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- What is a hysterectomy?
- How common is hysterectomy?
- Why is a hysterectomy performed?
- What tests or treatments are performed prior to a hysterectomy?
- How is a hysterectomy performed?
- What are the types of hysterectomies?
- Total abdominal hysterectomy
- Vaginal hysterectomy
- Laparoscopy-assisted vaginal hysterectomy
- Supracervical hysterectomy
- Laparoscopic supra cervical hysterectomy
- Radical hysterectomy
- Oophorectomy and salpingo-oophorectomy (removal of the ovaries or Fallopian tubes)
- What are complications of a hysterectomy?
- What are the alternatives to a hysterectomy?
- Should women who have had a hysterectomy continue to have Pap smears?
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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 on the abdomen 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 attempts at non-surgical treatments. Clearly a woman cannot bear children after this procedure, so it is not generally performed on women who desire childbearing 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.
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).