Choose the Right Type of Hysterectomy With Utmost Care
Type of hysterectomy becomes important factor
when you have already decided to go for it, or at least when you
are giving the whole notion a serious thought. However, any type
of hysterectomy will still be a hysterectomy -- a major gynecological
operation, involving removal of at least the uterus and performed
in general anesthesia.
The types of hysterectomy are usually given their own shortcuts
and these are:
|
TAH
|
Total abdominal hysterectomy
surgery |
|
VH
|
Vaginal hysterecomy surgery |
|
LH
|
Laparoscopic (laproscopic)
hysterectomy surgery |
|
LAVH
|
Laparoscopically assisted vaginal
hysterectomy or laproscopic assisted vaginal hysterectomy |
|
LSO
|
Removal of left ovary and fallopian
tube |
|
RSO
|
Removal of right ovary and
fallopian tube |
|
BSO
|
Removal of both ovaries and
fallopian tubes |
|
TAH/BSO
|
Total abdominal hysterectomy
with removal of both ovaries and fallopian tubes |
Type of Hysterectomy According to the Parts Removed
Total
hysterectomy is taking out the entire uterus, altogether with
cervix.
Many
lay people wrongly think that the term "total" here means taking
both the uterus and the ovaries, but that is not correct. The phrase
"complete hysterectomy" is also frequently used to describe taking
"everything out".
Subtotal
hysterectomy is taking out only the uterus, while leaving the
cervix in place. Tubes and ovaries may or may not be removed. This
procedure is always done through the abdomen.
In
recent years, there is a heightened interest in subtotal hysterectomy,
as the common sense dictates that the sexual enjoyment will be greater
of the cervix is left in place. Contrary to that, hard evidence
(interviewing women with and without cervix left in place after
a hysterectomy) shows that sexual pleasure is the same with or without
cervix out there.
After
subtotal hysterectomy, a woman still needs to have regular Pap smears
to prevent cervical cancer.
Radical
hysterectomy is taking out not only the cervix, uterus and fallopian
tubes, but also the upper third of the vagina and the tissues around
the cervix. Radical hysterectomy really is a surgical way of removing
the cancer of cervix, so the pelvic lymph glands will also be removed
at this time. Ovaries may well be target for the radical hysterectomy,
but it is up to your doctor to assess whether that should be so.
Should Ovaries Be Removed As Well?
The latin name of the ovaries is "oopher" and for the tubes, it is
"salpinx". So, oophorectomy
is taking the ovaries out, and salpingo-oophorectomy
is taking both the ovaries and the tubes out. If done on both sides,
it will be called bilateral
salpingo-oophorectomy, and is usually shorthened as "BSO".
If the surgeon believes that the cause for hysterectomy may endanger
the ovaries as well, you will be offered a BSO together with the hysterectomy.
It
is important to ensure that the surgeon will not take the ovaries
out only because it is convenient to him or her to do while you
are already on the table. Taking the ovaries out will put you in
the state of surgical menopause, meaning you will lack certain hormones
for the rest of your life. It turns you into a perpetual customer
for hormone replacements, so make it a joint decision before the
surgery.
Type of Hysterectomy According to How the Uterus Is Removed
Vaginal
hysterectomy is removing the uterus through the vagina.
The presence of large uterine fibroids, large ovarian cysts, extensive
endometriosis, or unexplained pelvic pain may stand in way of vaginal
hysterectomy. But when it can be can safely be performed, vaginal
hysterectomy generally involves fewer complications, a shorter recovery
period and no visible scar.
Abdominal
hysterectomy is removing the uterus through an incision in the
abdomen. This is still the most common type of hysterectomy.
Total
abdominal hysterectomy (or TAH), is removing the uterus
with the cervix through the abdomen.
Laparoscopic
hysterectomy (or LH) is perfoming the entire (or most
of the) hysterectomy through the laparoscope.
Laparoscopically
assisted vaginal hysterectomy (or LAVH) is using laparascope
and completing the hysterectomy through the vagina.
Laparoscopic
supracervical hysterectomy
(or
LSH) is
a relatively new procedure, from the mid 1990's. It cuts away the
body of the uterus, but leaves the cervix in place. Many say that
this is the future of hysterectomy, so if you must have it, at least
ask whether it is available in the operating "theatre near
you"!?
Choosing the Right Type of Hysterectomy -- Is TAH Better Than LH?
Given enough time to operate, laparoscopy is better. The incisions
are smaller and in case of LAVH, there are no abdominal incisions
at all. However, there are no hard data showing the LAVH is superior
the TAH, provided, of course, that both types of operation can be
done safely.
Laparoscopy
is clearly better then classical surgery for gallbladder and ovarian
cysts, since most of the problems the patient has comes from the
incision and not from what is done in the inside. Hysterectomy is
different in that regard, since the tissues around the uterus must
heal as well. Although this means that the difference between a
laparoscopic and classical hysterectomy is not that great after
all, if possible, opt for laparoscopy.
Think Twice Before Deciding for the Type of Hysterectomy
Some types of hysterectomies involve removing other organs as
well. There are several ways to classify a hysterectomy so discuss
with your doctor the kind of hysterectomy recommended to you. If
something rings false talking to the first doctor, ask for a second
opinion. Be peristent and open yourself to learning new things
and notions. Otherwise, why do you think your
situation can change for the better if you continue with your old,
bad ways!?
Return from Type
of Hysterectomy to home page of How To Avoid Hysterectomy.
|