Hysterectomy

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A hysterectomy is an operation in which the uterus is removed, through either the abdomen or the vagina. A hysterectomy may be performed for various reasons, but often it is used to treat profuse uterine bleeding caused by a benign or malignant disease.

The uterus consists of two basic parts: a pear-shaped body, or corpus, and a short neck, the cervix. If both parts of the uterus are removed, the operation is known as a total hysteroctomy. Ir only the body is removed, it is called a subtotal, or supracemical, hysterectomy. Both a total and a subtotal hysterectomy prevent the patient from menstruating and bearing children, but they do not affect her normal hormone balance. In cases where the patient's ovaries are diseased, they are also removed during the operation. In women past the age 45, both ovaries are usually removed at the time of a hysterectomy even if they are healthy. This is done as a means of preventing ovarian cancer, which is almost impossible to diagnose in its early stages. When the ovaries are removed, the patient's hormone balance is upset and she may suffer the symptoms characteristic of menopause, including hot flashes and fatigue.

Before a hysterectomy is performed, the doctor performs another type of procedure, called a curettage, in which a special scraping instrument is used to remove growths and other material from the wall of the uterus. Sometimes, the curettage is all that is needed to stop the uterine bleeding, but the primary purpose of this procedure is to obtain a sample of uterine material to determine if cancer is present.

If the uterus is found to be cancerous, the doctor may treat the patient with radiation therapy or perform a type of hysterectomy known as a radical hysterectomy. In this operation, the surgeon removes the entire uterus, both oviducts, the ovaries, the upper part of the vagina, and the lypmph nodes in the region. Sometimes, the doctor combines radiation therapy with surgery, inserting radium into the uterus about six weeks before the hysterectomy is performed.

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