4 Types of Hysterectomy, its Procedure & Recovery Time

Hysterectomy is a surgery of removal of uterus and is usually performed when there are some underlying conditions. It is important to know the types of hysterectomy surgeries, their procedure and recovery time involved to be able to take an informed decision. While there are some alternatives to hysterectomy, it is necessary to follow medical advice.

Some of the conditions in which hysterectomy may be recommended, include

• Chronic pelvic pain
• Uterine bleeding
• Endometriosis
• Cancer

Procedure of hysterectomy can be quite intensive depending upon the purpose for which it is being carried out. There are many structures surrounding the uterus, which may be removed during this surgery. Recovery time for hysterectomy also depends upon the severity of the condition and the choice of procedure.

There are generally four types of hysterectomy surgeries, the choice of which is made based on the condition. Some adjoining structures may also be removed along with the uterus, which include

• Removing entire uterus along with the cervix
• Removing only the upper part of the uterus and the cervix is left intact
• Removing uterus and its surrounding areas

There are different ways in which this surgery is carried out and the risks and benefits need to be carefully studied before opting for one. Hysterectomy may be carried out as vaginal or abdominal surgery and the risks vary accordingly. It is important to know about the types of hysterectomy surgeries, procedures, their indications, risks and recovery time and discuss the same with the physician.

The main four types of hysterectomy include

• Total or Complete Hysterectomy: This remains the most common type of hysterectomy in which the whole uterus is removed along with the cervix portion.
• Partial Hysterectomy (supracervical): In this type of hysterectomy, there is a partial removal of the uterus in which only the upper portion of the uterus is removed and the cervix portion is kept intact.
• Radical Hysterectomy: In this there is total removal of uterus, ovaries, cervix, fallopian tubes, upper vagina, lymph nodes and some surrounding tissues too.
• Bilateral salpingo-oophorectomy: In this procedure the uterus, fallopian tubes, cervix and ovaries are removed as well.

There are different techniques according to which hysterectomy procedures are carried out. These procedures are known as Total Abdominal Hysterectomy (TAH). With scientific advancements there has been significant improvement in the approaches towards hysterectomy procedures.

In the recent times there are two types of procedures for hysterectomy which have come up that are as follows:

• Vaginal hysterectomy
• Laparoscopic hysterectomy

In abdominal hysterectomy, a five inch long cut is made in the abdomen, usually below the navel area and above the pubic bone. This procedure may be required in case of cancer and fibroids. This type of surgery requires adequate post-surgical care and bed rest; recovery time is also a prolonged one in such cases.

In vaginal hysterectomy, a small incision is done on the vagina and the cervix portion is removed through the vagina. This procedure may be recommended for conditions like uterine prolapse. With a smaller incision, in vaginal hysterectomy the healing is faster than the abdominal procedure.

In laparoscopic surgery, the tiny incisions are made on the vagina and the abdomen. There are two ways in which the procedure is carried out – LAVH and LSH.

• LAVH is laparoscopically assisted vaginal hysterectomy in which procedure are akin to the vaginal hysterectomy. It is also useful for diagnostic purposes and for procedures performed to assess the extent of illness.
• LSH, is laparoscopic supracervical hysterectomy in which small incisions are made on the abdomen, through which the uterus is removed and the cervix is left intact.

The advantage of laparoscopic surgeries is that you have minimal incisions and minimal scarring thus speeding up recovery.

Hysterectomy and its recovery time depend a lot upon the type of procedure required and the severity of the underlying problem. Surgeries that involve complete removal usually need lot of rest and the recovery time may be more than the other procedures. The surgery for partial removal may also need sufficient time for recovery and also largely depends on the health condition and immunity of the person. Usually women are allowed to go home after three to four days, depending on the condition, complete recovery may take around six to eight weeks.

Similarly the recovery time may be more for abdominal hysterectomy while a little less for vaginal hysterectomy. But laparoscopic procedures have made hysterectomy surgeries even more convenient and the recovery time required is usually less than others. While recovery depends to a great extent on the severity of the illness and the health of the patient, in most cases, healing and recovery is faster with laparoscopic hysterectomy surgeries. Recovery time in this procedure may be few weeks, depending on the condition of the person.

In several hospitals, there are many robotic operations as well, which can make recovery even faster. If such procedures are apt then expected recovery time can be less without the need for deeper incisions, thus ensuring faster healing.

Women of child bearing age or for various other reasons, women may prefer medications instead of surgeries. Even after menopause, the doctors recommend to avoid the surgery for the removal of uterus because ovaries are responsible for the production of hormones which have great health benefits.

There are many treatments which may be a good alternative to hysterectomy, but this decision usually depends on the underlying condition. Certain conditions may respond to other treatment, which can be alternatives to hysterectomy. Medications like birth control pill may be advised in some cases. Hysterectomy and its alternatives are many and you need to talk to your doctor to choose the appropriate one.

Alternatives to hysterectomy may be considered in case of the following problems:

• Endometriosis
• Uterine fibroids
• Chronic pelvic pain
• Prolonged menstrual bleeding
• Prolapse of the uterus.

In these cases, drug therapy and less invasive surgeries may be advised by the physician. Rehabilitation and exercises can help to some extent and must be followed according to medical advice. Hormone therapy like progesterone and oral contraceptives can help to balance hormone levels. Alternatives to hysterectomy may include the use of natural supplements like fish oils to reduce the problems related to the menstrual cramps and excessive uterine bleeding.