Vaginal Hysterectomy

What Is a Vaginal Hysterectomy?

A vaginal hysterectomy is a type of hysterectomy surgery performed to remove a woman’s uterus and cervix through the vagina. The fallopian tubes and one or both ovaries may or may not be removed as well. Since the surgery is performed through the vagina and there are no external incisions, vaginal hysterectomies are considered the least invasive of all hysterectomy procedures. However, any hysterectomy is a major surgery that comes with respective surgical risks.

Why Would a Vaginal Hysterectomy Be Performed?

The followings are the common indicators for vaginal hysterectomy:

• Small non-cancerous fibroid tumors;
• Prolapsed uterus – the uterus is sliding down into the vaginal area;
• Endometriosis;
• Adenomyosis;
• Cancer of the uterus, cervix, ovaries, or endometrium.

In fact, for the majority of the listed conditions (except cancer) hysterectomy is not necessary and can be replaced with non-invasive and less invasive alternatives.

Who Is a Candidate For a Vaginal Hysterectomy?

A vaginal hysterectomy removes the uterus and possibly other reproductive organs through the vagina. Vaginal hysterectomies are considered the least invasive of all hysterectomy surgeries and therefore, preferred as the first course of action by surgeons. If a woman has an unusually large uterus or scarring from previous surgeries, a vaginal hysterectomy may not be possible. A consultation with your OB/GYN is necessary to determine if you are a candidate for a vaginal hysterectomy.

Do ask for a second opinion if you are offered to undergo a hysterectomy for uterine fibroids.

What to Expect From Vaginal Hysterectomy?

Vaginal hysterectomy surgery can be performed using local anesthesia or general anesthesia. The surgeon creates an incision at the top of the vagina and uses this natural path to access the uterus and cervix. Surgical instruments are inserted through the incision, and the uterus and other organs, depending on the type of hysterectomy, are detached and removed. Stitches that dissolve naturally are used to close the incision.

Recovery From Vaginal Hysterectomy Surgery

Patients who undergo a vaginal hysterectomy generally experience fewer complications as it does not require an abdominal incision. Recovery is shorter than that of any other type of hysterectomy, however, patients still need a few weeks to heal. Most patients can go home within 24 hours unless unexpected medical concerns arise. The surgeon will provide aftercare instructions to follow during the recovery process.

You can expect:

• Some bleeding that is similar to a light period that dissipates over time;
• Mild pain and discomfort in the lower abdomen;
• Some constipation and bloating;
• Refrain from using tampons, douching or sexual intercourse until cleared by the surgeon;
• No heavy lifting for 4-6 weeks;
• Refrain from performing strenuous tasks;
• Avoid swimming/bathing until the vaginal stitches are healed completely.

Recovery typically takes 2-4 weeks vs. 6-8 weeks for an abdominal hysterectomy.

Risks and Side Effects of Vaginal Hysterectomy:

• Adverse reaction to anesthesia;
• Infection;
• Bleeding;
• Damage to bladder or other nearby organs;
• Blood clots in the legs that may travel to the lungs;
• Early menopause with associated symptoms – hot flashes, vaginal dryness, etc.;
• Diminished bone health;
• Increased cardiovascular risks;
• May require hormone therapy;
• Loss of ability to become pregnant.

Uterine Fibroid Embolization Vs. Vaginal Hysterectomy

If you have been diagnosed with uterine fibroids or adenomyosis and a vaginal type of hysterectomy has been recommended, you may be a candidate for a non-invasive procedure that allows you to keep your uterus. Uterine Artery Embolization (UAE) and Uterine Fibroid Embolization (UFE) are two almost identical non-surgical procedures performed by an Interventional Radiologist. They are very effective in eliminating adenomyosis and fibroid symptoms, including heavy bleeding, pelvic pain, anemia caused by heavy flow, etc.

UAE/UFE allows a woman to keep her uterus fully functional, without risks and complications from fibroid surgery. The recovery time of about a week allows a woman to quickly return to normal life. Pregnancies after UAE/UFE are usually full term, and unlike pregnancy after myomectomy, do not require a C-section.

Contact Atlanta Fibroid Center at (770) 953-2600 or make an appointment on ATLii.com to find out if you are a candidate for UAE/UFE.