A hysterectomy is the surgical removal of the uterus. It can be a daunting experience, this post was written with the intent to provide you with a patient’s perspective on the pros, cons and realities of a hysterectomy. This post is not intended to replace medical guidance or treat any condition. Please discuss the risks and benefits of hysterectomy with your doctor if you are considering a hysterectomy.
Different types of a hysterectomy-
- Subtotal hysterectomy- removal of the upper part of the uterus, leaving the cervix in place.
- Total hysterectomy- removal the entire uterus and cervix.
- Radical hysterectomy- removal of the entire uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. (Typically is only done when cancer is present.)
Reasons to have a hysterectomy-
- Uterine Fibriods- Fibroids are benign tumors that grow in the muscles of the uterus.
- Endometriosis- Endometrial tissue grows on the outside of the uterus and on nearby organs, causing pain, infertility and endometriomas.
- Cancer
- Uterine prolapse- Benign condition in which the uterus abnormally moves and shifts into the vagina.
- Hyperplasia- The lining of the uterus becomes too thick and causes abnormal bleeding.
- Unresolved Pelvic pain
- Unresolved Abnormal bleeding
Different Surgical Techniques-
- Vaginal hysterectomy- The surgeon makes a cut in the vagina and removes the uterus through this incision.
- Laparoscopic hysterectomy- This surgery is done using a tube with a camera and surgical tools inserted through incisions made in the belly. The surgeon performs the hysterectomy with the use of surgical tools by viewing the operation on a video screen.
- Laparoscopic-assisted vaginal hysterectomy- The surgeon removes the uterus through an incision in the vagina assisted by laparoscopic surgical tools.
- Robot-assisted laparoscopic hysterectomy- The surgeon controls a robotic system of surgical tools to perform the hysterectomy by using laparoscopic incisions.
- Abdominal hysterectomy- Hysterectomy done through an open abdominal incision, giving the surgeon broad access to the pelvic organs.
Patient’s Perspective-
Deciding to have a hysterectomy is a daunting decision. You and your doctor need to have an extensive conversation regarding the risks and benefits of whether this life changing surgery is the best choice for you.
Things to consider-
Your quality of life.
Is your pelvic pain inhibiting your life? Is it impacting your ability to work, sleep or function normally?
Is your cycle normal? Are you bleeding heavily or more than once a month?
Is it impacting your intimacy?
Are you missing work or social functions because of your symptoms?
Are your hormones out of balance?
Do you have fibroids, endometriosis or frequent ovarian cysts?
Are you in pain?
Do you frequently rely on pain killers (such as NSAIDS, tylenol or prescription pain medication)?
The answers to these questions are what you need to speak with your doctor about if you are considering a hysterectomy.
Your quality of life is what matters.
A hysterectomy is a tough choice. It renders a woman unable to ever carry a biological child. It is life changing surgery and should not be taken lightly.
That being said, if you are suffering and a hysterectomy can help you….it is all but worth it.
Personal Note-
At 25 years old, I had to make the tough choice to have a hysterectomy due to uterine fibroids, endometriosis and severe pelvic pain. I tried every viable option before making this difficult, heartbreaking choice. I tried every form of birth control, natural hormone, pill, cream, IUD and surgical option- all to no avail.
I have aggressive endometriosis. Since the age of 12, I have suffered with agonizing periods, abnormal bleeding, menstrual migraines and pelvic pain. It only seemed to get worse the older I got.
I had my first gynecological surgery at age 18 after endometriosis was discovered during an appendectomy/cholecystectomy. I had a pelvic D&C surgery done just about every year after that due to the endometriosis, fibroids and pain.
I tried birth control pills.
I tried bio-identical hormone therapies.
I tried alternative therapies.
I tried progesterone cream.
I tried estrogen patches.
I tried two different IUDs. (Skyla and Mirena)
I tried several surgical options.
Nothing seemed to quell my symptoms or stop the aggressive endometriosis.
The Final Straw-
I had to travel back to North Carolina from Florida due to Hurricane Irma. I was stuck in NC for over a month and had my period the entire time. Already fighting Addison’s disease and Medullary Sponge Kidney, the strain on my already taxed body was just too much. The agonizing cramps, non-stop bleeding, menstrual migraines HAD to come to an end. I knew that a pregnancy would be dangerous if I ever attempted it. The odds of me successfully carrying a baby full term were slim to none.
I made an appointment with my GYN and voiced my concerns. He agreed with me that a hysterectomy was my best option.
On November 22, 2017 I had a total hysterectomy. The surgeon informed me that I made the right decision and my uterus could not have been saved. My endometriosis was so aggressive that it had covered my uterus, cervix Fallopian tubes and created an endometrioma on my left ovary- all of which had to be removed.
As a woman who wanted children, I was devastated but knew I made the right choice.
-What to expect-
Emotional Impacts-
As prepared as I thought I was, emotionally this surgery hit me hard. I do not regret my decision, but it is hard knowing that I will never be a mother. Prepare yourself for the loss. It is, indeed, a loss. This surgery takes away your ability to conceive a child, but it doesn’t take away your ability to be a mother, to nurture and to love.
This surgery also takes away horrible cramps, seemingly endless menstrual periods and fears of miscarrying and passing on horrible genetics.
Focus on what you are gaining from this surgery, not what you are losing.
If you are still struggling with emotional balance, seek help. Inform your doctor. There are many options for dealing with post-hysterectomy depression.
Physical Impacts-
I am not going to sugar coat it, this surgery is a painful one. Be sure you have a conversation with your surgeon about post surgery pain relief because you will need it.
Be sure you have pain medication, proper hydration and nutrition during your recovery.
You will need to sleep a lot to recover. There is no shame in this. Pushing through the pain will stall your recovery. Give your body what it needs, be gentle with yourself.
You will struggle to sit on wooden chairs, walk up stairs and bend over to grab things.
Ask for help if you need it. Don’t push yourself.
After my hysterectomy, I struggled to urinate on my own. This can be a complication from anesthesia. You may require urinary catherization post surgery. Be sure to communicate with your healthcare team if you are having trouble urinating to prevent discomfort and infection. Do not strain to pee! This can cause you to rip your incisions! If you are struggling, communicate with your nurse/CNA.
Relationship Impacts-
A hysterectomy doesn’t change who you are as a person, but it does change your physical ability. Some people may not understand what you are going through. Some people may say mean things like “You are selfish for choosing not to have children” or try to place guilt or blame on you.
DO NOT ALLOW THIS!
You had to make this difficult decision, if anything YOU ARE the victim here and NOT at fault.
You are not less of a woman just because you cannot have a baby.
You are not less of a woman because you no longer have menstrual cycles or a uterus.
You are not at fault. You are not to blame.
Your quality of life is what is important.
Those who truly love you will understand.
I hope this article helps you understand the reality of a hysterectomy.
Below is the video of my personal story with my hysterectomy.
Wishing you hope & healing,
-Win
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