A hysterectomy is a surgical procedure to cast off the womb (uterus). A woman may not be able to get pregnant after the operation. when you have not already long gone through the menopause, you will now not have periods, irrespective of your age.

Its defined as removal of uterus from the body. It may or may not be accompanied with removal of ovaries or fallopian tubes with it.

The procedure can be accomplished laproscopically or by open technique or sometimes vaginally.

Various indications for which this surgery is recommended can be:

1. Heavy menstrual bleeding not responding to medical management.
2. Having fibroids in uterus leading to bleeding, pain, pressure symptoms.
3. Ovarian masses, benign or malignant.
4. Endometriosis
5. Thickened endometrium not responding to medical treatment.
6. Other cancerous conditions like cancer cervix or endometrium(uterine lining).
7. Prolapse uterus(uterus coming out of the introitus).
8. Infections of genital tract rarely.
9. Rarely after delivery for uncontrolled bleeding or placenta which is morbidly adherent to uterus (placenta accreta).
10. Prophylactic Hysterectomy: Done in rare hereditary disorders having very high risk of endometrial cancer.

Preoperative workup

Investigations like Complete blood count, Renal function, coagulation profile, Chest X ray, ECG etc are done. Pap smear is also done. Pre anaesthesia check up done.

Anaesthesia

Can be general or spinal.

Procedure

• Skin incision may be transverse or vertical (in case of open surgery) or button hole sized 3-4 cuts over abdomen(in case of laparoscopy).
• Uterus is freed from its attachments and removed.
• Thereafter layers of abdomen are closed.

Postoperative care

Antibiotics and iv fluids are given after surgery. Dressings are changed after 2 days. Sutures are removed after 8-10 days or not if they are absorbable.