Abdominal Hysterectomy

Abdominal Hysterectomy - What it is

What is an abdominal hysterectomy?

An abdominal hysterectomy is an operation to remove the womb through the tummy. The womb is the pearshaped organ responsible for reproduction and your monthly menstruation.

On either side of the womb are the ovaries and Fallopian tubes. The womb opens into the vagina through the cervix that is found at the top of the vagina.

Why do I need An abdominal Hysterectomy?

The commonest reasons for an abdominal hysterectomy are:

Continuous heavy menstruation termed Dysfunctional Uterine Bleeding (DUB) leading to anemia.
Painful menstruation from Endometriosis or Adenomyosis of the womb.
Fibroids which are muscle swellings of the womb. 4. Abnormalities of the womb lining called Endometrial Hyperplasia.

Sometimes, a hysterectomy is also recommended in certain cases of prolapse of the womb. At other times, it is also a part of treatment for cancer of the cervix, womb or ovaries.

Abdominal Hysterectomy - Treatments

What kinds of Abdominal Hysterectomy are there?

There are various type of abdominal hysterectomy which may or may not involve removal of the Fallopian tubes and ovaries.

Total Abdominal Hysterectomy (TAH):

This is the traditional method of removing the womb through a surgical cut in the tummy. The cut (about 15cm long) is usually made across the lower part of your tummy along the bikini line. However in cases where the womb is very enlarged, an up-and-down cut in the middle of the tummy may be necessary.

Total Laparoscopic Hysterectomy (TLH):

This is a newer and more advanced method of removing the womb. It is also called key-hole surgery or minimally invasive surgery. It only involves 4 small cuts of 0.5cm each on the tummy. Surgery is carried out inside the tummy using laparoscopic instruments and high definition videoscopes. The womb is then removed through the vagina.

The main benefits of TLH are:

small to almost invisible surgical scars on the tummy
markedly reduced pain after surgery
reduced chance of infection
less bowel function disturbances and
a very much faster recovery within the week compared to TAH.

As this method requires more sophisticated instruments and advanced surgical skills, it may cost slightly more than the traditional abdominal hysterectomy.

The types of condition best suited for TLH include DUB, Endometrial Hyperplasia, Pelvic Endometriosis, Early Cervix / Womb Cancer and Fibroid not larger than 6cm.

Abdominal Hysterectomy - Post-surgery care

How will I feel after the hysterectomy

You are likely to feel some discomfort after the hysterectomy because of the anesthesia and drips in your arm. You may also feel uneasy at your bladder from the tube placed within to help you pee. These drips and tubes will be removed the next day.

Some pain will be present if the cut in the tummy is large or done up-and-down in the middle.

There might be a slight bloodstained discharge from the vagina after the hysterectomy. This will slowly clear after a week or two as you recover. Otherwise, you should consult your doctor.

For TAH, you may need to wait for a day or two to start drinking and eating. For TLH, you can usually start drinking fluids after the operation and start eating normally the next day.

You will be encouraged to get out of bed and move your legs as soon as you can. Naturally, this will depend on how well you feel and how you are coping with the pain.

When can I start eating and walking?

For TAH, you may need to wait for a day or two to start drinking and eating. For TLH, you can usually start drinking fluids after the operation and start eating normally the next day.

You will be encouraged to get out of bed and move your legs as soon as you can. Naturally, this will depend on how well you feel and how you are coping with the pain.

When Can i go home?

Once you are able to move about independently without pain, you will be able to go home. For TAH, this is usually

around the 3rd or 4th day after the operation whereas for TLH, it is usually earlier.

What happens internally after the hysterectomy?

The space that was once occupied by your womb will be covered by your bowel and intestines. There will be no empty space left behind and the vaginal remains unchanged. As such you should not worry that sexual relations will be any different from before the operation.

What are the risks of the hysterectomy

Like other surgeries, the risks include side effects of anaesthesia, bleeding and infection. Other risks include injury to the intestine, bladder and urine tubes that may require further surgery to repair.