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Abdominal Hysterectomy

VIEWS: 24 PAGES: 3

									                                                                                     Dr Nikki Kroon
                                                                                   MRCOG, Dip GUM, DFFP,
                                                                         Dip Advanced Obstetric Ultrasound
                                                                     Consultant Obstetrician & Gynaecologist



                                Abdominal Hysterectomy
                        This is an operation to remove you womb and cervix.

Dr Kroon has advised that you should have a hysterectomy.

This operation is done with a cut on the abdomen and the womb is removed. Depending on your
age and your symptoms the ovaries and/or the cervix will be removed as well. Dr Kroon will have
discussed with you before the operation whether it is advisable that the ovaries be removed at the
same time. Removal of the ovaries sometimes necessary e.g. if you have cancer of the womb, or
disease of the ovaries like cancer is suspected. There will be some cases where the ovaries will need
to be removed for chronic pain in the pelvis or severe premenstrual syndrome which is not
responding to medical treatment.

Why do I need my womb removed?
Some women have heavy bleeding. By removing the womb, the bleeding should stop. There are
alternatives to this procedure and your Consultant will discuss these with you.

    1. Mirena Coil: This aims to reduce the bleeding by making the womb lining very thin. This coil
       is protective against pregnancy. This coil needs to be changed every 5 years.
    2. Endometrial ablation/resection. This is a procedure designed to destroy the endometrium
       (lining of the womb) so that your periods will lessen or reduce.

There may be other reasons for your womb to be removed:

       Cancer of the womb
       Cancer of the ovaries
       Intractable pain in the pelvis

In the event of the above, your Consultant will discuss the procedure and treatment plan for you.

Serious or frequent occurring risks
This leaflet aims to give you information about the operation, but each case is different and there
will be reasons as to why the risks given to you in clinic are slightly different from what is listed
below. Women who have medical disease, such as diabetes, raised BMI or previous operations on
the tummy will have a slightly different risks. Dr Kroon will be happy to discuss this with you
before the procedure so that you can understand the reasons for this.

If you are on aspirin normally, this will need to be stopped one week before the operation.If you
take HRT you need to stop this one week before the operation. If you are on warfarin, this will
need to be interrupted but your hospital stay may be slightly longer.




Mount Carmel Hospital                    St Vincent’s Private Hospital           Suite 16, Blackrock Clinic
Braemor Park, Churchtown                  Herbert Avenue, Merrion                    Rock Road, Blackrock
Dublin 14                                          Dublin 4                                     Co. Dublin
                                                                                 Dr Nikki Kroon
                                                                               MRCOG, Dip GUM, DFFP,
                                                                     Dip Advanced Obstetric Ultrasound
                                                                 Consultant Obstetrician & Gynaecologist



Serious risks include
Two women in every 100 undergoing abdominal hysterectomy will experience at least one of these
complications:

       Damage to the bladder and/or the ureter (0.7%) and/or long-term disturbance to the
        bladder function.
       Damage to the bowel (0.04%)
       Haemorrhage requiring blood transfusion (1.5%)
       Return to theatre for additional stitches (0.6% - of these, in 39% the procedure was
        completed vaginally)
       Pelvic abscess/infection (0.2%)
       Venous thrombosis or pulmonary embolism (0.4%)

All operations carry some risk of death: 1 in every 4,000.

Frequent risks include:
       Wound infection and bruising
       Frequency of micturition
       Delayed wound healing
       Keloid formation
       Early menopause: evidence is inconclusive

Any extra procedures which may become necessary during the procedure
       Blood transfusion (overall transfusion rate 1.5%)
       Other procedures:
            o Repair to bladder, bowel or major blood vessel
            o Oophorectomy for unsuspected disease (this must be discussed and consent
                obtained prior to surgery)

If any of these procedures became necessary during the operation, the details will be discussed with
you afterwards.



Anaesthesia
Your anaesthetist will discuss this with you.




Mount Carmel Hospital                St Vincent’s Private Hospital           Suite 16, Blackrock Clinic
Braemor Park, Churchtown              Herbert Avenue, Merrion                    Rock Road, Blackrock
Dublin 14                                      Dublin 4                                     Co. Dublin
                                                                                  Dr Nikki Kroon
                                                                                MRCOG, Dip GUM, DFFP,
                                                                      Dip Advanced Obstetric Ultrasound
                                                                  Consultant Obstetrician & Gynaecologist




After the operation


You will be taken to the Recovery Area, where you will be monitored. You will have an oxygen mask
on your face, and will have one or two drips. You will have a catheter in your bladder.

You will be taken to the Ward when you are stable, and your pain control is adequate. When you are
on the Ward you will be monitored carefully, and will have regular Blood pressure, pulse checks. The
nurses will also check that you pain is controlled. You need to take the pain relief regularly to keep
on top of your pain, because this will help you move better and will aid your recovery.

The catheter and drips will come out on the first day after the operation.

You will have a blood test on the second day after the operation to check your blood count.

You will have a small injection of heparin every day until you are discharged. This is given to lessen
the risk of blood clot formation (thrombosis)

If you have been on HRT you will need to interrupt this for 4-6 weeks after the operation because of
the risks of blood clotting disease after a major operation like a hysterectomy.

The stitches will dissolve by themselves.

On average you will be discharged on the fifth day after your operation. You need to take it easy
when you get home with adequate rest. You should not lift heavy things, such as shopping bags,
hoovering etc. You should not drive for a minimum of 4 weeks after the operation because your
insurance company will not cover you in the event of an accident. You must confirm with your
insurance company that you will be insured to drive.

You will be given an appointment with Dr Kroon 6 weeks after the operation.

You should not work for 6 weeks, and you will be given a letter to book you off work when you are
discharged from the hospital.



References


RCOG Abdominal Hysterectomy (Consent 4 2004)




Mount Carmel Hospital                St Vincent’s Private Hospital            Suite 16, Blackrock Clinic
Braemor Park, Churchtown              Herbert Avenue, Merrion                     Rock Road, Blackrock
Dublin 14                                      Dublin 4                                      Co. Dublin

								
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