An open hysterectomy, otherwise known as an abdominal hysterectomy, is a surgery that involves the removal of the uterus, by detaching it from the fallopian tubes, ovaries and upper vagina, and then extracting it through a slit in the abdomen. It plugs the monthly menstrual cycle, and marks an end to a woman’s childbearing years.
A hysterectomy may be recommended for one or more of the following reasons:
- Chronic pelvic pain
- Excessive vaginal bleeding
- Cancer of the ovaries, uterus or cervix
- Adenomyosis, a condition where the lining of the uterus spreads into the uterine muscles
- Pelvic inflammatory disease, a disease where reproductive organs become infected
- Endometriosis, a condition where the lining of the uterus grows outside the uterus, leading to pain and bleeding
- Vaginal prolapse, a condition where the uterus sinks, often hanging through the vagina
A hysterectomy is saved as a last resort for a woman who still wants to have children. Fortunately, there are therapies available as alternatives to a hysterectomy. For example, endometriosis can be treated with hormone replacement therapy. Similarly, fibroids can be operated on without the uterus being affected. However, in certain cases, a hysterectomy may be deemed the most effective option, especially when traces of cancer have been identified.
An open hysterectomy is the most popular form of hysterectomy across the globe. During the procedure, the surgeon makes either a vertical or a horizontal incision into the abdomen, and proceeds to detach the uterus from its adjoining organs. Here’s how it works:
1.Before the surgery begins, the surgeon may conduct some standard tests to check for cancer. These could include a pelvic ultrasound, an endometrial biopsy and a cervical cytology.
2.Just before the operation begins, the vagina is cleansed. An intravenous antibiotic medication is also given to minimise the risk of infection.
3.A urinary catheter is passed through the urethra, to gather urine from the bladder. This remains intact through the surgery.
4.During the surgery, regional anaesthesia is administered, either in the form of spinal anaesthesia or as an epidural. Typically, an abdominal hysterectomy lasts about two hours.
5.The surgeon makes either a vertical or a horizontal incision in the abdomen. The direction of the incision depends largely on the reason for the hysterectomy. Factors that affect this decision include the need to open the upper abdomen, scars from previous operations, and the size of the uterus.
6.After the surgery, it is advisable to remain in the hospital for a minimum of two days.
7.It’s normal to bleed after the surgery, and it’s best to wear sanitary pads to soak in the excess blood. This may continue for days. The incision will heal in time, and a scar will be left in its place. It may take between four and six weeks to completely recover.
An abdominal hysterectomy is a low-risk operation, and more common than you think. If you are experiencing any of the conditions included in this article, meet a doctor at Cloudnine to find out how to live pain-free. Our experienced gynaecological team will guide you through every step of the way.