A hysterectomy is a surgery to take out your uterus. The uterus is a hollow, round organ in your lower abdomen. It is where your baby grows when you are pregnant. You cannot have children after your uterus has been removed. You also will not have monthly periods. Four types of hysterectomies are performed at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford.
- TAH (Total Abdominal Hysterectomy): A 5- to 7-inch abdominal incision
- TVH (Total Vaginal Hysterectomy): Vaginal incision only
- LAVH (Laparoscopic-Assisted Vaginal Hysterectomy): Three to four 1/4-inch abdominal incisions plus a vaginal incision
- LSH (Laparoscopic Supracervical Hysterectomy): Four 1/4 to 1/2-inch incisions. No vaginal incisions. The cervix remains in place.
A fallopian tube is attached to each side of your uterus. The ovaries are below and behind the fallopian tubes. If your tubes and ovaries are not removed, you will have menopause at the normal time. This is usually between 40 to 50 years of age. If your tubes and ovaries are removed, you may need to take hormone medicine. This medicine helps your body wait to go through menopause at the regular time.
A laparoscopy looks inside the abdomen through one to four, 1/4- to 1/2-inch incisions to diagnose and treat gynecological problems. Through laparoscopies, medical professionals can:
- Remove ectopic pregnancies
- Treat endometriosis
- Remove tubes and/or ovaries
- Treat ovarian cysts
- Treat internal scar tissue (Lysis adhesions)
- Perform a hysterectomy
- Complete laparoscopic tubal ligation
Types of Laparoscopies
A laparoscopic tubal ligation is surgery to tie your fallopian tubes. It is also called "tying the tubes" or being "sterilized." Your caregiver will use a laparoscope to do the surgery. This scope is a long metal tube with a magnifying glass and a light on the end.
A fallopian tube is attached to each side of your uterus. Each month one of your ovaries releases an egg. The egg then travels through one of the tubes and into your uterus. The tubes will be burned or have clips put on them so that you cannot have any more children. You must be sure that you do not want more children. You will still have monthly periods. It shouldn't change the way you feel about sexual intercourse.
Laparoscopy for Urinary Incontinence
The Laparoscopic Burch procedure is surgery to fix stress urinary incontinence (SUI) or prolapse. SUI is when you lose urine during exercise or when straining, like coughing or sneezing. Prolapse is when the ligaments supporting the bladder, uterus or urethra become weak. This causes the bladder or uterus to feel like it is sagging into the vagina so urine leaks when you strain or cough. Stitches (thread) are used to support the bladder, which helps stop the leaking of urine.
Caregivers will look through a laparoscope to do the surgery instead of doing "open" surgery. A laparoscope is a long metal tube with a light and magnifying glass on the end. Laparoscopy means that you will have 3 to 4 small, 1/4-inch incisions instead of the 5-inch incision with open surgery. You should also have less pain after laparoscopy and you may only have to stay in the hospital for one or two days.
Other procedures for urinary incontinence are:
- Marshal Marchetti Krantz
- T-V-T (Tension-Free-Vaginal Tape)
- Pubo-Vaginal Slings
- Cystocele Repair
- Burch Procedure
Dilation and Curettage
A dilation and curettage is also called a D & C. It is when the lining of the uterus is scraped to remove tissue, or a suction machine may be used to remove the tissue. The tissue is sent to a lab for tests. A D&C may be done to treat problems with your monthly period or to see if you have cancer. You may need a D&C if you have had a miscarriage. You may bleed, cramp, or have back or abdominal pain after a D&C.
Hysteroscopy is surgery to look at the inside of your uterus. The uterus is the pear-shaped organ in your abdomen where a baby grows when you are pregnant. There is one ovary on each side of the uterus, which makes the female sex cells or eggs. A fallopian tube is attached to each side of your uterus. Each month an egg travels from the ovary through the fallopian tube and into the uterus. The egg leaves the uterus through the cervix (the opening in the uterus) if you do not get pregnant. The vagina is the canal from the outside of the body to the cervix at the bottom of the uterus.
A hysteroscopy may be done to help find out why you are having trouble getting pregnant. A hysteroscopy may be done to find out what is causing you to bleed too much or to locate an IUD. An IUD is an intrauterine device that helps prevent pregnancy. A hysteroscopy can also be used to check for cancer or to remove polyps or fibroids. A polyp is a lump of tissue on the inside of the uterus. A fibroid is a benign tumor of the uterus.
- Novasure: For treatment of heavy periods. This procedure decreases menstrual flow or may even stop periods. This procedure takes a shorter amount of time than the Thermachoice Balloon procedure listed below.
- Thermachoice Balloon: For treatment of heavy periods. This is an outpatient procedure where a balloon is inserted inside the uterus and filled with a heated solution that cauterizes the lining of the uterus. This procedure decreases menstrual flow or may even stop periods.
- Resection/Ablation of Tissue: This is an outpatient procedure where the lining of the uterus is shaved and cauterized. This procedure stops menstrual flow or greatly reduces it most of the time.
Cervical Cone Biopsy
A cervical cone biopsy is surgery to remove tissue from the cervix. The cervix is the small round opening at the bottom of the uterus. The cervix connects the uterus to the top of the vagina. You may need a cervical biopsy if cells that are not normal are found during a Pap test. A cone biopsy may also be used to treat early cancer and other problems.
Sometimes instead of surgery to remove your uterus, cone biopsy can be done so you can still have children. Reasons you may need this surgery include:
- Cervical dysplasia, which is disease of the tissue of the cervix
- Chronic cervicitis, which is inflammation of the cervix
- Positive Pap smear, which might mean that you have cancer of the cervix
A biopsy that needs only a small amount of tissue may be done in the doctor's office. Since your caregiver needs to remove a larger, cone-shaped biopsy specimen (LEEP) you need to go to the hospital. This is an outpatient procedure.
Removal of fibroids may be done with the laparoscope or abdominal incisions. A uterine fibroid is a benign tumor of the uterus. Benign means it is not cancer. The uterus is also called the womb. Fibroids can grow on the inside, outside or within the wall of the uterus. Uterine fibroids are common and grow slowly. Women between the ages of 30 and 40 are most likely to get fibroids. They may be small or large and usually cause minor to no problems.
Cesarean Section (C-Section)
A Cesarean section, or C-section, is done when you cannot have your baby through your vagina. Caregivers make an incision in your lower abdomen and into the uterus. The baby is delivered through this incision. Your Cesarean section may be done for reasons that are known ahead of time, so you and your caregiver can plan ahead. You may also have a Cesarean section done very quickly in an emergency situation to save you and the baby. If it is an emergency, you may already be in labor while caregivers are getting you ready for surgery.
You may need a Cesarean section if your labor has slowed or stopped, or if your baby is showing signs of problems, or if there are problems with the position of your baby or the position of the placenta. Having had a Cesarean section with a past pregnancy can increase your risk during a regular labor, so you may need a Cesarean section for future pregnancies. Being pregnant with more than one baby or having an infection or a medical problem may also be reasons for needing a Cesarean section. It takes about 6 to 8 weeks for you to heal after having a Cesarean section.