(This is third in my series of my blogs associated with Hysterectomy. In my previous two blogs, I had covered the basics – as to when is hysterectomy needed and what are the possible routes for the same)
Hysterectomy for reasons unknown has many myths surrounding it. In my clinical practice while counseling a patient before the surgery, I many a times have to answer some of their wrong notions (traditional beliefs, one may say). Let me put forth some these queries and my responses for them.
- What are the problems associated with the removal of the uterus at early age, say between 35 – 40 yrs of age?
When we advise hysterectomy it is for the permanent relief of the suffering which fails to respond to the conservative line of treatment. Uterus in the broad sense has only two physiological functions, to serve as an organ for harboring a fetus during pregnancy and secondly for the cyclical menstruation. If the uterus is removed, then one will not get menses and would not conceive (both probably not desirous at this stage). Besides these there are no other changes in the functions of the body. - What is the importance of removing or conserving the ovaries?
The physiological functions of the female body are maintained by the estrogen (hormone generated by woman’s body which is typically essential for normal female sexual development and for the healthy functioning of the reproductive system) secreted by the ovary. Removing the ovary before menopause therefore deprives the woman of this hormone leading to early menopausal changes. Therefore lest there is a strong reason to remove the ovaries (like suspicious pathology, strong family history of an ovarian or a breast cancer, cysts, tumors) they should be conserved as far as possible. - Does removing the uterus at an early age accelerate the menopause?
The strong belief in the medical community is that it does not. There are umpteen numbers of studies which have shown that menopause is not accelerated if uterus is removed and ovaries conserved. - Is there any effect on the sexual performance after hysterectomy?
Absolutely not! If only the uterus is removed the vagina is intact for a normal sexual intercourse. When the ovaries are conserved there are no changes in the desire, arousal, or orgasm. - Can you have bleeding or discharge after hysterectomy?
One can have intermittent spotting or minimal amount of bleeding for up to six weeks after surgery, but not beyond that. Even if the uterus is removed white discharge can occur (but not so frequently as before). This can harbor infection at times that can be easily cured by medications. - Which is the best route for removing the uterus?
I have covered this aspect in detail in my previous blog. Removal of the uterus by the vaginal route stands far ahead of other routes as numerous studies have documented. Recovery is quick and quite comfortable. - Can hysterectomy be done by vaginal route if there are multiple or big fibroids (common tumor-like growths in woman’s reproductive system)?
Generally yes, except is some rare cases when the size of the fibroid is more than 10 cm’s or location is such that access by vaginal route is difficult. - Can the uterus be removed by vaginal route if there are previous cesarean sections?
Absolutely! In fact this is a better route as the possibility of encountering the abdominal adhesions is obviated. - Do you put on weight after hysterectomy?
In my opinion there is no reason why one should put on weight after hysterectomy. Probably prolonged period of rest and overall feeling of well being after the sufferings are over could be the reason if at all, one might put on some pounds. - Does removal of the uterus cause visual disturbances?
This is an unfounded myth. There is no relation between uterus and eyes. - How soon can one resume the routine work or activities?
If we do a hysterectomy by vaginal or a laparoscopic route, then within a couple of days to a maximum of a week. Abdominal route has a delayed recovery. - What are the precautions to be taken after undergoing hysterectomy?
Generally the patient is advised not to undertake any activity or exercise like straining, lifting of heavy weights, coughing, etc. which raises intra-abdominal pressure for a period of about 2 months. Sexual intercourse is forbidden for the same period. Besides this one can do anything like climbing stairs, walking, jogging, squatting, cooking, etc. There are no restrictions on eating or not eating anything.
If you would have any additional question, please feel free to post them in the comments section.
