Gynecology Clinic
Gynecology Clinic
- Ultrasound Pelvis
- Hysteroscopy
- Gynecologic Surgery
- Cesarean section
- Tubal Sterilization
- Gynecologic Cancer
Hysterectomy
A Hysterectomy is a surgical removal of the uterus. It ends menstruation and the ability to become pregnant.
Why is it done?
Hysterectomy may be performed to treat:
- Abnormal uterine bleeding that is not controlled by other treatment methods
- Severe endometriosis (uterine tissue that grows outside the uterus)
- Uterine fibroids (benign tumors) that have increased in size, are painful or cause bleeding
- Increased pelvic pain related to the uterus but not controlled by other treatment
- Uterine prolapse – (uterus that has “dropped” into the vaginal canal due to weakened support muscles) that can lead to urinary incontinence or difficulty with bowel movements
- Cervical or uterine cancer
- Complications during childbirth (like uncontrollable bleeding)
Types Of Hysterectomies
There are four types of hysterectomies in which can be performed depending on the condition and severity of the patient. These four types are:
- Vaginal hysterectomy
- Laparoscopic hysterectomy
- Minilaparotomy (a “short incision”) hysterectomy
- Abdominal hysterectomy
These procedures are listed in order of preference, ranked by criteria such as scarring and recovery time.
Koh Samui Hospital provide abdominal hysterectomy and vaginal hysterectomy(for prolapse uterus)
Vaginal Hysterectomy
With this procedure, the doctor accesses the uterus through the vagina. A vaginal hysterectomy and is often preferred by patients because:
- It does not leave any visible scars: the internal sutures are the same as the other procedures, but because the access point is different, there are no scars or open wounds on the skin.
- There is a significant reduction in the time it takes to become active after the surgery.
- Lower complication rate:
- There is less of a chance of any infection to the surgical site.
- There is far less of a chance of causing damage to any other organ.
In the past, vaginal hysterectomies were only used when the conditions were optimal for the procedure. Now, as the skill of our surgeons has grown, vaginal hysterectomies can be used even under complicated conditions. It is important to note that it is possible to have this procedure if you have had a Caesarean section.
This procedure must be done by a surgeon specifically trained in the vaginal hysterectomy method.
Abdominal Hysterectomy
Abdominal hysterectomies are usually performed only when needed. These types of operations typically require a 15 cm incision to perform. While an abdominal hysterectomy is quite safe to perform, it has a longer recovery time and more risk of scarring. Hence in more advanced hospitals, and in conditions which allow it, other types of hysterectomies are performed.
General Information on Hysterectomies
A hysterectomy generally takes 1 to 3 hours. It may be performed under general or regional anesthesia. During a Hysterectomy, the uterus may be completely or partially removed. The fallopian tubes may also be removed. After surgery, a catheter may remain in place for 1 to 2 days to help the bladder pass urine. The average hospital stay depends on the type of surgery, but is usually 1 to 3 days.
Risks & complications
There are possible risks and complications associated with anesthesia, including respiratory or cardiac malfunction. Other complications include:
- Wound complication (i.e. abscess, disruption)
- Excessive bleeding or blood clots
- Infection
- Bladder, ureter or bowel injury
- Pain with intercourse, decreased libido, or reduced ability to have an orgasm
- Temporary abdominal distention due to bowel ileus or transient decreased bowel movement
Following surgery, some women may feel a sense of loss or become depressed, but these emotional reactions are usually short-lived.
Risks can be reduced by following the surgeon’s instructions before and after surgery.
Alternatives
Alternate treatment options will depend very much on the source of the problem. The surgeon may discuss alternative approaches to Hysterectomy:
- Birth control pills or other medications may be helpful in treating prolonged bleeding
- Endometrial ablation (removal of the lining of the uterus) may help with very heavy periods
- Drugs can be used to shrink uterine fibroids
- Myomectomy, or surgical removal of fibroids, is major surgery; one in three women have tumors recur in 5 years
- Chronic pain may be treated with anti-inflammatory drugs, birth control pills, or physical therapy Expectations after Surgery
Removal of the ovaries along with the uterus in premenopausal women causes immediate menopause, and estrogen replacement therapy may be recommended.
Pap Test (Pap Smear)
The pap test or pap smear is performed to detect cervical cancer. A doctor will insert a speculum into the vagina to widen it and cells from the cervix will be collected for analysis in the laboratory. Abnormal or mutated cells may cause or indicate cervical cancer.
Who Should Undergo a Pap Smear?
We recommend discussing with your doctor the best time for you to undergo the pap smear and how often. The American Cancer Society has issued the following recommendations for women regarding the pap smear:
- All women over 21 years of age or within three years for the first sexual intercourse should undergo a Pap Smear, depending on whichever time arrives first. The test should be repeated every one to two years after that.
- Women over 30 years of age should undergo an annual Pap Test. After three consecutive normal Pap Smear results, these women may undergo the test every three years, with the exception of those at risk for cervical cancer, such as women infected by HIV or HPV (human papillomavirus), those with compromised immune systems, or women who used diethylstilbestrol during pregnancy. Women at risk for cervical cancer should continue annual Pap Tests.
- Women over 70 years of age who have had normal results for three consecutive years and no abnormal results in the last ten years and who are not at risk for cervical cancer do not need to undergo any more Pap Tests.
Preparing For a Pap Smear
- A Pap Test should be performed when you are not menstruating.
- Do not douche before the test.
- Do not use any vaginal suppositories, creams, or spermicide 48 hours before the test.
- Do not have sexual intercourse at least 24 hours before the test.
