A hysterectomy is a common operation to remove the womb (uterus) with one in five women opting to have the procedure.

Hysterectomies are usually the final option after less abrasive therapy, but many women choose to have a hysterectomy to treat heavy periods, long term pelvic pain, non-cancerous tumours and various cancers, such as ovarian, uterine, cervical or cancer in the fallopian tubes.

A total hysterectomy requires the removal of the womb and cervix and a sub total hysterectomy only removes the womb but leaves the cervix in place. A total hysterectomy with bilateral salpingo-oophorectomy involves removing the womb, cervix, fallopian tubes and the ovaries, and a radical hysterectomy removes the womb and surrounding tissues, the fallopian tubes, part of the vagina, ovaries, lymph glands and fatty tissue.

There are three ways of carrying out the various hysterectomies. There is a vaginal hysterectomy which involves removing the womb after a small incision to the top of the vagina. An abdominal hysterectomy removes the womb after a small incision in the abdomen. Keyhole surgery is also another method, where the womb is removed after a few incisions into the abdomen.

A hysterectomy is a major surgical procedure, and patients are advised to rest and leave a recovery period of six to eight weeks. Patients are usually hospitalised for up to five days, and are advised not to lift anything heavy, and to avoid bending too much as the abdominal muscles and tissue need time to repair.

Surgical menopause can occur if the patient is premenopausal (still has regular periods) before the operation and due to the removal of the womb it prompts the onset of menopause. Surgical menopause usually occurs within five years of the operation, if not immediately afterwards. Once the menopause begins the patient should be offered HRT (Hormone Replacement Therapy) which can help relieve some of the symptoms of the menopause.

Words: Rachael Kitson 

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