Our Summary

This research paper discusses a study that compares two types of hysterectomy operations: non-descent vaginal hysterectomy and total abdominal hysterectomy. A hysterectomy is a surgical operation to remove a woman’s uterus and is one of the most common surgeries performed by gynecologists. The study was conducted at Kathmandu Model Hospital over a year, using a sample of 70 women.

The women were split into two groups, with one group undergoing non-descent vaginal hysterectomy and the other group undergoing total abdominal hysterectomy. The researchers recorded various data such as the amount of blood lost during the operation, any complications during or after the operation, the length of time the operation took, the level of pain experienced by the women, and how long they stayed in the hospital.

The results showed that the women who underwent non-descent vaginal hysterectomy had significantly less blood loss and a shorter hospital stay compared to those who had the total abdominal hysterectomy. They also experienced less pain at the time of discharge and during their follow-up appointments. The overall rate of complications was low and not significantly different between the two groups.

The study concluded that non-descent vaginal hysterectomy is a safer, more efficient, and feasible procedure compared to abdominal hysterectomy. It has fewer complications, a faster operating time, and allows for easier recovery post-operation, making it more patient-friendly.

FAQs

  1. What are the two types of hysterectomy operations discussed in this study?
  2. How did the non-descent vaginal hysterectomy and total abdominal hysterectomy procedures compare in terms of safety, efficiency, and patient recovery?
  3. What were the primary findings of the study conducted at Kathmandu Model Hospital comparing non-descent vaginal hysterectomy and total abdominal hysterectomy?

Doctor’s Tip

A doctor might tell a patient that non-descent vaginal hysterectomy is a safer and more efficient procedure with fewer complications and a quicker recovery time compared to total abdominal hysterectomy. It may be a better option for some patients, depending on their specific health needs and circumstances. It is important for patients to discuss all available options with their doctor and choose the best option for their individual situation.

Suitable For

Patients who may be recommended for a hysterectomy include those with:

  1. Uterine fibroids: These are non-cancerous growths in the uterus that can cause heavy menstrual bleeding, pelvic pain, and pressure on surrounding organs.

  2. Endometriosis: This is a condition where the tissue that lines the uterus grows outside of it, causing pain, irregular bleeding, and infertility.

  3. Uterine prolapse: This is a condition where the uterus descends into or protrudes out of the vagina due to weakened pelvic floor muscles.

  4. Gynecological cancers: Hysterectomy may be recommended for patients with uterine, cervical, or ovarian cancer to remove the affected organs.

  5. Chronic pelvic pain: Hysterectomy may be considered as a last resort for patients with severe, debilitating pelvic pain that does not respond to other treatments.

  6. Adenomyosis: This is a condition where the tissue that lines the uterus grows into the muscular wall, causing heavy menstrual bleeding, pelvic pain, and pressure.

  7. Abnormal uterine bleeding: Hysterectomy may be recommended for patients with heavy, prolonged, or irregular menstrual bleeding that does not respond to other treatments.

It is important for patients to discuss with their healthcare provider the reasons for recommending a hysterectomy, as well as the potential risks and benefits of the procedure. In some cases, alternative treatments may be considered before undergoing surgery.

Timeline

Before the hysterectomy, a patient typically undergoes a series of consultations with their gynecologist to discuss the reasons for the surgery, the different types of hysterectomy available, and the potential risks and benefits. They may also undergo pre-operative testing such as blood work, imaging scans, and a physical exam to ensure they are healthy enough for surgery.

On the day of the surgery, the patient will be admitted to the hospital and prepared for the operation. They will be given anesthesia to ensure they are unconscious during the procedure. The surgery itself can take several hours, depending on the type of hysterectomy being performed.

After the hysterectomy, the patient will spend some time in the recovery room before being transferred to a hospital room for monitoring. They may experience pain, discomfort, and fatigue in the days following the surgery, and will be given pain medication to manage these symptoms.

In the weeks and months following the hysterectomy, the patient will gradually recover and may experience changes in their hormone levels, emotions, and physical abilities. They will need to follow up with their gynecologist for post-operative care and may need to make lifestyle adjustments to accommodate the changes in their body.

Overall, a hysterectomy is a major surgical procedure that requires careful consideration and preparation before, as well as support and care after, to ensure a successful recovery and improved quality of life for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hysterectomy include:

  1. What are the reasons for recommending a hysterectomy in my case?
  2. What are the different types of hysterectomy procedures available and which one do you recommend for me?
  3. What are the potential risks and complications associated with the hysterectomy procedure?
  4. How long will the recovery process take and what can I expect during this time?
  5. Will the hysterectomy affect my hormonal balance or sexual function?
  6. Are there any alternative treatments or procedures that I could consider instead of a hysterectomy?
  7. How many hysterectomies have you performed and what is your experience with this procedure?
  8. Will I need to take any medications or make any lifestyle changes before or after the surgery?
  9. How will the hysterectomy impact my future reproductive health or menopausal symptoms?
  10. What follow-up care or monitoring will be necessary after the hysterectomy procedure?

Reference

Authors: Tiwari KD, Dangal G, Karki A, Pradhan HK, Shrestha R, Bhattachan K, Bharati S. Journal: J Nepal Health Res Counc. 2022 Nov 2;20(2):326-330. doi: 10.33314/jnhrc.v20i02.3924. PMID: 36550708