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What is a hysterectomy?
A hysterectomy is the removal of the uterus (womb). For certain conditions, the Fallopian tubes and ovaries are also removed.
The most common medical reasons for doing a hysterectomy include benign fibroid tumors of the uterus, abnormal uterine bleeding, endometriosis, genital prolapse, and chronic pelvic pain. Some women choose to have a hysterectomy for other reasons, including other types of tumors. Uterine cancer is an uncommon, but important reason for doing a hysterectomy.
What is a laparoscope?
A laparoscope is a viewing tube through which structures within the abdomen and pelvis can be seen. A small surgical incision (cut) is made in the abdominal wall to permit the laparoscope to enter the abdomen or pelvis. Additional tubes can also be pushed through the same or other small incisions allowing the introduction of probes and other instruments. In this way, surgical procedures can be performed without the need for a large surgical incision.
What is laparoscopically assisted vaginal hysterectomy (LAVH)?
Laparoscopically assisted vaginal hysterectomy (LAVH) is a surgical procedure using a laparoscope to guide the removal of the uterus and/or Fallopian tubes and ovaries through the vagina (birth canal). (A different procedure, called a laparoscopic hysterectomy, is entirely performed using a laparoscope and other instruments inserted through tiny abdominal incisions, and the uterus, Fallopian tubes etc. are removed in tiny portions.)
Not all hysterectomies can or should be done by LAVH. In certain situations, a laparoscopic hysterectomy (see above) may be sufficient. In other cases, an abdominal hysterectomy or a vaginal hysterectomy (without laparoscopy) is indicated. The surgeon determines the appropriate procedure for each individual case based upon the reason for the hysterectomy and the medical history and condition of the patient.
How is LAVH performed?
During LAVH, several small incisions (cuts) are made in the abdominal wall through which slender metal tubes known as "trocars" are inserted to provide passage for a laparoscope and other microsurgical tools. The laparoscope acts as a tiny telescope. A camera attached to it provides a continuous image that is magnified and projected onto a television screen for viewing.
In the course of LAVH, the uterus is detached from the ligaments that attach it to other structures in the pelvis using the laparoscopic tools. If the Fallopian tubes and ovaries are to be removed, they are also detached from their ligaments and blood supply. The organs and tissue are then removed through an incision made in the vagina.
What are the disadvantages of LAVH?
LAVH can be a longer operation and more expensive than a vaginal hysterectomy and, under certain circumstances, it can be more dangerous.
What are the advantages of LAVH?
The incisions in an LAVH are relatively small. The scars, pain, and recovery time from LAVH are usually significantly less than with an abdominal hysterectomy, which requires both a vaginal incision and a 4-6 inch (10-15 cm) long incision in the abdomen). LAVH is similarly less physically traumatic than a routine vaginal hysterectomy. When LAVH is feasible, it has distinct advantages.It can allow for a vaginal hysterectomy in patients who have not had children.
Women's Conditions Resources
UpToDate.com. Laparoscopic approach to hysterectomy.
Laparoscopically Assisted Vaginal Hysterectomy - What is LAVH
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ColposcopyDuring a colposcopy procedure, the vulva, vaginal walls, and uterine cervix is examined to detect abnormalities that may suggest diseases. Tests performed during colposcopy include acetic acid wash, color filter, or biopsy of the cervix. Treatments for cervical abnormalities include:
- carbon dioxide laser photoablation,
- LOOP (LEEP),
- cold knife cone biopsy, or
Common Medical Abbreviations and Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and infertility.
Treatment of endometriosis can be with medication or surgery.
A hysterectomy is a surgical procedure in which the uterus is removed. There are a variety of surgical techniques for performing hysterectomies, which include vaginal hysterectomy, total hysterectomy, laparoscopy-assisted vaginal hysterectomy (LAVH), supracervical hysterectomy, laparoscopic supracervical hysterectomy, radical hysterectomy, and oophorectomy and salpingo-oophorectomy hysterectomies.
Complications include infection, pain, and bleeding. The type of hysterectomy performed is dependant upon the woman and the reason for the procedure.
LaparoscopyA laparoscopy is a minimally invasive surgical procedure that is used to treat diseases of the gastrointestinal tract. Surgery is performed through three or more 5 to 10 mm incisions in the abdomen. A blood test, lung function test, ECG, chest X-ray, and other tests may be performed prior to surgery.
Surgery QuestionsSurgery is the branch of medicine that employs operations in the treatment of disease or injury. Prior to surgery you might consider asking your surgeon questions about the operation (procedure).
Uterine CancerThough uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including being over age 50, having endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, and/or having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Uterine fibroids are benign (non-cancerous) tumors in the womb (uterus). Most uterine fibroids do not cause symptoms; however, if the fibroid is large enough and in the right location, it may cause symptoms of pelvic pain, abnormal vaginal bleeding, and pressure on the bladder or rectum.
Uterine fibroids that remain small and do not grow usually do not need treatment; however, surgery to remove the fibroid may be necessary. Uterine fibroids do not cause cancer; however, there is a rare, fast-growing cancerous called leiomyosarcoma.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include:
- Abdominal pressure and pain
- Pelvic pain
- Pain during intercourse
- Pain during bowel movements
Diagnosis and treatment of benign uterine growths depends upon the type of growth.
Vagina PictureThe vagina is an elastic, muscular canal with a soft, flexible lining that provides lubrication and sensation. See a picture of the Vagina and learn more about the health topic.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions that may include:
- Uterine fibroids
- Pelvic inflammatory disease
- Emotional stress
- Anorexia nervosa
- Polycystic ovary syndrome (PCOS)
- Early pregnancy
The treatment for abnormal or irregular vaginal bleeding depends upon the cause.