What Are the Pros and Cons of Hysterectomy for Fibroids?

Hysterectomy is a gynecological operation. Depending on the nature, location, size, and age of the lesion, different surgical methods such as partial resection, subtotal resection, total resection, subtotal resection, and extensive resection can be taken. Surgery can be performed abdominally, laparoscopically, and transvaginally.

Basic Information

Chinese name: Hysterectomy
Anesthesia: general anesthesia

Indication: Uterine tumors, conservative treatment of uterine disease is ineffective
complication: Infections, bleeding, and pelvic organ damage
Postoperative management: Prevent infections and avoid elevated intra-abdominal pressure

Hysterectomy anesthesia

general anesthesia.

Preparation before hysterectomy

1. One day before surgery, prepare the skin and enema for the abdomen and perineum, and routinely prepare blood.

2. If pelvic and abdominal adhesions are suspected, intestinal preparation should be performed.

Indications for hysterectomy

1. Uterine benign tumors: those with uterine fibroids larger than the uterus at 12 weeks of gestation; or those with fibroids less than 12 weeks of gestation, but with more uterine bleeding and ineffective drug treatment.

2. Malignant tumors of the uterus: such as cervical cancer, endometrial cancer, uterine sarcoma, uterine velvet cancer, etc.

3. Patients with severe dysfunctional uterine bleeding who have failed treatment with conservative treatment.

4. Atypical endometrial hyperplasia, adenomyosis, endometriosis, etc., those who have failed drug treatment.

5. Ovarian or fallopian tube malignancy.

6. Uterine prolapse, uterine prolapse, uterine rupture, etc. Those who do not need or cannot retain the uterus.

Contraindications to hysterectomy

1. Contraindications to surgery caused by systemic diseases, such as heart, liver, kidney and other important organ dysfunction.

2. If the uterus is too large beyond 20 weeks of pregnancy, it should be carefully considered.

Hysterectomy

Transvaginal hysterectomy

Suitable for surgical treatment of varus inversion. It is suitable for patients with localized infection or tissue necrosis of varus uterus; patients with varus uterus who have subversion of uterine fibroids for a long time, edema of the uterine body thickened, recovery is difficult, and they are older; The difference from a transvaginal subtotal hysterectomy is that the posterior uterine wall incision reaches the posterior vaginal fornix without retaining the cervix.

2. Transvaginal Hysterectomy

It is suitable for patients with localized infection or tissue necrosis of varus uterus; patients with varus uterus who have subversion of uterine fibroids for a long time, edema of the uterine body thickened, recovery is difficult, and they are older;

3. Extensive hysterectomy

The basic procedure for the surgical treatment of cervical cancer is to remove all regional lymph nodes and perform a comprehensive hysterectomy to remove the parauterine, paracervix, paravaginal and proximal vaginal tissues.

4. Transabdominal hysterectomy

It is a common technique for benign uterine lesions. The subtotal hysterectomy is beneficial because it preserves a healthy cervix and a certain role of the cervix in regulating body secretion. The cervix can still secrete mucus, the vaginal length remains unchanged, and there is no vaginal scar after cervical resection. Women's physical and mental health after surgery.

5. Transabdominal or laparoscopic hysterectomy

Is the most commonly used technique. Mostly used to remove uterine tumors and certain uterine bleeding and accessory lesions. During the operation, care must be taken not to damage the ureter and to minimize blood loss.

Hysterectomy complications

Intraoperative bleeding, bladder injury, ureteral injury, rectal injury, infection.

Hysterectomy considerations

1. When cutting the reflexed peritoneum, be careful not to damage the bladder. When the anatomical relationship is unclear, the fornix incision is extended into the pelvic cavity, and the peritoneum is folded back in front of the uterus and cut.

2. When clamping tissues on both sides of the uterine isthmus, it should be close to the uterus to prevent damage to the ureter. It should not be too much to clamp the ligaments and fallopian tubes to avoid slipping.

Nursing after hysterectomy

1. It is advisable to enter a liquid diet 1 to 2 days after surgery, to enter a semi-liquid food 3 to 4 days, and to enter a normal diet on the 5th day. Should enter a high-protein, high-vitamin, nutritious diet. Should pay attention to increase the amount of fresh crude fiber vegetables and fruits, avoid raw, cold, spicy, spicy diet, to prevent constipation.

2. Indwelling the catheter, the specific time according to the operation.

3. Remove the gauze stuffed in the vagina 24 hours after surgery.

4. Give antibiotics, generally preventive use does not exceed 48 hours.

5. Pay attention to rest. Avoid the action of increasing abdominal pressure within six months after the operation, avoid cough, constipation, and should not stand, sit and lift heavy objects for a long time.

6. Pay attention to keep warm and prevent colds. Check again after 1 month, and forbid sex and tub bath for 3 months.

7. If there is pain in the lower abdomen and abnormal discharge of the vagina, see a doctor promptly. Pay attention to maintain personal hygiene and strengthen pelvic floor function exercises.