Hysterectomy (cont.)
Total abdominal hysterectomy
This is the most common type of
hysterectomy. During a total abdominal hysterectomy, the doctor removes
the uterus, including the cervix. The scar may be horizontal
or vertical, depending on the reason the
procedure is performed, and the size of the area being treated.
Cancer of the ovary(s) and uterus,
endometriosis, and large uterine fibroids are treated with total abdominal hysterectomy. Total abdominal
hysterectomy may also be done in some unusual cases of very severe pelvic pain, after a very thorough
evaluation to identify the cause of the pain, and only after several attempts at non-surgical treatments.
Clearly a woman cannot bear children herself after this procedure, so it is not performed on women of
childbearing age unless there is a serious condition, such as cancer. Total abdominal hysterectomy allows
the whole abdomen and pelvis to be examined, which is an advantage in women with cancer or investigating
growths of unclear cause.
Vaginal hysterectomy
During this procedure, the uterus is removed through the vagina. A vaginal hysterectomy is appropriate
only for conditions such as uterine prolapse, endometrial hyperplasia, or cervical dysplasia. These are
conditions in which the uterus is not too large, and in which the whole abdomen does
not require examination
using a more extensive surgical procedure. The woman will need to have her legs raised up in a stirrup
device throughout the procedure. Women who have not had children may not have a large enough vaginal canal
for this type of procedure. If a woman has too large a uterus, cannot have her legs raised in the stirrup
device for prolonged periods, or has other reasons why the whole upper abdomen must be further examined, the
doctor will usually recommend an abdominal hysterectomy (see above). In general, laparoscopic vaginal
hysterectomy is more expensive and has higher complication rates than abdominal hysterectomy.
Next: Laparoscopy-assisted vaginal hysterectomy »
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