Many women are filled with anxiety when they learn that they may need to have their uterus removed due to illness.
To cut or not to cut? How much to cut? What are the risks of cutting? Will there be any negative effects after cutting?
This article will take you through the ins and outs of hysterectomy.
The uterus is the organ that nurtures the embryo and fetus and produces menstruation. It is suspended in the center of the pelvic cavity by ligaments, muscles, and fascia. It is connected to the bladder in front, the rectum behind, the vagina below, and the fallopian tubes and ovaries on the left and right.
The uterus itself can be divided into two parts: the uterine body and the cervix.
Why is it necessary to remove the uterus?
The importance of the uterus to women goes without saying. But what terrible things has it done that made women have to painfully give it up?
A hysterectomy may be necessary in the following situations:
Obstetric diseases
This condition is indicated for patients with scar pregnancy, placental abruption, placenta previa, placenta accreta, amniotic fluid embolism, postpartum hemorrhage, or other conditions where bleeding cannot be controlled despite aggressive treatment; as well as patients with uterine rupture, uterine inversion, or toxic uterine infection.
Reproductive organ tumors
Uterine fibroids with severe symptoms that are unresponsive to treatment or growing too rapidly and suspected of being malignant; benign and malignant tumors such as cervical cancer and cervical lesions, endometrial cancer, uterine sarcoma, ovarian cancer, and fallopian tube cancer whose symptoms cannot be controlled.
Uterine bleeding
Dysfunctional uterine bleeding that is unresponsive to treatment, or bleeding due to abnormal endometrial proliferation during perimenopause or postmenopause.
Endometriosis
Those who do not wish to have children, are older, have more severe symptoms, or have not responded to multiple treatments.
Adenomyosis
Those whose symptoms are so severe that they cannot live or work normally, whose medication is ineffective, who are older, and who do not wish to have children.
How many "parts" are sacrificed when a hysterectomy is performed?
Depending on the extent of resection required for different diseases, hysterectomy can be divided into total hysterectomy, subtotal hysterectomy, radical hysterectomy, and so on.
For benign lesions, the uterine body and cervix are usually removed, and one or both fallopian tubes and ovaries may be removed depending on the situation.
Malignant tumors often require more extensive resection, such as removing more ligaments and the vagina, and performing lymph node dissection.
The cervix cannot be retained?
For malignant lesions of the uterus/ovary, the cervix is generally not preserved; if there is cervical hypertrophy, severe erosion, or old lacerations, it is also removed.
If the lesion is benign, whether or not to remove the cervix also requires consideration. The advantages and disadvantages need to be explained to the patient and the decision needs to be discussed.
If the cervix is preserved, there is still a risk of developing stump cancer in the future. During a second surgery, the adhesions caused by the previous surgery will also bring certain difficulties and risks to this surgery.
Some studies have also shown that preserving the cervix can maintain the integrity of the pelvic floor and normal anatomy.
For women under 40, preserving a healthy cervix and physiological function is beneficial. The secretions can lubricate the vagina, facilitate sexual intercourse, and may participate in regulating ovarian function. However, those who preserve their cervix should have regular check-ups.
Should fallopian tubes not be preserved?
The fallopian tubes are used to transport eggs and provide a place for fertilization. When there is no longer a desire to have children, they become practically useless.
Studies have shown that after hysterectomy, complications such as hydrosalpinx and adhesions are more likely to occur in the fallopian tubes. Furthermore, some ovarian cancers originate from the fallopian tubes, so preserving the fallopian tubes may be like leaving a time bomb.
Therefore, the fallopian tubes are usually also destroyed during a hysterectomy.
Should the ovaries not be kept?
Women who retain their ovaries generally have benign uterine lesions, such as uterine fibroids or adenomyosis; early-stage cervical cancer patients and young women may also retain their ovaries.
Malignant lesions are often surgically removed in one procedure to prevent residual lesions.
Of course, preserving the ovary does not eliminate the risk of future cancer development, but it can also provide hormone supplementation for young patients, so there are both advantages and disadvantages.
How many risks are involved in removing a hysterostomy?
No surgery is too small or too small. Hysterectomy can be performed via laparoscopy, vagina, or abdomen, and each method carries its own risks.
As mentioned earlier, the uterus is located in the center of the pelvic cavity, adjacent to the bladder and rectum; during the operation, separating the ureters, arteries and veins of all sizes carries the risk of damaging these surrounding tissue structures.
Postoperative complications such as surgical site infection and vaginal stump infection are still possible. Patients should be fully informed before the procedure.
Does removing the uterus also remove "sexual happiness"?
The thought of surgery involving the reproductive organs immediately brings to mind the question of what will happen to one's sexual well-being, prompting a series of questions!
Does a short vagina affect sexual life?
For benign conditions, a hysterectomy will preserve the vagina as it is essentially intact. After suturing, the length will not change much and will not affect sexual intercourse at all. Besides, men, you don't have that much length, do you?
For malignant tumors, the vagina may be removed to varying degrees, from 1/2 to 3/4, and the length of the vagina may be significantly shortened. However, the incidence of these malignant tumors is not as high in young women as it is in middle-aged and elderly women.
If you tie a hole in your vagina, could it be punctured?
After a hysterectomy, the vagina is sutured to form a blind end.
First, you need to trust that the doctor's suturing skills are excellent and that they won't leave you with a rotten bag.
Secondly, good postoperative infection control and recovery will accelerate wound healing.
Finally, sexual activity is prohibited for three months after the surgery. It's not too late to resume sexual activity once the vagina has fully healed, but avoid overly vigorous methods, you know what I mean.
Does vaginal orgasm occur after hysterectomy?
The stimulation of orgasm comes from the vagina and clitoris, while the arousal of sexual desire originates from sex hormones secreted by the ovaries. As long as the ovaries are preserved, it will not affect anything.
This seems to have absolutely nothing to do with the uterus.
Are there any side effects to hysterectomy?
The uterus is, after all, one of the most important organs in the human body, and it cannot be removed casually.
Affecting ovarian function
The blood supply to the ovaries comes partly from the uterus. Hysterectomy may affect the blood supply to the ovaries. Although ovarian failure will not occur immediately after the operation, the long-term risk of ovarian failure or premature menopause will increase.
If one ovary is removed during surgery, the contralateral ovary will still have some secretory function and will not immediately show obvious perimenopausal symptoms.
If both ovaries are removed, there is no need to worry too much, as symptoms can be relieved through exogenous supplementation.
Increased risk of related diseases
The uterus plays an important role in supporting the pelvic cavity. After hysterectomy, the support relationship between pelvic organs is disrupted, which may lead to vaginal prolapse, urinary incontinence, and other conditions.
Studies have shown that women who have had their hysterectomies have an increased incidence of cardiovascular disease in the long term, and if the ovaries are also removed, the risk of developing cardiovascular disease increases significantly.
In addition, hysterectomy can be psychologically challenging for women, so it's important to communicate actively and recover with the support of family members.
Infertility
Of course, the uterus is the origin of life, and it is impossible to conceive after it is removed.
However, some women who retain their ovaries can still have their own baby through uterine transplantation, but the cost is enormous.
The physiological phenomena that every woman experiences throughout her life, such as menstruation, pregnancy, and perimenopause, are things that men cannot understand.
When they face illness, they also bear more burdens. Hysterectomy is a great physical and mental trauma for them. Accompanying them is the most enduring expression of love.
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