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hysterectomy, abdominal
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Hysterectomy Movie
Definition
Total abdominal hysterectomy, or TAH, is a surgery that removes the uterus and cervix through an incision in the abdomen.
The ovaries and fallopian tubes may or may not be removed at the same time. If they are removed, the medical term for this is bilateral salpingoophorectomy, or BSO.
Who is a candidate for the procedure?
An abdominal hysterectomy may be done for the following problems: - abnormal cells in the lining of the uterus or cervix that are suspicious for very early cancer
- abnormal or heavy bleeding from the uterus
- adenomyosis, noncancerous tumors made of gland tissue and muscle
- chronic pelvic pain
- endometriosis, a condition in which small pieces of the uterine lining attach to tissue outside the uterus
- fibroids, which are noncancerous muscle tumors that grow in the wall of the uterus
- pelvic inflammatory disease, or widespread infection of the pelvic organs
- uterine prolapse, a condition in which the uterus drops from its normal position at the top of the vagina
Women may also have an abdominal hysterectomy if they suffer from certain types of cancer, such as:
How is the procedure performed?
Before surgery, several items of preparation are needed: - An intravenous line (IV) is placed in a vein, usually in the hand or arm. The IV can be used to replace fluids and give medicine or a blood transfusion.
- A urinary catheter is placed in the bladder to drain urine.
- An anesthesiologist meets with the woman. He or she will discuss possible approaches to anesthesia for the operation, and will take note of any allergies to medicines.
- Medicines, such as sedatives, are given.
In the operating room, the woman is given either local or general anesthesia. The skin around the vagina and lower abdomen is cleaned with a soapy solution to remove any bacteria and sometimes shaved.
A cut is then made in the lower abdomen, It may go up and down in the middle (a vertical incision) or across at the bikini line (a horizontal incision).
The layers of the abdominal wall are then all cut until the area of the uterus is reached and the uterus, tubes, ovaries and other tissue in the area is examined. The blood vessels that supply the uterus and the supporting tissue around the uterus are cut and sewn with stitches that will later dissolve.
The uterus is removed from the top of the vagina, and the vagina is closed at the top.
The surgery usually takes 60 to 90 minutes. At times, the ovaries and tubes may be removed. Other organs may be repaired or removed as needed.
Other steps may also be needed during the surgery if cancer is found, including: - Remove lymph nodes to see if cancer has spread.
- Fix, alter, or remove other organs.
- Remove as much cancer as possible.
What happens right after the procedure?
The woman usually stays in the hospital for 1 to 3 days. She may be asked to sit up in bed and walk a short distance the first night after surgery. The urinary catheter is usually removed the next morning. The IV is usually removed if there is no evidence of fever or infection and the woman is drinking fluids. She will need to be able to eat, drink, and urinate before going home.
What happens later at home?
Women having this surgery are advised to follow certain tips at home: - Antibiotics and pain medicines should be taken as directed.
- She should not drive a car until she is no longer using narcotic pain medication
- A balanced diet with iron replacement should be followed to promote healing.
- Exercise programs should be followed as directed.
- Heavy lifting should be avoided for 4 to 6 weeks.
- Intercourse should be avoided for 4 to 6 weeks after surgery to allow the vagina and internal structures to heal.
- Stool softeners, such as docusate (i.e., Colace, Peri-colace), may be used. Eight glasses of fluids should be taken in each day. This helps prevent constipation and straining and damage to the incision.
- Walking every day is recommended.
The results of surgery often depend on what caused the problem. Removing the uterus ends abnormal uterine bleeding and pelvic pressure. Some other conditions, such as cancer, may come back.
After a hysterectomy, a woman will no longer have periods and cannot become pregnant.
If the ovaries are removed along with the uterus and cervix, hormone therapy with estrogen is often advised. This helps prevent symptoms of surgical menopause, such as hot flashes and vaginal dryness.
If the procedure was performed for cancer, further treatment, such as radiation or drug therapy (chemotherapy), may be necessary.
What are the potential complications after the procedure?
Surgery can be complicated by bleeding, infection, or a reaction to the anesthetic. Any new or worsening symptoms such as fever, increased bleeding or increased pain should be reported to the healthcare professional.
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Author: Eva Martin, MD
Date Written: 02/22/00
Medical Review: Gloria Halverson, MD
Date Written: 9/11/2006
Reviewer: Reginald Finger, MD
Date Reviewed: 10/24/2006
Contributors
Potential conflict of interest information for reviewers available on request
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