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Hysterectomy

Hysterectomy. Eric Cui Bio 199 Spring 2009. Hysterectomy. Usually performed by a gynecologist Uterus is removed Other reproductive organs may be removed No longer able to have a baby Periods will stop. Indications. Fibroids Endometriosis Uterine prolapse

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Hysterectomy

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  1. Hysterectomy Eric Cui Bio 199 Spring 2009

  2. Hysterectomy • Usually performed by a gynecologist • Uterus is removed • Other reproductive organs may be removed • No longer able to have a baby • Periods will stop

  3. Indications • Fibroids • Endometriosis • Uterine prolapse • Cancer of the uterus, cervix, or ovaries • Vaginal bleeding • uncontrollable postpartum obstetrical haemorrhage • Transgender man

  4. Risks and Side Effects • Earlier onset of menopause • Greater risk of cardiovascular disease • Increased chance of osteoporosis and bone fractures • Uncontrolled urination • Reduced libido • Vaginal dryness

  5. Epidemiology • Hysterectomy is the second most common surgery among women in the United States • One in three women in U.S. had one by age 60 • Each year, more than 600,000 are done • Over 90% are performed for benign conditions • Over 70% also involved the surgical removal of ovaries

  6. Types of Hysterectomy • Partial Hysterectomy • Removes 2/3 of uterus • Total Hysterectomy • Removes uterus and cervix • Radical Hysterecomty • Removes uterus, cervix, and vagina

  7. Types of Incisions Vertical Incision Pfannenstiel Incision

  8. Abdominal Hysterectomy • the uterus is removed through an incision in the woman’s abdomen. • Most invasive method • Incision site at abdomen • Hospital stay of 5-6 days • Recovery time 6 weeks • Possible retention of cervix • Required for endometriosis and large fibroids

  9. Vaginal Hysterectomy • the uterus is removed through the vagina. • Less invasive than abdominal hysterectomy • Incision site at inner vagina • Hospital stay 1-3 days • Recovery time 4-6 weeks • Cervix cannot be preserved

  10. Laparoscopic Hysterectomy • the uterus is removed in sections through small incisions using a laparoscope • Hospital stay 1-3 days • Recover time is 4-6 weeks • Longer duration of procedure • Requires greater surgical expertise • Urinary track injuries are more likely • Fewer abdominal wall infections or febrile episodes • Less blood loss

  11. Robotic Hysterectomy • 3-dimensional image • Greater articulation • Eliminate hand tremors • Increased accuracy and precision

  12. References • “Hysterectomy.” Wikipedia. <http://en.wikipedia.org/wiki/Hysterectomy>. • Johnson, Neil, et al. “Methods of hysterectomy: systematic review and meta-analysis of randomised controlled trials.” BMJ  2005;330:1478 (25 June). 18 June 2009 < http://www.bmj.com/cgi/content/full/330/7506/1478>. • Kho, Rosanne M. MD, et al. “Robotic hysterectomy: technique and initial outcomes.” Am J Obstet Gynecol 2007;197;113.e1-113.e4. • “Laparoscopic Supracervical Hysterectomy.” 18 June 2009 <http://www.laparoscopicsupracervicalhysterectomy.com/>. • Torpy, Janet M., Cassio Lynm, and Richard M. Glass. “Hysterectomy .” JAMA. 2004;291(12):1526. 18 June 2009 <http://jama.ama-assn.org/cgi/reprint/291/12/1526.pdf>. • “Types of hysterectomy.” Online image. 18 June 2009 <http://www.lifespan.org/adam/graphics/images/en/17073.jpg>. • “Vertical and Pfannenstiel incisions.” Online image. 18 June 2009 <http://www.mayoclinic.com/health/medical/IM00129>.

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