A hysterectomy is an operation that removes the uterus, though is some cases this will also include the removal of the fallopian tubes or ovaries. Hysterectomies are performed due to the presence of abnormal vaginal bleeding, endometriosis, uterine fibroids, cervical dysplasia, adenomyosis, or cancer of the uterus, cervix or ovaries.
There are three types of hysterectomies that your doctor can perform. A radical hysterectomy is a procedure where the uterus, cervix, upper vagina and parametrium are removed in their entirety. A total or complete hysterectomy involves moving the uterus in its entirety. A partial hysterectomy is a surgical procedure that removes the uterus but leaves the cervix behind.
How to Perform Partial Hysterectomy
There are a number of ways a hysterectomy can be performed, but these are largely similar for all types of hysterectomies. Partial hysterectomies are typically performed by removing the uterus through a small incision just above the pubic hairline. The uterus can also be removed through the vagina, though this is not recommended for those with an enlarged uterus. Laparoscopic surgery can also be used to assist with a vaginal hysterectomy. This is performed by making two or three incisions throughout the abdomen, which will be used to insert miniaturized surgical instruments that the surgeon will control with 3-D imaging to perform the surgery.
Side Effects of Partial Hysterectomy
Any surgical procedure you undertake comes with the risk of side effects. Removing reproductive organs such as the uterus will frequently come with hormonal side effects as well, which will need to be considered before you complete the procedure.
- Surgical Complications-Any time you undergo surgery, complications may arise during or after the procedure. Common complications include infection, pain or heavy bleeding near the surgical site. Women may also experience blood clots, internal hemorrhage or develop a heavy amount of scar tissue near the incision. Surrounding organs such as the bladder, ureters or bowel may accidentally get damaged during the surgical procedure. Your doctor will go over all of these risks with you before your surgery and will inform you of any measures taken to help prevent these risks. In many cases the patient will be put on a course of antibiotics to help reduce the risk of infection.
- Hormonal Changes -A partial hysterectomy results in decreased blood flow to the ovaries, which lowers the estrogen levels in the bloodstream. This can also lower the natural testosterone levels in the bloodstream which can lead to reduced bone density or height. Studies have shown that women who have a hysterectomy are three times more likely to develop cardiovascular or skeletal issues due to these hormone changes. If the ovaries are removed as well, women are seven times more likely to develop these issues.
- Emotional Problems-Due to the high level of hormone changes that will occur after a hysterectomy, emotional disturbances may appear. These may include anxiety, depression, irritability, mood swings and increased nervousness.
- Risks of Cervical Cancer-Because partial hysterectomies leave the cervix intact, the risk of cervical cancer still remains. While a partial hysterectomy does not increase the risk of developing cervical cancer, it does not help to reduce this risk. Patients will need to continue to have annual pap smears with their doctor to check for cervical cancer after their surgery.
- Other Complications- The alternate hormone levels the body experiences after a partial hysterectomy which can cause symptoms of menopause to set in. This may include fatigue, headaches, hair loss, hot flashes, insomnia, joint pain, loss of sexual desire, pain during intercourse, palpitations, urinary incontinence, vaginal dryness or weight gain.
Tips for Performing Partial Hysterectomy
Find Support - As you begin to contemplate having a partial hysterectomy performed it is important to remember that this will be a trying physical and emotional experience. Patients should seek out an expert they can trust to consult about their procedure. This will help you get accurate advice on how to proceed.
You should also seek out support from family and friends after your procedure. You will need to take your time to recover, and having people to care for you can make this easier. Surrounding yourself with supportive people can also help you cope with the emotional changes that will occur after your procedure.
Determine Type of Surgery - In many cases a partial hysterectomy is preferred over other types of hysterectomies because there is a lower risk of complications during and after the procedure. Removing the cervix can cause the vagina to shorten or may result in vaginal cuff granulation or vaginal vault prolapse, conditions that are easily avoided by leaving the cervix intact.
The type of surgery that is needed to treat your condition will vary based on the medical issues present. You will need to talk with your doctor about whether or not it is possible to leave the cervix or other reproductive organs intact. In most cases your doctor will attempt to leave unaffected organs behind to minimize your risk of side effects.