Vaginal Hysterectomy: What is it?

A vaginal hysterectomy is an alternative surgical procedure to an abdominal hysterectomy. The primary difference between the two methods is that a vaginal hysterectomy involves the detachment and removal of the uterus through the vagina instead of through an abdominal incision.

Vaginal Hysterectomy vs. Abdominal Hysterectomy

A vaginal hysterectomy has several advantages over an abdominal hysterectomy. These include

  • Rapid recovery. Women who have vaginal hysterectomies are usually discharged from the hospital within one or two days of the procedure. You will be able to resume normal functioning within a few weeks of the surgery,
  • No visible scarring. While an abdominal hysterectomy necessitates a 5- to 7-inch slit being made across your stomach, a vaginal hysterectomy is performed via a vaginal incision. There is therefore no scar visible after your surgery.
  • Lower complications. Vaginal hysterectomies have been associated with fewer risks and complications than abdominal hysterectomies.

Vaginal hysterectomy: Who needs it?

A vaginal hysterectomy may be used to treat a number of different conditions. With the exception of cancerous cases, however, it is usually considered a last-resort treatment since it makes conception in the future impossible. The conditions that may require a vaginal hysterectomy include (but are not limited to):

  • Uterine fibroids. A vaginal hysterectomy can be used to treat cases involving small uterine fibroids (non-cancerous growths in the uterus)
  • Endometriosis: A vaginal hysterectomy can be used to treat cases of mild endometriosis (a condition characterised by the abnormal growth of endometrial tissue) when more conservative methods fail to work.
  • Uterine prolapse: The weakening of pelvic muscles can lead to a condition known as uterine prolapse. This can cause a number of problems, including urinary incontinence and pelvic pain. A vaginal hysterectomy can help relieve these symptoms.

Do note that not every woman is physiologically suited for a vaginal hysterectomy. Vaginal hysterectomy may not be ideal when the uterus is massively enlarged; if there is a presence of severe intra abdominal adhesion, or a presence of concurrent adnexal (tube/ovaries) pathology. Dr G will determine whether this a viable option for you after an examination and considering your medical history.

Vaginal hysterectomy: How is it done?

Before Dr G begins the procedure, the anaesthetist on his team of specialists will give you either general or regional anaesthesia. During the procedure, Dr G will detach the uterus from the fallopian tubes, ovaries, upper vagina, and surrounding connective tissue through an incision made in your vagina. The uterus will be removed through this vaginal incision. When this has been completed, Dr G will close the incision with absorbable stitches.

Vaginal hysterectomy: Risks

Though generally considered safe, a hysterectomy has been associated with certain complications. These include infection, haemorrhaging, blood clots, and accidental damage to pelvic or abdominal organs. Factors like diabetes, obesity, and high blood pressure have been found to increase the chances of surgical complications. These risks are rare, however, so talk to Dr G if you have any concerns. He will be able to give you a safety-assessment based on your medical history and current state of health.

After Your Hysterectomy

Women who undergo vaginal hysterectomies generally recover quickly. You will be prescribed medicines to dull any pain you might be having and to reduce your chances of developing an infection. Vaginal bleeding after a hysterectomy is normal, and lasts for a few weeks. Dr G recommends using sanitary pads to absorb this blood since tampons can increase your chances of developing an infection.

While you should be able to resume normal activities within two weeks of the surgery, you should abstain from heavy-lifting, vigorous exercise, and vaginal intercourse until you’ve healed completely (usually around week six).

You will not menstruate or conceive after your hysterectomy. If your ovaries and fallopian tubes were removed during your hysterectomy, you will enter menopause soon and may experience symptoms like mood swings, vaginal dryness, and hot flashes. If necessary, Dr G can prescribe you medicines to mitigate these symptoms.

Please visit our page Life After a Hysterectomy to know more about what to expect after your procedure.