Vaginal Hysterectomy for Uterine Fibroids
A vaginal hysterectomy may be done to remove uterine fibroids. A fibroid is a noncancerous growth in the wall of the uterus. A vaginal hysterectomy involves the removal of the uterus and cervix through a small incision in the vagina. The ovaries and fallopian tubes may also be removed during the procedure.
Who is a candidate for the procedure?
Uterine fibroids do not usually produce symptoms. But sometimes, these problems may occur:
bleeding or spotting between periods
constipation
the feeling that something is falling out of the vagina
heavy or prolonged menstrual periods
low backache
more frequent urination
pain with deep penetration during sexual intercourse
pelvic pain or pressure
rectal pressure
A vaginal hysterectomy for fibroids is best for women who do not want to bear children and have many symptoms. If the bladder or rectum is protruding through a tear in a muscle or tissue, it can be fixed during the surgery. The ovaries and tubes may also be removed if there is no scarring or enlargement that would prevent their removal through the vagina.
How is the procedure performed?
Before surgery, several things are usually done.
The abdomen and vulvar area, which is the area between the legs, are sometimes shaved.
An anesthesiologist meets with the woman. He or she will discuss the anesthesia options and allergies to medicines.
An intravenous line, or IV, is placed in a vein, usually in the hand or arm. The IV can be used to replace fluids and give medicine or a blood transfusion.
Medicines, such as sedatives, are given.
A urinary catheter is placed in the bladder to drain urine.
In the operating room, the woman is given either local or general anesthesia. The skin around the vagina is cleaned with a soapy solution to remove any bacteria. A cut is then made in the upper part of the vagina to expose the tissue, such as blood vessels, that surrounds the uterus and cervix. These tissues must be cut and tied off before the uterus can be removed. Sutures are placed in these deep structures. These will heal during the weeks following surgery and do not need to be removed. The uterus is removed from the top of the vagina, and the vagina is closed at the top.
The surgery usually takes 60 to 90 minutes. At times, the ovaries and tubes may be removed. Other organs may be repaired or removed if necessary.
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