Uterus, fallopian tubes, ovaries, and vagina constitute the reproductive system in a female body.
Uterus is an upside-down pear shaped organ with a thick lining and muscular walls. These muscles expand and contract during pregnancy and labor.
Uterus is about 7 cm long and 5 cm wide; fallopian tubes are connected to both upper corners, connecting to ovaries which produce eggs.
Long ago, hysterectomy (uterus removal) was used as a treatment for women with ‘hysteria’ – which meant anxiety and depression. Uterus removal is now a common surgical procedure performed in the world.
Apart from cancerous conditions that account for nearly 10% of the cases, major other indications for womb removal include fibroids (leiomyoma), dysfunctional / abnormal uterine bleeding, genital prolapse (when uterus moves down from its normal position), endometriosis (presence of the uterine lining in nearby organs causing severe pain and bleeding), and chronic pelvic pain / adhesions.
Gynaecological ultrasound is the standard tool to evaluate and diagnose the issues in uterus.
Treatment options differ as per symptoms, age, marital status, fertility status, and of course the patient preferences.
There are three techniques to remove the uterus – abdominal, vaginal, laparoscopic assisted vaginal.
The surgeon determines the appropriate procedure for each individual case based upon the reason for the hysterectomy and the medical history and condition of the patient.
Unless medically necessary, hysterectomy can bring a lot of risks for a women’s life if ovaries are also removed along with. All alternative choices should be explored before resorting to this option.
Ovaries are the source of female hormones oestrogen and progesterone. Losing these hormones gives all menopausal symptoms including hot flashes, loss of sex drive, deranged bone health, increased cholesterol, etc.
Post total hysterectomy, hormone replacement therapy should be thought of. Though artificial hormones carry the risk of stroke, blot clots, and heart diseases; but pros and cons must be weighed properly beforehand.
Also, the morcellation technique used in taking the uterus out by cutting it into smaller pieces; can potentially increase the risk of spreading cancerous cells.
Emotional healing is more important in patients who underwent uterus ovaries removal than the physical healing. Post operative depression, insomnia, loss of appetite, mood swings are a part of it all.