absent endometrium; surgical removing of uterus
Hysterectomy is surgical removal of uterus. However, even though it is about removing the uterus, the operation may involve also the removal of the cervix, ovaries and the fallopian tubes (Pic. 1). Depending on the reason of the operation, the extensity of the operation and removal is set.
Hysterectomy may be made due to several reasons. It includes from heavy or irregular menstruation periods, through severe chronic pains as the result of adenomyosis (inner lining of the uterus grows into uterus muscle) or endometriosis (inner lining of the uterus grows outside and cause pain and bleeding), uterine prolapse (when uterus drops through the cervix and protrudes from the vagina) until uterine fibroids (non-cancerous growths within the muscular walls of the uterus, outside the uterus and within the uterine cavity) and several types of cancer (cervical, uterine, ovarian, fallopian tube cancer). After the procedure of hysterectomy, the woman has no longer the menstrual period or is able to have a child in natural way.
The different types of hysterectomy
Usually, hysterectomy is classified into 5 types:
Hysterectomy may be performed by three main techniques:
In case of uterine prolapse, pelvic floor exercises, insertion of a pesary into the vagina to support the uterus or surgical procedures without hysterectomy are also possible solutions.
Associated diseases
Complications
Risk factors
Uterus is main part of female reproductive system and place in the body, where the embryo and baby develop after the conceiving. Without uterus, the eggs from ovaries cannot be fertilized naturally and woman cannot conceive the baby and be pregnant.
A hormonal birth control or an intrauterine device may successfully treat endometriosis and heavy vaginal bleeding the causes of possible hysterectomy in future. These options might also allow controlling the symptoms of uterine fibroids (causes of heavy bleeding).
In case of uterine prolapse, pelvic floor exercises to strengthen the muscles are also beneficial prevention.
Symptoms may be connected to associated diseases, mostly in case, when hysterectomy is later executed. For hysterectomy, the most common reason is uterine fibroids, benign growths of the uterus. Uterine fibroids may cause excessive size of uterus, pressure or pain, bleeding or even severe anemia. Pelvic relaxation is another condition which may lead until hysterectomy. Mild relaxation may cause first degree prolapse when the cervix is on the halfway down to vagina. A woman experiences a loosening of the support muscles and tissues in the pelvic floor area.
There are several causes for hysterectomy procedure, from which heavy bleeding or pain, are the most common ones. However, there are ways how to reduce the causes and thus to avoid hysterectomy.
Heavy bleeding and painful periods may be influenced by diet. For a woman with these problems, reducing the meat and dairy products consumption is recommended as well as avoiding to drink coffee and alcohol. Besides, stress management techniques are a plus.
In addition, dietary supplements with essential fatty acids, acidophilus and bioflavonoids are seen beneficial. These supplements acts as weak natural estrogens and are able to block stronger estrogens; the estrogen dominance is the primary cause of uterine fibroids development and thus pains and heavy bleeding. Natural progesterone is also the way to correct estrogen dominance and return hormonal balance to the body.
Homeopathic medication and herbal remedies has shown to be beneficial as well to treat the problems with pains and heavy bleedings.
Correcting hormonal imbalance in general may be accomplished through a purification program, stress release, eating well and changing other lifestyle factors.
There are some methods and procedure which may be chosen to treat heavy or irregular periods, chronic pains and other problems without hysterectomy, such as hormonal therapy. In other cases of other reasons and diagnoses (uterine cancer, uterine fibroids, uterine prolapse, and more), the hysterectomy may be the first and best solution. However, when providing hysterectomy itself, there is just the surgical solution.
Pharmacotherapy
Hormone replacement therapy
When removing uterus surgically, a woman looses the organs producing typical feminine hormones, which are needed to replace pharmacologically.
Surgical therapy
For some of these causes, nowadays, there exist also different procedures except the hysterectomy. Hormone therapies or combined oral contraceptive pills might be the solution to treat abnormal uterine bleeding. Besides, there are the procedures of treating heavy bleeding, fibroids, endometriosis or adenomyosis:
If all treatments used by conventional medicine fail, the approaches of artificial reproductive techniques are used.
If the ovaries show the normal development and normal function, there is possibility of egg retrieval and following in vitro fertilization (IVF). IVF and ART generally start with stimulating the ovaries to increase egg production. Most fertility medications are agents that stimulate the development of follicles in the ovary. Examples are gonadotropins and gonadotropin releasing hormone. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Fertilization takes place outside the body.
The fertilized eggs (embryos) are cultivated under very stringent conditions and examined every day by the embryologist to evaluate their progress. The embryos are usually cultured for 3 to 5 days, before the best one(s) are selected to be put (transferred) in to the womb.
Infertile couples may also resort to egg donation or embryo donation when the female partner cannot have genetic children because her own eggs cannot generate a viable pregnancy.
However if the uterus is absent, there is necessary to place the fertilized egg into surrogate mother, if the law of the country allows to do so. Surrogacy via a gestational carrier is also an option when a patient's medical condition prevents a safe pregnancy, when a patient has ovaries but no uterus due to congenital absence or previous surgical removal, and where a patient has no ovaries and is also unable to carry a pregnancy to full term.
A state in which pieces of the tissue alike to the lining of the uterus (endometrium) grow in other parts of the body.
Medical condition characterized by the presence of ectopic endometrial tissue within the myometrium.
Cancer that arises from the endometrium, the lining of the uterus.
The most common benign smooth muscle tumors of the uterus encountered in women of reproductive age.
A type of cancer in which abnormal cells begin to grow in one or both of a woman's ovaries.
Surgical removal of one or both ovaries.
An abnormal growth of fallopian tube tissue.
The narrow inferior portion of the uterus that projects into the vagina.
Two very fine tubes that transport sperm toward the egg, and allow passage of the fertilized egg back to the uterus for implantation.
The ovum-producing organs of the internal female reproductive system
The uterus is the largest and major organ of the female reproductive tract that is the site of fetal growth and is hormonally responsive
A female germ cell involved in reproduction.
The very early stage of pregnancy at which the embryo adheres to the wall of the uterus.
The failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
Process by which a woman donates eggs for purposes of assisted reproduction or biomedical research.
A micromanipulative fertilization technique in which a single sperm is injected directly into an egg.
The procedure in which a man (sperm donor) provides his sperm for fertility treatment.
A process in which an egg is fertilised by sperm outside the body: in vitro. Own or donated gametes may be used.
The embryo is gestated in a third party's (surrogate) uterus.
