• Fibroids

• Endometriosis

• Uterine prolapse

• Cancer of the uterus, cervix, or ovaries

• Vaginal bleeding, DUB

• uncontrollable PPH

• Transgender man

•Pelvic inflammatory disease

• Severe pelvic adhesions

•Bilateral ovarian pathology

•Adenomyosis

•Pelvic congestion syndrome

• Intractable, recurrent dysmenorrhea or metrorrhagia

• Uterine anomalies• Recurrent intrauterine polyps• Uterine perforation • Mentally retarded patient

with no hygiene control• Pregnancy

• Placenta increta, percreta, or acreta

• Atonic uterus• Uterine perforation • Ruptured uterus

Risks and Side Effects

•Earlier onset of menopause•Greater risk of cardiovascular disease• Increased chance of osteoporosis and bone fractures•Uncontrolled urination•Reduced libido•Vaginal dryness

Epidemiology

•Hysterectomy is the second most common surgery among women in the United States

•One in three women in U.S. had one by age 60

• Each year, more than 600,000 are done

•Over 90% are performed for benign conditions

•Over 70% also involved the surgical removal of ovaries

Types of Hysterectomy

• Partial Hysterectomy• Removes 2/3 of uterus

• Total Hysterectomy• Removes uterus and cervix

• Radical Hysterectomy• Removes uterus, cervix, and

vagina

Types of Incisions

Vertical Incision

Pfannenstiel Incision

Abdominal Hysterectomy

• the uterus is removed through an incision in the woman’s abdomen.•Most invasive method• Incision site at abdomen•Hospital stay of 5-6 days•Recovery time 6 weeks•Possible retention of cervix•Required for endometriosis and large fibroids

Vaginal Hysterectomy

• the uterus is removed through the vagina.

• Less invasive than abdominal hysterectomy

• Incision site at inner vagina

•Hospital stay 1-3 days

•Recovery time 4-6 weeks

•Cervix cannot be preserved

Laparoscopic Hysterectomy

• the uterus is removed in sections through small incisions using a laparoscope

• Hospital stay 1-3 days

• Recover time is 4-6 weeks

• Longer duration of procedure

• Requires greater surgical expertise

• Urinary tract injuries are more likely

• Fewer abdominal wall infections or febrile episodes

• Less blood loss

Robotic Hysterectomy

•3-dimensional image

•Greater articulation

• Eliminate hand tremors

• Increased accuracy and precision