Hysterectomy

1. HYSTERECTOMY Fahad zakwan

2. Hysterectomy Usually performed by a gynecologist Uterus is removed Other reproductive organs may be removed No longer able to have a baby Periods will stop

3. Indications Fibroids Endometriosis Uterine prolapse Cancer of the uterus , cervix , or ovaries Vaginal bleeding, DUB uncontrollable PPH Transgender man

4. Pelvic inflammatory disease Severe pelvic adhesions Bilateral ovarian pathology Adenomyosis Pelvic congestion syndrome Intractable, recurrent dysmenorrhea or metrorrhagia Uterine anomalies Recurrent intrauterine polyps Uterine perforation Mentally retarded patient with no hygiene control Pregnancy Placenta increta , percreta , or acreta Atonic uterus Uterine perforation Ruptured uterus

5. Risks and Side Effects Earlier onset of menopause Greater risk of cardiovascular disease Increased chance of osteoporosis and bone fractures Uncontrolled urination Reduced libido Vaginal dryness

6. Epidemiology Hysterectomy is the second most common surgery among women in the United States One in three women in U.S. had one by age 60 Each year, more than 600,000 are done Over 90% are performed for benign conditions Over 70% also involved the surgical removal of ovaries

7. Types of Hysterectomy Partial Hysterectomy Removes 2/3 of uterus Total Hysterectomy Removes uterus and cervix Radical Hysterectomy Removes uterus, cervix, and vagina

8. Types of Incisions Vertical Incision Pfannenstiel Incision

9. Abdominal Hysterectomy the uterus is removed through an incision in the woman’s abdomen. Most invasive method Incision site at abdomen Hospital stay of 5-6 days Recovery time 6 weeks Possible retention of cervix Required for endometriosis and large fibroids

10. Vaginal Hysterectomy the uterus is removed through the vagina. Less invasive than abdominal hysterectomy Incision site at inner vagina Hospital stay 1-3 days Recovery time 4-6 weeks Cervix cannot be preserved

11. Laparoscopic Hysterectomy the uterus is removed in sections through small incisions using a laparoscope Hospital stay 1-3 days Recover time is 4-6 weeks Longer duration of procedure Requires greater surgical expertise Urinary tract injuries are more likely Fewer abdominal wall infections or febrile episodes Less blood loss

12. Robotic Hysterectomy 3-dimensional image Greater articulation Eliminate hand tremors Increased accuracy and precision