HERE ARE SOME OF THE THINGS YOU CAN EXPECT WHEN YOU HAVE THE OPERATION

Once upon a time, in extreme cases, they were carried out to cure women of “hysteria”.

These days, hysterectomies are performed to deal with a variety of conditions, from endometriosis to a prolapsed uterus.

They’re not performed as often as they once used to be because there are now alternative treatments for conditions that previously warranted the removal of the uterus. For example, heavy menstrual bleeding was once a common reason for a hysterectomy, while today it can be successfully treated using hormone-releasing IUDs.

In many cases, a hysterectomy is only carried out after other treatments have been ineffective. WHY DO YOU NEED A HYSTERECTOMY?

Your specialist may recommend a hysterectomy for problems such as: • Fibroids

• Endometriosis

• Pelvic inflammatory disease • Prolapsed uterus

• Cancer of the uterus, cervix or ovaries

• In some cases of abnormal or heavy bleeding.

WHAT DOES THE

SURGERY INVOLVE?

There are several types of hysterectomies and which one you have will depend on the condition being treated. These include:

• Partial hysterectomy, in which the main part of the uterus is removed but the cervix is left behind.

• Total hysterectomy, in which the whole uterus including the cervix is removed.

• Extended hysterectomy. This involves removing tissue around the uterus and sometimes also the fallopian tubes and ovaries. The most common reason for this operation is if you have cancer of the uterus, ovaries or cervix.

There are also several different ways the surgery can be done:

• Abdominally. A cut is made in the abdomen so that the uterus and any other parts to be removed can be clearly seen. It can take around four to six weeks to recover from this type of surgery.

• Vaginally. The uterus is removed via the vagina. Recovery time is shorter, but not every woman may be able to have this type of surgery.

• Laparoscopically. A telescope and the operating instruments are inserted into the abdomen via several small incisions in the abdominal wall and the uterus is removed this way. It is easier to recover from because there are only small cuts, not one large one.

The operation usually requires a general anaesthetic, although in some cases it can be done just using an epidural anaesthetic. You’re likely to stay in hospital for one or two days afterwards if you had a laparoscopic hysterectomy or four to five days if it was an abdominal one. You’ll have a drip to provide fluid and medications, and you may also have a catheter in your bladder for a day or two after surgery.

WHAT HAPPENS AFTERWARDS?

You’ll have to rest when you get home so you don’t risk straining the wound and developing an infection. You may have to avoid driving for a period of time recommended by your doctor if you have had an abdominal hysterectomy. You should not have sex for four to six weeks to allow the internal scars to heal.

Complications following a hysterectomy are rare, but you should contact your doctor if you experience:

• Bright red vaginal bleeding • Difficulty passing urine and pain when you try to go

• A high temperature

• Flu-like symptoms.

Once your uterus is gone, your periods, if you were still having them, will stop. But you won’t necessarily experience menopause. If you still have your ovaries, they will continue to put out hormones, so you won’t go through symptoms associated with menopause, like hot flushes, night sweats and mood swings. However, if your ovaries were taken out, then you’ll experience what is known as surgical menopause.

The menopause symptoms can be quite strong because the loss of hormones has been very sudden, compared to the gradual diminishing of hormones when you go through menopause naturally.

If you do have surgical menopause, you may want to talk to your doctor about hormone therapy.

CAN THERE BE PSYCHOLOGICAL EFFECTS? Yes. As well as the physical effects of having your uterus removed, you may also notice psychological ones. For some women, losing their uterus, and with it their ability to have children, can have a big impact, especially if they were hoping to start or add to their family. Depression after a hysterectomy is not uncommon and you may notice you feel sad, have no motivation or feel like there’s nothing to look forward to.

Loss of appetite and trouble sleeping can also be signs of depression. Talk to your GP if you think you may be depressed.