Abdominal Hysterectomy

Definition - What does Abdominal Hysterectomy mean?

An abdominal hysterectomy is a surgical procedure in which the uterus is removed through a cut in the lower abdomen. The surgery may involve removing only the uterus while leaving the cervix intact, a procedure referred to as a partial hysterectomy. In contrast, a total hysterectomy removes the entire uterus and the cervix. An abdominal hysterectomy can be done for pelvic adhesions or scars causing infertility, where a vaginal approach is not suitable. However, the risk of impending complications with the abdominal route is greater than that of a vaginal hysterectomy.

FertilitySmarts explains Abdominal Hysterectomy

An abdominal hysterectomy may be needed in the following conditions:

  • Cancer of the reproductive tract such as the uterus, cervix, or endometrium
  • Fibroids: usually harmless uterine tumors but can sometimes give rise to intractable bleeding, anemia, pelvic pain or pressure, mandating surgery
  • Uterine prolapse that doesn’t respond to other conservative treatments
  • Endometriosis, in which inner lining of the uterus called endometrium, grows outside the uterus on the ovaries, fallopian tubes, or other pelvic or abdominal structures
  • Profoundly heavy vaginal bleeding that has failed to respond to less invasive treatments

Just like any other major surgery, the hysterectomy is done under general anesthesia, so the woman won't be conscious during the surgery. A tube called urinary catheter is inserted into the urinary tract to empty the bladder. The abdomen and vagina are cleaned with an antiseptic solution before surgery. The surgeon then makes one of the following cuts (incisions) in the lower abdomen to remove the uterus:

  • A vertical incision that begins in the mid of the abdomen and runs from below the navel to just above the pubic bone. It is generally used for removal of the uterus for endometriosis, large fibroids or other cancers
  • A horizontal bikini-line incision is placed parallel above the pubic bone

Following an abdominal hysterectomy, the hospital stay is relatively longer than that of a vaginal hysterectomy. The abdominal cut will gradually heal, but it does leave a visible scar on the abdomen.

Although a hysterectomy is usually safe, being a major surgery, it can come at the risk of the following complications:

  • Wound infection
  • Bleeding due to damage to a major artery: While it's normal to experience a bloody vaginal drainage for several days after a hysterectomy, heavy vaginal bleeding that resembles a menstrual period is a concern
  • Blood clots
  • Nerve and tissue damage
  • Inability to get pregnant and premature menopause even if the ovaries are not removed
  • Heart disease

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