تعريف

Hysterectomy is the surgical term for the removal of the uterus (womb). This results in the inability to become pregnant.

There are different types of surgeries, such as:

  • Supracervical hysterectomy—removal of the uterus only
  • Total hysterectomy—removal of the uterus and cervix (the opening of the uterus leading to the vagina)
  • Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
  • Salpingo-oophorectomy —removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)

أسباب هذا الإجراء

You may have a hysterectomy if your uterus is causing health problems that cannot be treated by other means. Some reasons a woman may have a hysterectomy are to:

  • Treat cancers (eg, uterine, endometrial, ovarian cancers)
  • Remove uterine fibroids
  • Treat chronic pelvic pain
  • Treat heavy bleeding

Explore your options before having a hysterectomy. There are other treatments for many of these problems.

المضاعفات المحتملة

If you are planning to have hysterectomy, your doctor will review a list of possible complications, which may include:

  • Reactions to anesthesia
  • الألم
  • العدوى
  • نزيف
  • تعب
  • Injured pelvic organs (bowel and/or bladder)
  • Urinary incontinence (problems controlling your urine)
  • Loss of ovarian function and early menopause
  • اكتئاب
  • Sexual dysfunction

بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:

  • السمنة
  • التدخين
  • أمراض القلب أو الرئة
  • مرض السكري
  • Previous pelvic surgery or serious infection
  • Use of medicines during the past month

Discuss the risks with your doctor before surgery.

ما يمكن توقعه

قبل الإجراء

قد يقوم طبيبك بما يلي:

  • اختبارات الدم والبول
  • Pap smear
  • X-ray of abdomen and kidneys—a test that uses radiation to take a picture of structures inside the body
  • Pelvic ultrasound —a test that uses sound waves to show organs in the abdomen
  • Dilation and curettage (D&C)—surgical removal of tissue from the lining of the uterus

You should do the following:

  • التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
    • الأسبرين أو غيره من العقاقير المضادة للالتهابات
    • مخففات الدم ، مثل الوارفارين (الكومادين)
    • كلوبيدوجريل (بلافيكس)
  • Arrange for a ride home and for help at home.
  • تناول وجبة خفيفة في الليلة السابقة للجراحة. لا تأكل أو تشرب أي شيء بعد منتصف الليل.

التخدير

General anesthesia will be used. You will be asleep during the surgery.

جراحة استئصال الرحم بالمنظار

وصف الإجراء

You may be given antibiotics just before your surgery.

Laparoscopic procedures are minimally invasive. This means that small incisions are made, rather than the large incisions that are used during open surgery.

Supracervical Hysterectomy

During this procedure, the doctor will make small incisions in the area of your navel and hip bone. A laparoscope (a small tool with a camera on one end) will be inserted through one of the incisions. The tool will allow the doctor to view your pelvic organs on a monitor. Other tools will also be inserted to do the surgery. Next, the doctor will detach the uterus from the cervix. A tool will be used to break down the uterus into smaller pieces. The doctor will then remove this tissue through the small incisions.

Laparoscopic-Assisted Vaginal Hysterectomy

Similar to the above surgery, the doctor will make small incisions in the abdominal area and insert tools. The doctor will then make an incision in the vagina to help detach the lower portion of the cervix and the uterus. The cervix and uterus will then be removed through the vaginal opening.

Robot-Assisted Hysterectomy

A hysterectomy can also be done using robotic technology. Like the laparoscopic procedures, tools are placed through small incisions in the abdominal area. The doctor, though, sits at a console and views the organs via a monitor that displays a 3D image. The surgery is done using a joystick-like device to control the tools.

مباشرة بعد الإجراء

You will be given IV fluids and medicines.

كم من الوقت سيستغرق ؟

1-3 ساعات

هل سيكون هناك ألم؟

You will not have pain during the surgery because of the anesthesia. During your recovery time, your doctor will give you pain medicine.

متوسط ​​الإقامة في المستشفى

You may be able to leave the hospital on the same day or the next day. You will stay longer if you have complications.

رعاية ما بعد العملية

في المستشفى

أثناء تعافيك في المستشفى ، قد تتلقى الرعاية التالية:

  • On the first night, the nurse will help you sit up and walk.
  • During the next morning, the IV will be removed if you are eating and drinking well.
  • You may need to wear special stockings or boots to help prevent blood clots.
  • You may have a Foley catheter for a short time to help you urinate.

في البيت

During the first few days, you may have pain, bloating, vaginal bleeding, and vaginal discharge.

When at home, take these steps to care for yourself:

  • To prevent infection, take proper care of the incision areas.
  • Slowly increase your activities. Begin with light chores and short walks.
  • During the first two weeks, rest and avoid strenuous activities, like heavy lifting.
  • Ask your doctor when it is safe for you to return to work and drive.
  • Ask your doctor when you will be able to shower, bathe, or soak in water.
  • Eat a diet rich in fruits and vegetables.
  • Pain medicines can cause constipation. To avoid constipation:
    • Eat high-fiber foods.
    • اشرب الكثير من الماء.
    • Use stool softeners if needed.
  • Ask your doctor when you can use tampons.
  • Wait six weeks before resuming sexual activity.
  • Ask your doctor if you should do Kegel exercises to strengthen the pelvic floor muscles.
  • اتبع تعليمات طبيبك.

ملحوظة: If the doctor has not removed your cervix, you will need to continue to havePap smears to check for cervical cancer.

استدعاء الطبيب

بعد مغادرة المستشفى، اتصل بطبيبك في حالة حدوث أي مما يلي:

  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • Redness, swelling, increasing pain, excessive bleeding, leakage, or any discharge from the incision sites
  • الغثيان و/أو القيء
  • الدوخة أو الإغماء
  • السعال، ضيق التنفس، أو ألم في الصدر
  • نزيف شديد
  • ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
  • ألم أو حرقة أو إلحاح أو كثرة التبول أو نزيف مستمر في البول
  • Swelling, redness, or pain in your leg

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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