Total Abdominal Hysterectomy

A partial or total abdominal hysterectomy is often needed when women have health problems involving their reproductive organs or pelvic area. Any woman who is experiencing abnormal menstrual bleeding or chronic pelvic pain should seek professional medical assistance. Though there may be nothing seriously wrong, such symptoms are often associated with endometriosis, uterine fibroids, or uterine prolapse. These are conditions that need prompt diagnosis so that proper treatment can begin. The physician will want to take a complete medical history that may include questions about the health history of the patient's mother, sisters, and aunts. Research has shown that some conditions seem to run in families. The patient can also expect to undergo a physical exam. Additionally, the physician may schedule other tests that will help in making an accurate diagnosis. A partial or total abdominal hysterectomy is major surgery so women should discuss any available alternatives as well as the operation's risks with their physicians. If the patient feels that the physician is not taking her concerns seriously, she should seek a second opinion or find another physician with a better bedside manner.

Menstrual problems such as excessive bleeding are often caused by endometriosis. This condition occurs when the endometrial cells, the uterine lining that provides support to a fertilized egg, grows or implants in other areas of the abdominal region. For example, the endometrial cells may attach themselves to the outside of the uterus, the ovaries, or the fallopian tubes. In some cases, endometrial cells have attached themselves to the intestines, the lungs, and even the brain. These implants can cause severe pelvic pain and are a leading cause of infertility. Though a total abdominal hysterectomy may not be needed, the woman certainly needs relief from the pain. Since a hysterectomy is a procedure that involves the removal of the uterus, this is not a viable option for a woman who wants to become pregnant. In the case of infertility, specialists may be able to provide alternative treatments so that a pregnancy can eventually occur. King Solomon wrote of the grief women feel when they're unable to become pregnant. He said: "There are three things that are never satisfied, yea, four things say not, It is enough: The grave; and the barren womb; the earth that is not filled with water; and the fire that saith not, It is enough" (Proverbs 30:15b-16).

A total abdominal hysterectomy involves the removal of uterus and the cervix. When medically necessary, the surgeon also might remove the woman's ovaries and fallopian tubes. This procedure is known as a bilateral salpingo oophorectomy. Physicians won't usually remove these organs, however, without a very good medical reason. When a woman who is still menstruating has her ovaries removed, early menopause begins. The woman may experience the symptoms of menopause, such as hot flashes and mood swings. A radical hysterectomy involves the removal of the upper vagina and the pelvic lymph glands. These are major operations that require a long recovery time. The abdominal muscles need approximately six to eight weeks to recover from the surgical incision. The total abdominal hysterectomy does have a few advantages. Also known as open hysterectomies, these procedures involve a long surgical incision. But this provides the surgeon with more operating space and the ability to take a closer look at the abdominal region. The surgeon may be able to see pelvic tumors, for instance, that need to be removed.

As mentioned above, uterine fibroids, uterine prolapse, and endometriosis are common conditions that require women to get hysterectomies. Fibroids are uterine tumors that, though usually benign, can cause anemia, abnormal bleeding, and pelvic pain. Uterine prolapse refers to a condition where the ligaments and tissues surrounding the uterus are no longer strong enough to keep it in place. The uterus slides into the vagina causing pain and urinary incontinence. If the condition is severe enough, the patient may need a partial or total abdominal hysterectomy to alleviate the symptoms. While endometriosis has already been discussed, women should be aware that endometrial cancer often occurs in individuals with a body mass index (BMI) greater than 25. The BMI is a calculation involving a person's height and weight and a designation above 25 indicates obesity. Many women suffering from endometrial cancer also suffer from diabetes or cardiovascular disease. Though endometriosis may occur in women who are otherwise healthy, this connection with diabetes and cardiovascular disease is ominous. Women need to take care of their health through good nutrition and physical exercise.

Like all major surgeries, a total abdominal hysterectomy has its risks. The woman may suffer from postoperative infections, for example, or ill effects from the anesthesia. Blood clots or painful scarring may occur. The surgeon may inadvertently cause other pelvic injuries during the operation. However, the operation is seldom life-threatening. When possible, some women opt for a less invasive procedure known as laparoscopically assisted vaginal hysterectomy (LAVH). The surgeon uses a laparoscope, a thin lighted instrument, to remove the uterus and cervix through the vagina. While less invasive, the procedure takes greater surgical skill and is a longer operation. This may cause increased difficulties with the anesthesia, but when all goes well, the recovery time is less than that of the traditional total abdominal hysterectomy. Women who under go any of these procedures need the loving support of their families and friends to help them in their physical recovery. For many women, especially those who won't be able to have children because of their health problems, the procedure also causes emotional issues. These grieving women need shoulders to cry on and compassionate understanding.

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