Glossary

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
  • Hysterectomy
    • A procedure to remove the uterus.
    • Total hysterectomy describes the removal of the cervix with the uterus. This is the standard approach. It does not refer to the ovaries.
    • Hysterectomy is a fertility ending procedure, but it does not cause menopause. The ovaries are responsible for the hormones which are associated with being premenopausal.
    • Oophorectomy describes removal of the ovaries. This issue will be discussed before surgery.
    • Hysterectomy may be completed through different approaches:
      • Subtotal or supracervical hysterectomy describes removal of the uterus while leaving the cervix. This is rarely done.
      • Abdominal: hysterectomy completed through a bikini-type incision or one that is vertical between pubic bone and umbilicus.
      • Vaginal: hysterectomy completed through incisions in the vagina. This technique offers the most advantages when it comes to speed of recovery and decreased operative risk factors to the patient. The exposure is limited, so many patients are ineligible.
      • Laparoscopically-Assisted Vaginal Hysterectomy (LAVH): the hysterectomy is started abdominally with a laparoscope and small trocars placed through the anterior abdominal wall. It is finished vaginally. This technique attempts to harness the advantages of the abdominal and vaginal approaches.
      • Total laparoscopic: a further variation of the LAVH. This technique involves actual completion of the procedure through the laparoscope; therefore, no vaginal approach is necessary.
    • Recovery from hysterectomy depends on the approach used and the patient: Abdominal cases are typically in the hospital two to three nights. At home, patients improve daily. Rate of improvement depends on the individual. Most may return to work in four weeks, but will feel quite tired. Six weeks may be more realistic. Vaginal cases typically stay a single night in the hospital. Most could work at two to three weeks but would feel very tired. Four weeks is a more realistic goal for return to work.
    • The risks of surgery also depend on the route. There are some general risks: all patients have the risk of bleeding and the risk of transfusion. There is a risk of infection. This would typically manifest as a postoperative fever. Sources of infection could include operative site, urinary tract, even pneumonia. There is a risk of damage to surrounding structures. The most significant usually is the urinary tract. At times, additional procedures or intra-operative consultations must be made to appropriately care for these problems. There are also risks of anesthesia, and of venous thromboembolism, that is, formation of clots in the leg or pelvic veins.
  • Hysteroscopy Hysterectomy

    (A: hysteroscopic view through the dilated cervix.
    B: hysteroscopic view of right tubal ostia.)

    • Procedure done to visualize and operate on the inside of the uterus.
    • Performed by first dilating the cervix and then placing a pen-sized scope into the uterus.
    • Polyps and fibroids may be removed. The lining may be ablated (cauterized) to reduce bleeding.
    • This is an outpatient procedure and is well tolerated.
    • Patients typically experience some cramping and spotting after the procedure.
    • The risks are the same as for a suction D&C. Risk of bleeding, infection. There is a risk that an instrument can perforate the uterus.
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