Hysterectomy – Removal of uterus

Hysterectomy may be advised for the treatment of many health conditions in women. Some of the indicated conditions include:

• Abnormal bleeding from the uterus
• Cancers of the uterus, revealed by Papanicolaou test, commonly known as Pap smear
• Noncancerous growth such as leiomyoma of uterus
• Prolapsed uterus- uterus drops into the birth canal (vagina)
• Overgrowth of uterus or endometriosis
• Menorrhagia(heavy menstrual bleeding), pain, pressure on pelvis, frequent urination
• Fibroids in the uterus (intramural fibroids, sub-serosal fibroids): Myomectomy, a procedure to remove uterine fibroids, may be suggested before considering the need for hysterectomy.

The gynaecologist will decide the best approach to conduct hysterectomy, depending upon the nature of the case and the medical condition of the patient. Hysterectomy can be done in the following different ways:

Vaginal Hysterectomy: The uterus is removed through the vagina, which is the area between the lower part of the uterus i.e the cervix and the exterior of the body.

Abdominal hysterectomy: An incision is made in the lower abdomen to view the pelvic organs and remove the uterus. Abdominal hysterectomy is performed in presence of complications like adhesions or large uterus where vaginal hysterectomy is not possible.

Laparoscopic surgery or key hole surgery: Few small incisions are made in the abdomen or sometimes through the vagina. A thin instrument called the laparoscope is then inserted through these incisions/vagina to let the surgeon view the pelvic organs and remove the uterus. The success of this procedure depends on the skills of the gynaecologist.

While hysteroscopy evaluates entire uterus, colposcopy evaluates cervix, vagina and vulva for any diseases or anamolies.