Hysterectomy is the so-called operation to remove the female reproductive organ. It is conducted solely on the testimony of which number is enormous. Among the common testimonials it is worth noting:
- malignant processes in the uterus;
- cervical oncology;
- uterine fibroids, in sizes greater than 12 weeks of pregnancy;
- rapid tumor growth;
- necrosis of myomatous nodule;
- menorrhagia complicated by anemia;
- adenomyosis of 3-4 grade;
- chronic pain syndromes in the pelvic area;
- prolapse of the uterus;
- endometriosis without improvement after the conducted conservative (drug) therapy, curettage.
Ways to remove the uterus
When performing a surgical procedure, various methods of uterus removal are used. The choice of a particular depends on the type of violation, the extent of reproductive organ lesion and its appendages. Based on the results of the ultrasound, doctors decide to use this or that technique. Often, removal of the uterus is combined with excision of nearby tissues. Depending on the volume of the operation, there are:
In addition, depending on the method of access to the reproductive organ during surgical intervention, hysterectomy may be:
- laparotomic – the uterus is removed through an incision in the abdomen;
- removal of the uterus by laparoscopic method – using a special device, through small holes in the abdominal wall;
- vaginal – access to the affected uterus is carried out through the vagina.
Subtotal uterine hysterectomy
Subtotal hysterectomy is carried out when there is a possibility of preserving the cervix when there are no lesions of this part of the reproductive organ. Manipulation is carried out in order to shorten the time of surgical intervention in case of severe extragenital pathology. This method of surgery is also used if there is pelvic endometriosis, a pronounced adhesive process in the small pelvis. With such pathologies the risk of damage to the ureter increases. The indications for this type of surgery are:
- lack of pathology of appendages;
- the presence of sufficient mobility of the uterus;
- omission of the vagina;
- the size of the tumor does not exceed the size of the fetus at the 12th week of pregnancy;
- the presence of sufficient surgical field.
This type of surgical treatment is often referred to as hysterectomy. The method is one of the most common types of hysterectomy. Access to the body is obtained by opening the abdominal cavity. In this operation, ectomy of the fallopian tubes and ovaries is conducted. Restorative treatment after total hysterectomy involves the use of hormones before menopause.
Removal of the uterus with appendages
Such a radical surgical intervention is preceded by a special examination. It is called hysterosalpingography. In this examination, the diagnostics of fallopian tubes are conducted. A special contrast agent is introduced in tubes. Then a series of radiographic images are taken.
If an oncological process is found in the tubes, which is spread to the nearest organs and tissues, the uterus is removed. Access to the disordered organ is achieved through the vagina or the anterior abdominal wall. Due to the fact that elderly patients do not tolerate extensive surgery, surgeons often choose the vaginal type. This completely removes the uterus and appendages – genital gland, fallopian tubes.
The operation to remove this type of uterus is performed with extensive damage to the reproductive system. It is conducted in the cases of malignant tumors of the pelvis, with numerous metastases. The operation involves the removal of the uterus and appendages, the upper third of the vagina, pelvic tissue, regional lymph nodes. Often this type of treatment is used after numerous conservative methods. After such surgical treatment, the woman completely loses the reproductive system, which requires hormone replacement therapy.