What it is - It is surgical removal of the uterus, usually performed by a gynecologist. Hysterectomy is a major surgery.
How it is done - it needs general anesthesia and requires surgical cut in lower abdomen, the size of scar depends on how big the uterus is. It can be abdominal, vaginal or laparoscopic.
What it accomplishes - effective in curing gynecological problems like urinary incontinence due to uterine prolapse, very large fibroids of more than 18 cm and uterine, cervical, endometrial cancer.
Side effects - Risk of bleeding is very common, requires blood transfusion. Short term death rate (within 40 days of surgery) is usually reported in the range of 1-6 cases per 1000 when performed for benign causes. The mortality rate is several times higher when performed in patients having cancer or other complications.
Long term effect on mortality is relatively more under the age of 45 years believed to be caused by the hormonal side effects of hysterectomy and prophylactic oophorectomy.
Approximately 35% of women after hysterectomy undergo another related surgery within 2 years.
Ureteral injury is not uncommon and can range from 2.2% to 3%.
Pros & Cons of surgery - Hospital stay is 3 to 5 days or more for the abdominal procedure and between 2 to 3 days for vaginal or laparoscopically assisted vaginal procedures.
Time for full recovery is very long and largely independent on the procedure that was used. Depending on the definition of "full recovery" 3 to 12 months have been reported. Serious limitations in everyday activities are expected for a minimum of 4 months.
It ends your ability to bear children, and if you also elect to have your ovaries removed, it brings on menopause and the question of whether you'll take hormone replacement therapy.
What it is - It is surgical removal of the fibroids, usually performed by a gynecologist. Myomectomy may be open or laparoscopic approach. Some time it done by hysteroscope. But it is also a major surgery.
How it is done – it needs general anesthesia and requires surgical cut in lower abdomen, the size of scar depends on how big the fibroid is. It can be abdominal or laparoscopic.
What it accomplishes – It is done for uterine fibroids.
Side effects –
Excessive blood loss. The uterus has a rich network of blood vessels and fibroids stimulate growth of new vessels to obtain their own blood supply. So during myomectomy, surgeons must take extra steps to avoid excessive bleeding. Blood transfusion may be needed.
Scar tissue. Incisions into the uterus to remove fibroids can lead to adhesions — (bands of scar tissue) which may block implantation of a fertilized egg in the uterine lining and adhesions could entangle neighboring structures and lead to a blocked fallopian tube or a trapped loop of intestine.
Development of new fibroids. Myomectomy doesn't eliminate your risk of developing more fibroids later. If fibroids return, future treatment — a repeat myomectomy, hysterectomy or other procedure — may be necessary.
During Childbirth- If myomectomy incision is deep incision in your uterine wall, the doctor who manages your subsequent pregnancy may recommend cesarean delivery to avoid rupture of the uterus during labor.
Inability to restore the structure of the uterus. To remove embedded fibroids, the surgeon might cut into the muscular wall (myometrium), leaving a gap.
Pros & Cons of surgery - Hospital stay is 3 to 5 days or more for the abdominal procedure and between 2 to 3 days for laparoscopic.
Time for full recovery is very long and largely independent on the procedure that was used.