Hysterectomy surgery

What is hysterectomy?

Why is hysterectomy?

How long does a hysterectomy surgery take?

Is a hysterectomy considered as major surgery?

Who is right candidate for the treatment?

Who is not right candidate for the treatment?

What are the post-treatment guidelines?

How long does it take to recover?

Are the results of the treatment permanent?

What are the alternatives to the treatment?

Is a hysterectomy considered as major surgery?

What is hysterectomy?

The word ‘Hysterectomy’ is derived from its Greek root ‘Hysteria’ which means the womb and ‘Ektomia’ implying to cut out of. A Hysterectomy surgery concerns the surgical removal of a woman’s uterus. It can also mean the surgical removal of the uterus, ovaries and the cervix. So technically, a Hysterectomy surgery means that the woman can never be a biological mother again.

This type of a surgery, which is one of the most common gynaecological procedures performed, does become important in certain scenarios. It can either be a total (removal of the uterus along with the cervix) or a partial (removal of the uterus but not the cervix).

A Hysterectomy surgery can be carried out for the following reasons: uterine fibroids (the common non-cancerous growths on the uterus muscles), uterine prolapse (a benign condition wherein the uterus drops into the vagina from its usual spot), endometriosis (a condition characterized by the growth of the uterus lining tissues outside the uterus), cancer and hyperplasia ( thickening of the uterus lining resulting in bleeding).

Other reasons include pelvic pain that is chronic, chronic PID (Pelvic Inflammatory Disease) and heavy, persistent bleeding.

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Why is hysterectomy?

Hysterectomy surgery in Iran is an invasive surgical procedure, performed on women, to remove the entire uterus (womb), or parts of it. With the removal of the uterus and ovaries, the woman experiences premature or early menopause and cannot be pregnant again.

This surgery is normally performed to address different health issues in a woman, such as:

1. Uterine Fibroids– These are abnormal growths that develop in a woman’s uterus and are the most common reason for hysterectomy.

The causes of uterine fibroids include:

Family history of fibroids

Hormones such as estrogen and progesterone, which can stimulate the growth of fibroids
Pregnancy, as the production of estrogen and progesterone are high in a pregnant woman.

2. Endometriosis– It occurs when tissue normally found inside the uterus grows in other parts of the body, such as the abdomen, ovaries, fallopian tubes, ligaments that support the uterus, the area between the vagina and rectum, the outer surface of the uterus, and the lining of the pelvic cavity.

The causes of endometriosis include:

Immune system disorder

Retrograde menstruation, which occurs when the menstrual blood containing endometrial cells instead of flowing out of the body, flows back through the fallopian tubes and into the pelvic cavity.

Transformation of peritoneal cells or cells which line the inner side of the abdomen into endometrial cells.

3. Pelvic Floor Disorders– These are disorders such as uterine prolapse, which occurs when the uterus sags or slips from its normal position into the vagina, or the birth canal.

The causes of pelvic floor disorders include:

Aging
Chronic coughing

Chronic constipation

Difficult vaginal delivery

Frequently lifting heavy objects

Obesity
Pelvic fractures

Surgery (abdominal, vaginal)

4. Abnormal Uterine Bleeding– Constant bleeding which occurs through the vagina.

The causes of abnormal uterine bleeding include:

Hormonal imbalances

Benign (non-cancerous) growths like fibroids or polyps
Complications related to pregnancy

Medications such as anticoagulants or anti-inflammatory

Bleeding disorders

Use of Intrauterine device (IUD)

Abnormal ovary function

Adenomyosis, a condition in which glands from the endometrium (tissue lining the inner cavity of the uterus) grow into the uterine muscle causing cramps, lower abdominal pressure, and bloating apart from bleeding

Cancer
Illnesses such as thyroid problems, endometriosis, lupus, liver or kidney disease and pelvic inflammatory disease (PID).

5. Cervical Dysplasia– It is a precancerous condition in which abnormal cell growth occurs on the surface lining of the cervix). This is very common among sexually active women, usually under the age of 30.

The causes of cervical dysplasia include:

Having multiple sexual partners

Having a partner who has multiple sexual partners

Smoking
Immunosuppressed conditions

6. Uterine Cancer– It starts with the growth of abnormal cells in the lining of the uterus. The most important cause of uterine cancer is the hormone estrogen. Estrogen stimulates the lining (called endometrium) of the uterus to grow causing an increase in the growth of abnormal cells.

The causes of uterine cancer include:

Aging
Obesity
Taking estrogen supplements to relieve the symptoms of menopause may be a possible cause

A family history of uterine cancer may have increased chances of getting uterine cancer.
Women who have undergone radiation therapy for any other cancer near their pelvic region may face increased risk of uterine cancer.

Eating foods high in animal fat.

7. Endometrial Hyperplasia– It is an abnormal thickening of the lining of the uterus due to an increase in the number of endometrial glands. Mostly young women who are just beginning to menstruate and older women approaching menopause are affected by this disorder. The causes of endometrial hyperplasia include:

Overproduction of estrogen

Due to unopposed estrogen replacement therapy (taking estrogen without progesterone) in middle-aged women.

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How long does a hysterectomy surgery take?

A Hysterectomy Surgery usually takes about two hours at the maximum. General anesthesia is administered after which, an IV catheter will be inserted to supply medications and other fluids.

The process of hysterectomy depends on the type of the surgery. In the case of abdominal hysterectomy, first, an incision (either transverse or vertical) of about 7 inches is made in the lower abdomen. The supportive tissues and the blood vessels around the uterus are excised and then the uterus is taken out through the incision. Finally, the incision is closed. A major advantage of this type is that hysterectomy can be performed even if there is scarring or presence of large fibroids. In the case of vaginal hysterectomy, an incision is made around the top of the woman’s vagina. After the ligaments, fallopian tubes and the blood vessels are cut off, the uterus is taken out through the vagina. The advantage here is that scarring is minimal with almost no operative pain. The patient can resume normal activities within a month. However, the chances of complications are more in the case of a vaginal hysterectomy. In the case of Laparoscopically assisted vaginal Hysterectomy, the same procedure is followed with a laparoscope assisting the doctor.

Is a hysterectomy considered as major surgery?

A hysterectomy is a major operation with a long recovery time and is only considered after less invasive treatments have been tried.

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Who is right candidate for the treatment?

The Hysterectomy surgery is opted for only if other methods haven’t been able to provide results. The most common eligibility criteria include:

Heavy periods: Often caused by the presence of fibroids, heavy periods can pose other problems such as menstrual cramps, irritability and nausea.
Uterine prolapse: This is characterized by the uterus dropping into the vagina as a result of the weakening of the supportive ligaments and tissues.
Pelvic pain: This can be because of endometriosis, adenomyosis, incomplete treatment of PIDs and/or fibroids.

Cervical or ovarian cancer

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Who is not right candidate for the treatment?

There are no non-eligibility criteria as such, however:

The woman should talk it out with the doctor regarding her sex life post hysterectomy as a woman’s libido could take a beating and also suffer from sexual dysfunction.
Also, if the woman is running a temperature, the surgery should not be carried out.

Hysterectomy side effects

The possible side effects include:

Damage to the surrounding organs

Problems related to anesthesia, such as heart or breathing problems
Formation of blood clots in the lungs or legs

Heavy bleeding

Infections
Premature menopause in case the ovaries have been removed as well
Pain during engaging in sexual intercourse

What are the post-treatment guidelines?

The basic post-operative guidelines are:

The woman should avoid lifting any heavy weight post-surgery.
The woman must also avoid bathing in tubs for a period of about 5-6 weeks post-surgery.

How long does it take to recover?

For an abdominal hysterectomy, complete recovery can take about a month to 8 weeks. However, for vaginal/laparoscopically assisted vaginal hysterectomies, the downtime is much shorter; about 1-2 weeks.

Are the results of the treatment permanent?

Yes, a Hysterectomy surgery offers a permanent solution to the treatment of fibroids.

What are the alternatives to the treatment?

Some of the alternatives to Hysterectomy include embolization, endometrial ablation, and myomectomy.

Hysterectomy surgery Iran

Hysterectomy Cost Iran is a reasonable procedure at all the network hospitals and clinics under Select IVF, the medical tourism company for the women who are dealing with the cause of fibroids and require the removal of her uterus. The Hysterectomy Cost Iran is normally 80% less than the cost for the same performed in other developed countries like the USA, UK, Australia, Canada etc.
The Cost of Hysterectomy in Iran is around $2500 including all other expenses whereas the cost of the Hysterectomy performed with the same procedure will cost you between USD 20,000 to USD 25,000 in other developed countries.
The reason behind offering the reasonable Hysterectomy Cost Iran is that the gynecologist in Iran does not want to make any profit out of the couple’s pocket. They wish that women live the healthy lives who all are dealing with chronic pelvic pain, heavy bleeding and chronic pelvic inflammatory disease and the only option for them is the removal of the uterus to relief them from the pain.

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Is a hysterectomy considered as major surgery?

A hysterectomy is surgery to completely or partially remove the womb (uterus). This is done to relieve symptoms caused by medical conditions affecting the womb. A hysterectomy is a major operation with a long recovery time and is only considered after less invasive treatments have been tried.

What happens to your body when you have a hysterectomy?

A hysterectomy removes only the uterus (supracervical hysterectomy), or the uterus and cervix. It’s important to understand the role of the ovaries in menopause.

Hysterectomy removes the uterus and the cervix. This procedure leaves the ovaries intact, and should not induce menopause.

• Menopause begins when the ovaries are removed or when they no longer produce estrogen. While periods will stop with a hysterectomy, menopause is the result of reduced (or eliminated) estrogen production. The procedure that removes the ovaries is called an oopherectomy.
• If having a hysterectomy before natural menopause, if only the uterus, or uterus and cervix are removed, periods will cease, but hormone production should not be affected.  This procedure should not change the course of natural menopause.
• Only a hysterectomy with a bilateral salpingo-oopherectomy procedure (fallopian tubes and ovaries are removed on both sides) will induce menopause. It is important to know what your procedure includes so that you know what to expect.

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Is hysterectomy surgery painful?

You can expect to feel better and stronger each day, but you may need pain medicine for a week or two. It’s normal to also have some shoulder or back pain. It is normal to have light vaginal bleeding or a dark brown discharge for about four to six weeks after surgery. You may feel discomfort at the incision site for about four weeks, and any redness, bruising or swelling will disappear in four to six weeks. Feeling burning or itching around the incision is normal.

Can you still get PID after hysterectomy?

Pelvic inflammatory disease (acute or chronic PID), caused by bacterial infection, often from sexually transmitted infections (stis). In both abdominal and vaginal hysterectomy, pelvic infection occurs in approximately 4% of cases. Pelvic cellulitis is an infection of the soft tissues and usually occurs around the third day following surgery.

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Can you get pelvic infection after hysterectomy?

The most common clinical manifestations of endometritis and pelvic cellulitis are fever within 24–48 hours of surgery, tachycardia, tachypnea, and lower abdominal pain and tenderness in the absence of any other localizing signs of infection.

What causes pelvic pain years after hysterectomy?

Endometriosis can represent with a variety of symptoms including pelvic pain, dyspareunia and pain with defaecation, up to several years after hysterectomy and bilateral salpingo‐oophorectomy. This may occur when all endometriotic tissue is not excised at the time of the initial procedure.

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Does hysterectomy cure PID?

Pelvic inflammatory disease (PID) is an infection of the female reproductive system. If detected early, PID can be treated with antibiotics. However, if the infection spreads it can damage the fallopian tubes and womb and lead to chronic (long-term) episodes of pain. A hysterectomy can treat severe PID by removing the womb and fallopian tubes and taking away the source of pain. If the pain from PID is severe and the woman no longer wants any children, a hysterectomy may be recommended.

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Can I still get pregnant if I’ve had PID?

Getting pregnant with pelvic inflammatory disease (PID) can be challenging. However, women with the condition should not lose hope. With certain infertility treatments, women with PID can have the same chances of getting pregnant as those without the condition. About 1 in 8 women with PID struggle to get pregnant. PID is an infection of the female reproductive organs and can be a complication of some sexually transmitted diseases (STD). Women who get PID treated early are less likely to have difficulty getting pregnant. The earlier the condition is caught, the easier PID is to treat.

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