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Uterine Prolapse Without Incision Surgery (Hysterectomy)

Uterine Removal from Vagina

Vaginal hysterectomy means entering through the vagina and removing the uterus. While receiving the uterus, we can also remove the ovaries and tubes at the same time.

For what reasons is vaginal hysterectomy performed?

  • Abnormal uterine bleeding (intermediate bleeding, excessive bleeding, prolonged bleeding) (In these cases, we usually try medical treatment first, if there is no improvement, surgery may be considered) (For detailed information, you can read the related topic on the website)
  • Fibroids (Fibroids can cause pain, bleeding) (For detailed information, you can read the related topic on the website)
  • Uterine prolapse
  • Cervical abnormalities
  • Thickening of the inner lining of the uterus (endometrial hyperplasia)
  • Chronic pelvic pain

How to evaluate before hysterectomy?

Before the surgery, the patient and the physician should decide together whether or not the ovaries will be removed. The necessity of post-operative hormone therapy should also be discussed.

Retrieval of ovaries

Uterine removal surgery does not mean that the ovaries will be removed. In women who have not yet reached menopause, it is generally not preferred to remove the ovaries. Because hormone production still continues from those ovaries and hormones are very important for women's health. Hormone production is especially important in terms of sexual interest, heart, osteoporosis and hot flashes. But on the other hand; There are some women (such as premenstrual tension syndrome, menstrual-related migraine patients) who are relieved when their ovaries are removed and their hormone levels decrease. For these reasons, an individual decision should be made according to the patient whether or not the ovaries will be removed. However, sometimes the ovaries may not be removed due to adhesions and scar tissue even if it is desired to be removed.

Removal of tubes

It is almost always possible to take the tubes at the time of removal of the uterus. Removing the tubes slightly reduces the risk of ovarian cancer. Similarly, sometimes the tubes cannot be removed due to adhesions and scar tissue.

Estrogen therapy

Estrogen therapy may be recommended in patients whose ovaries have been removed and who are not in menopause. Hormone therapy can be planned to prevent hot flashes, night sweats and bone loss in patients whose ovaries are removed by surgery. The patient and his doctor should discuss the risks and benefits of hormone replacement. Patients who are already in menopause usually do not need hormone therapy when their ovaries are removed.

Tests before hysterectomy surgery

A detailed physical examination, ECG, chest X-ray, blood tests and, if necessary, some further tests according to the age of the patient are performed preoperatively.

What kind of surgery is removing the uterus from the vaginal route?

This operation should be performed under hospital conditions. It usually takes 1-2 hours depending on the patient.

However, it may take longer (approximately 2-3 hours) if an additional surgery such as sagging is performed (approximately 2-3 hours). During the surgery, the patient's heart rate, blood pressure, blood loss and respiration are closely monitored. After the surgery, patients are taken to the recovery room and followed closely until they wake up. Patients are usually discharged the next day.

Can it be passed from the abdomen to the vaginal route during the surgery?

From time to time; when performing the surgery vaginally; The patient presents with advanced adhesions. This condition may not be detected before surgery. For this reason, surgeons sometimes leave the vaginal tract in patients and remove the uterus from the abdomen by making an incision in the patient's abdomen.

What are the complications?

Unfortunately, some undesirable complications may develop due to surgery. Most of these are easily manageable and do not cause problems in the long run.

  • Excessive Bleeding (in a few cases, excessive bleeding sometimes requires blood transfusion)
  • Infection (slight fever can be expected after hysterectomy, it usually regresses without treatment) Serious infection is expected below 5% and resolves with intravenous antibiotic therapy.
  • Constipation
  • Inability to urinate (usually improves in 1-2 days with catheter application)
  • Coagulation (in surgeries performed in the pelvis, there may be a blood clot in the large vessels of the leg or lung. 6 weeks after the surgery is the risky period. Generally, anticoagulant medication is used after the surgery. Especially patients using birth control pills or hormone replacement therapy should discontinue these drugs 1 month before the surgery .
  • Injury to neighboring organs (urinary bag, ureters, intestines are located in the pelvis. These neighboring organs can be injured during surgery. Urinary bag injury occurs around 1-2%, but intestinal injury occurs less than 1%. These damages are mostly noticed during surgery and If it is not noticed later, a second surgical intervention may be required.
  • Premature menopause (Women who have had their womb removed have been shown to enter menopause earlier than expected)

The healing process after removal of the uterus from the vagina

Liquids and food are started to be consumed shortly after the operation. On the day of surgery, intravenous fluid therapy is given. Certain medications can be given on the day of surgery, especially for nausea and vomiting. If the patient has pain, painkillers are given as needed. Patients are motivated to return to their daily activities as soon as possible. Being active is very important. Most patients can be sent home the next day.

Life after hysterectomy

Scientific studies; shows that women are very satisfied after vaginal removal of the uterus. Sex life has improved in most women.

Medications to be discontinued 1 week before surgery

(Consult the doctor following you (heart doctor, neurologist etc.)

  • Aspirin
  • Plavix
  • Kumadin
  • Heparin
  • Innohep
  • Ticlid (ticlopdipine)
  • Dipyridimole
  • Pletal
  • Rheopro
  • Trental (pentoxifylline)

Foods to be cut 1 week before surgery

  • Garlic
  • Echinacea
  • Ginger
  • Ginkgo biloba
  • Ginseng
  • Liquorice
  • Valerian

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