Demystifying hysterectomy

“After living with severe period pain for 17 years, treating it with a hysterectomy was the best gift I could give myself!” An endo warrior.

A hysterectomy is a treatment solution for a wide range of gynaecological problems. It is the surgical procedure to remove a woman’s uterus (womb). 

A hysterectomy can do it all; treating painful endometriosis, heavy bleeding, and even preventing ovarian cancer. 

But, like any other surgery, a hysterectomy can be a nerve-wracking decision. It can mean an end to a woman’s fertility, whereas, for others, it can be a beginning to a pain-free life. 

Considering this procedure is not reversible, there are many myths surrounding hysterectomy which need to be dispelled. 

Here are our top 10 myths and facts about hysterectomy

Myth 1: Hysterectomy will always lead to menopause

Don’t be worried about losing the battle to menopause, as hysterectomy removes only the uterus and not usually normal healthy ovaries. 

When a hysterectomy is carried out, Dr. Kotasthane will discuss the pros and cons of removal versus conservation of ovaries on an individual basis, taking into account various factors, and a joint informed decision is made on whether it is best to remove or preserve ovaries in your case.

Some examples where ovarian removal is considered are, in certain cases of familial genetic cancer where the risk of cancer is high, any suspicious ovarian pathology or recurrent endometriosis cysts (endometrioma) affecting the ovaries directly.

Myth 2: I will have a large cut through my stomach

This may sound impossible, but with the help of minimal access technology (robotic and laparoscopy), surgeons can remove the uterus through small incisions in the abdomen. 

This laparoscopic procedure (also called keyhole surgery) is minimally invasive. It uses only about an inch of opening in the belly, leaving minor to no visible scars.

Laparoscopic surgery for hysterectomy

Many obstetricians and gynaecologists perform this procedure via “open” surgeries which involve a cut in the abdomen (laparotomy). In comparison to that, a laparoscopic (keyhole/minimally invasive) hysterectomy which I routinely perform, offers distinct advantages;

• less bleeding
• safer surgery than open
• less pain
• early recovery
• lesser infection risk
• the less long-term pain
• early mobilisation
• early return to work (useful for working women and cheaper for them in the long run as they can return to earning capacity sooner)
• ability to drive and commence activities sooner.

Myth 3: After the surgery, I will need months to recover

It is normal to wake up feeling tired and in some pain; after all, it’s surgery. But the level of pain is often much lower requiring lesser analgesia than open surgery.

Also, since the surgery is minimally invasive, the recovery time is also shorter. You can get back to your everyday life and resume light activities in as little as 2 weeks. 

During the time of your recovery, you’ll need to take good rest, refrain from doing heavy lifting, as well as the need to abstain from having sex for at least 6-8 weeks. This is a component of pelvic rest and needs to be followed to ensure complete recovery.

How long is the recovery for a laparoscopic hysterectomy?

Most women go home within 24 hrs after the operation (compared to 3-5 days with open surgery) with minimal analgesia needs and are driving within 7-10 days (compared to 6 weeks with open surgery). This service has been established by Lotus Medics in Orange (public and private) and Parkes(public) hospitals.

Myth 4: Hysterectomy will kill my sex drive

This is simply not true. You’ll still be able to enjoy sex, but please abstain for the first 6-8 weeks after surgery to give the tissues time to heal and adhere to all components of pelvic rest.

That said, sex might feel a little different. Many women will actually find it better because a hysterectomy can resolve issues like bleeding and pain.

Myth 5: There will be an empty space where my uterus used to be

This might be a common concern for many. But, after the uterus is removed, all the usual organs surrounding the uterus will simply fill in the space. 

Myth 6: After the surgery, I shouldn’t do anything but be in bed

Your doctors will recommend what, when and how you can do some simple exercises. Walking is one of the safe and easier options that can help you recover quicker. 

To ensure there is no blood clotting around the wound, you can go on short walks and keep mobilising after your surgery.

Myth 7: Once you undergo a Caesarean, you can’t have a minimally invasive hysterectomy

With modern minimally invasive hysterectomy, you can still have a hysterectomy done even after you undergo a C-section surgery. 

Myth 8: Partial (Subtotal) hysterectomy is better

A partial hysterectomy will remove the uterus, but the cervix is still left. In this case, you will need to continue regular cervical screenings. 

With that said, when a total hysterectomy is done, you should consult your doctor about your individual situation if you need regular screenings.  

Myth 9: There are no alternatives to hysterectomy

There are non-surgical and less invasive alternatives to hysterectomy and the choice of which is best for you will depend on your individual circumstances.  

Unless it is cancer, you can delay getting a hysterectomy. For alternative options, it is best advised to see Dr Kotasthane.

Myth 10: Minimally invasive hysterectomy is only available in major cities

At Lotus Medics, Dr Sachin Kotasthane has brought minimally-invasive hysterectomy right here in Orange, Bathurst and Central West NSW, making it more accessible to women living in the region.

We believe in the principle of informed choice, so when you meet us, we will discuss in detail if a hysterectomy will benefit you.