Hysterectomy: surgical procedure and clinical applications

¶ … along with its prognosis and other important details such as when it is necessary and why in many cases, it may be absolutely unnecessary. The paper first explains why I chose this subject and then goes on to explain the procedure, its various types and the ways it can be performed. The essay also sheds light on the controversy surrounding hysterectomy to argue that in many cases, hysterectomy is not the answer.

The essay supports its claim with the help of some highly credible sources. The paper also sheds light on the number of complications connected with this procedure. This is of importance to me because of personal reasons as I have explained in the essay. The paper is an essay but research has been included because I studied some credible sources to get adequate, authentic and critical information about this procedure.

Essay: Hysterectomy is one of the more common procedures performed on women today. I have selected this topic because as a woman I would like to have more knowledge about the procedure and its complications. I have studied the procedure in detail to discover to have reached the conclusion that in more cases than not, it is a highly unnecessary panacea and many patients can live very well without ever undergoing this surgery.

The procedure involves an incision in abdomen area to remove the uterus. The most common reason for this kind of surgical procedure is uterine fibroids. Other reasons can be cancer, pelvic relaxation and endometriosis. Hysterectomies are usually performed for non-life threatening situations and are hence quite controversial. Some of the common symptoms that may lead to hysterectomy include: "a constant heavy bloated feeling, urinary tract problems or incontinence, unusually heavy or long menstrual periods, unusual swelling in the abdominal region (due to fibroid tumors); infertility (due to fibroid tumors or endometriosis), complications of childbirth, cancer and intolerance to the drug therapy usually prescribed for endometriosis." (Balch, p. 504)

Hysterectomy can be performed through abdomen, vagina or laparoscopic-assisted. In the case of abdominal removal of uterus, women may need to stay at the hospital longer than in case of vaginal procedure. In either case, the procedure is not performed on women in child-bearing age because once the uterus is removed, women cannot have children. Hence doctors are careful about performing this procedure after woman has crossed her child-bearing years. There are different ways in which hysterectomy takes place,"Total Hysterectomy: in this procedure, the cervix is removed along with the uterus

Partial (also known as subtotal and supracervical) hysterectomy: in partial hysterectomy, the uterus is removed but cervix and other female reproductive organs remain intact; Pan (or radical) hysterectomy: In this, the most extensive form of hysterectomy, the ovaries, the cervix, supporting ligaments, tissues, fallopian tubes, upper portion of the vagina, pelvic lymph nodes and uterus are removed." (Balch, p. 506)

The decision to opt for vaginal, abdominal or laparoscopic assisted hysterectomy depends on the nature and complexity of the problem. Abdominal hysterectomy tends to have more complications associated with it, and hence it is performed only in cases of major problems. Vaginal hysterectomy is performed to correct relatively less serious problems such as: "Prolasped uterus, Relatively small fibroid growths, Cervical or uterine dysplasia" (Hass, p. 177). Abdominal hysterectomy on the other hand is performed for complications such as, "Fibroid growths are too large to be removed through the vagina, the ovaries are enlarged, you are experiencing unexplained abdominal pain, uterine infection is suspected, extensive endometriosis or adhesions are present, early endometrial cancer exists, a radical hysterectomy is performed because of cervical or uterine cancer." (Hass, p.177).

I would like to discuss the complications resulting from this procedure as my mother has undergone this surgery and I have seen how a patient can suffer from numerous consequences. Hysterectomy can lead to many long-term complications which may include urinary problems, hormone imbalance, sexual issues, depression, adhesions and heart complications etc. For this reason, hysterectomy has often under attack. It is believed that this procedure is being performed far more commonly than needed and hence some critics are skeptic of the need to have this performed because in most cases, the problems are not very serious. "Many people question the fact that more than 650,000 hysterectomies are performed in the United States each year. Very few of these operations are performed because of a life-threatening situation, and it is likely that many of them are unnecessary. Per capita, half as many hysterectomies are performed in the Great Britain as in the United States, and statistically American women show no health benefits for their incidence of surgery." (Balch, p.504). The reason that hysterectomies are controversial is because of the high number of these procedures taking place in the U.S. each year and most of the times, this procedure may actually not needed. The long-term complications with hysterectomy tend to make this procedure even more unpopular among critics. Women who have undergone this surgery report many problems and quality of life is hugely compromised after this procedure and hence it is important that a more responsible attitude is adopted when recommending hysterectomy. Dr. Stanley West is strictly against hysterectomy for he believes that in most cases, it is simply not needed. This is a very drastic measure which can be completely avoided in so many cases but since people have inadequate knowledge of their own bodies or what hysterectomy can do to them, they follow doctor's recommendation for the procedure without getting a second opinion. Stanley West argues: "You don't need a hysterectomy. It can do you more harm than good. Those are strong words but the fact is that more than 90% of hysterectomies are unnecessary. Worse, the surgery can have long-lasting physical, emotional and sexual consequences that may undermine your health and well being…. Most of the "female problems" that lead to hysterectomy are medically trivial. They can be uncomfortable. Untreated, some can make your life miserable. But they will not kill you." (West, p. 1-2). While this may be a common procedure, it is still a highly unnecessary one and patients must be given more information before they agree to this surgical procedure. Medical community must show great responsibility and caution when recommending hysterectomy for some of the very common and trivial medical problems. They must understand that such a procedure can lead to life long problems and may actually do more harm than good.