FemaleHealthMadeSimple

 

Hysterectomy

This page provides basic knowlege about the medical procedure known as a hysterectomy (removal of the womb).

The decision to undergo a hysterectomy rest with the patient and her medical attendent. We will discuss the procedure, the different techniques to do it and the usual indications for doing a hysterectomy.

The procedure can be done either through the vagina or abdominally ( through the tummy). Abdominal hysterectomies can either be total or subtotal. In recent years there was a dramatic improvement in laparoscopic surgery. The new options are either a laparoscopic assisted vaginal hysterectomy or a laparoscopic subtotal hysterectomy.

Contrary to popular believe the term total hysterectomy has nothing to do with the ovaries and the term does not refer to the ovaries. The term refers to the cervix.

In a total abdominal hysterectomy the uterus and the cervix are removed. In a subtotal hysterectomy only the uterus is removed while the cervix is left intact.

The next drawings will illustrate the difference.

 

Subtotal Abdominal Hysterectomy Illustrated

Drawing One

Drawing Two

The first drawing indicates the level of cut through the uterus. The cut is above the cervix. The second drawing shows the uterus sererated from the body and the cervix still in position.

Total Abdominal Hysterectomy illustrated

Drawing One


The black line referred to as incision indicates the incision line when a total hysterectomy is done.

Drawing Two


This drawing illustrates how the whole womb , including the cervix, is removed.

 

 

A vaginal hysterectomy is always complete, it is imposible to leave the cervix. The vagina is opened into the peritoneal cavity by cutting around the cervix and than pulling the womb down through the vagina. The walls of the vagina are very elastic. and can strech wide enough.

Vaginal Hysterectomy Illustrated


 

One or both ovaries are sometimes remove during a hysterectomy. The following terminology are than used:

1. Total(or subtotal) abdominal hysterectomy and bilateral salpingo oopharectomy

This means that a total or subtotal hysterectomy was done and both ovaries and tubes were also removed. ( salpinx or salpingo refers to the tubes. See glossary .

2. Total(or subtotal) abdominal hysterectimy and left( or right) salpingo oopharectomy.

This means that either a sub total or a total hysterectomy was done and one of the ovaries with it's fallopian tube was also removed.

3. Vaginal hysterectomy and bilateral oopharectomy

This means that both ovaries were also removed while the vaginal hysterectomy was performed.

4 Vainal hysterectomy and left (or right) oopharectomy.

This means that one of the ovaries was removed while the vaginal hysterectomy was performed.