Total Vaginal Hysterectomy

Have you ever wondered what a total vaginal hysterectomy is? Well, a total vaginal hysterectomy is a surgical procedure where a gynecologist removes the uterus and cervix from a woman’s pelvis through the vagina.

Aside from the total vaginal hysterectomy, another type of hysterectomy is the abdominal hysterectomy where the uterus is removed through an incision on the abdomen.

Total Vaginal Hysterectomy vs. Abdominal Hysterectomy

Abdominal hysterectomy is the traditional hysterectomy, and is performed when a woman’s uterus is enlarged, or when there are malignant tumors. A total vaginal hysterectomy, on the other hand, is performed when the uterus is of the appropriate size and when the reason for the surgery is not cancer-related.

In general, a hysterectomy prevents a woman from bearing children and can also cause hormonal level changes in her body if her ovaries are removed at the time of surgery.

Although abdominal hysterectomy is the more commonly performed procedure, findings show that total vaginal hysterectomy is the better option and that it should be used whenever possible.

The following are the advantages that a total vaginal hysterectomy has over an abdominal hysterectomy:

• Shorter hospital stays
• Less complications
• Fewer incidents of high fever and infections
• Quicker recovery
• No abdominal incision (i.e. no scars)
• Minimal post-op pain

Conditions that Require Total Vaginal Hysterectomy

Although the following conditions can be treated with alternative procedures, a total vaginal hysterectomy can sometimes be the most effective treatment or even the last resort:

Fibroids. Fibroids are non-cancerous muscle outgrowths in the uterus that can cause irregular and excessive bleeding of the uterus.

Abnormal uterine bleeding. This condition is characterized by prolonged and heavy vaginal bleeding that can lead to fatigue and anemia (low blood counts).

Cervical abnormalities. Total Vaginal Hysterectomy can be performed when other procedures fail to treat dysplasia or precancerous cells of the cervix.

Pelvic organ prolapse. This condition is when the uterus falls into the vagina due to the weakening and stretching of the pelvis’ ligaments and muscles.

Chronic pelvic pain. This condition is mainly caused by scarring between organs in the pelvis but may also be caused by the urinary and gastrointestinal systems.

Endometrial hyperplasia. This condition is characterized by the excessive growth of the uterus’ lining, which can cause cancer if not treated.

Preparation for Total Vaginal Hysterectomy

The following are some of the standard tests that a woman must have before undergoing a total vaginal hysterectomy:

• Physical exam
• Electrocardiogram or ECG
• Blood test
• Chest X-Ray
• Pelvic Ultrasound
• Endometrial biopsy if specified by the doctor

There are also a couple of things that a woman must decide on before undergoing a total vaginal hysterectomy. These are whether to have her ovaries removed, and whether she would want to undergo estrogen replacement therapy.

A woman undergoing total vaginal hysterectomy may opt to have her ovaries removed due to any of the following reasons: pelvic pain; ovarian cysts or masses and age greater than 45. The removal of the ovaries can also help alleviate pelvic pain and discomfort caused by epilepsy or migraine that’s induced by the menstrual cycle, as well as a severe case of pre-menstrual syndrome.

A woman who is nearing menopause can opt to keep her ovaries in order to have a natural source of hormones, which include testosterone, progesterone, and estrogen. These can prevent bone density loss and hot flashes, and help maintain a sexual appetite.

Estrogen replacement therapy may be introduced for women whose ovaries are removed in order to maintain the right hormonal levels.