Hysterectomy
 
Q. What is the meaning of hysterectomy?  
A. Hysterectomy essentially means the removal of the uterus or womb. It essentially means the end of menstrual cycles and natural childbearing.
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Q. Does hysterectomy mean a woman will go into menopause? 
A. No. Surgical menopause occurs only when ovaries are also removed surgically along with the uterus. However, many women go into menopause within 2 - 3 years of hysterectomy even if ovaries are not removed during hysterectomy.
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Q. What are the ways in which a hysterectomy may be done?
A. Removal of the uterus may be done by the vaginal, abdominal or laparoscopy route. All routes may not be applicable or safe in every case and it is best to make a decision in consultation with your doctor.
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Q. What are the common reasons for a hysterectomy?
A. a) Tumors of the uterus (fibroids); (b) Heavy menstrual bleeding not responding to medicines; (c) Along with ovarian cysts in patients who have completed their family; (d) Cases of uterine prolapse (uterus protruding through the vagina) (e) Severe Infections (f) Advanced Endometriosis (g) Cancers
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Q. How can I prevent hernia after a hysterectomy?
A. Hernia is a relatively rare, yet commonly feared, complication seen after any abdominal operation, hysterectomy being no exception. Avoiding strain on the abdominal wall (coughing/constipation) in the immediate postoperative period is the key. However hernia may also occur if the scar is weakened by infection or faulty operative technique. Often women with poor nutrition status may have a weak abdominal wall predisposing them to hernias.
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Q. How will hysterectomy affect my sex life?
A. Hysterectomy usually does not affect sex life as most of the length of the vaginal passage is retained after the operation. Normal intercourse is usually advised six weeks after a surgery.
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Q. Should ovaries be removed during hysterectomy?
A. The decision to remove ovaries is usually taken after discussion between you and your doctor. Diseased ovaries are almost always removed. The advantage of retaining ovaries is the continuous production of natural hormones. The disadvantage of retaining ovaries is potential risk of future development of cysts/cancer (~5%) needing surgical removal later. 
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Q. What are the risks of a hysterectomy operation?
A. Hysterectomy by any route carries the risk of anesthesia. Injury to internal organs, bleeding and infection consist the short-term problems. Long-term complications include hernias, fistulas and chronic pain.
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Q. Are there alternatives to blood transfusion for major surgery?
A. There are methods to boost up the hemoglobin levels in the body without administering blood. These include iron IV injections or erythropoietin injections, which are often quite effective. These may be administered two to three weeks before the operation or immediately after an operation in an anaemic woman. See Section on Anaemia
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Q. Are abdominal belts advisable after a hysterectomy?
A. Some women feel better with an abdominal belt after any operation on the tummy. Though it may make one feel good by tucking the tummy in, it does not have a lasting effect and is not an alternative to abdominal exercises, which are usually advised six weeks after an operation.
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