Our Summary

This research paper provides guidance to medical professionals who perform hysterectomies (the removal of the uterus) for non-cancerous reasons. The paper is intended to be used by various healthcare professionals, including gynaecologists, nurses, and medical students. The target population is adult women who are undergoing hysterectomy for benign (non-cancerous) gynaecological reasons. The study reviews different approaches to hysterectomy and the benefits of performing other surgical procedures at the same time.

To create the guidelines, the researchers looked at studies from the last five years in databases like PubMed, Medline, and the Cochrane Library. The guidelines were then reviewed and approved by the Gynaecology Committee and the Society of Obstetricians and Gynaecologists of Canada.

The paper points out that there is a lot of variation in how hysterectomies are performed, and these guidelines aim to improve the quality of care for women undergoing this surgery. The guidelines will be reviewed every five years, but the authors can request a review sooner if they think it’s necessary. The research was funded by the Society of Obstetricians and Gynaecologists of Canada.

FAQs

  1. Who is the target audience for this research paper on hysterectomy?
  2. What databases did the researchers use for the study?
  3. How often are the guidelines for hysterectomy reviewed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hysterectomy is to ask about the different types of hysterectomy procedures available and discuss which option is best for their individual situation. It is important for the patient to be informed and ask questions about the procedure, recovery process, potential risks, and expected outcomes. Additionally, following the doctor’s post-operative care instructions and attending follow-up appointments are crucial for a successful recovery. It is also important for the patient to talk to their doctor about any concerns or questions they may have before and after the surgery.

Suitable For

Patients who are typically recommended a hysterectomy for non-cancerous reasons include those with conditions such as:

  • Fibroids: Large or multiple fibroids in the uterus that cause symptoms such as heavy menstrual bleeding, pelvic pain, and pressure on other organs.
  • Endometriosis: Severe endometriosis that does not respond to other treatments and causes significant pain and other symptoms.
  • Adenomyosis: A condition where the tissue that lines the uterus grows into the muscular wall of the uterus, causing heavy menstrual bleeding, severe cramping, and pelvic pain.
  • Uterine prolapse: When the uterus descends into the vaginal canal, causing discomfort, urinary incontinence, and other symptoms.
  • Abnormal uterine bleeding: Excessive or irregular bleeding that does not respond to other treatments and impacts the patient’s quality of life.

It is important for healthcare providers to carefully assess each patient’s individual situation and discuss the potential risks and benefits of hysterectomy as well as alternative treatment options. The decision to recommend a hysterectomy should be made collaboratively with the patient, taking into account their preferences and goals for treatment.

Timeline

Before a hysterectomy:

  1. Patient consults with their gynaecologist and discusses the need for a hysterectomy.
  2. Pre-operative tests and evaluations are conducted to ensure the patient is healthy enough for surgery.
  3. Patient may need to make lifestyle changes or stop certain medications in preparation for surgery.
  4. Consent forms are signed and surgical details are discussed with the patient.
  5. Patient receives instructions on how to prepare for surgery, including fasting guidelines and medication restrictions.

After a hysterectomy:

  1. Patient undergoes the surgical procedure, which may be performed vaginally, abdominally, laparoscopically, or robotically.
  2. Patient is closely monitored in the recovery room for any complications.
  3. Patient is discharged from the hospital after a few days and given instructions for post-operative care.
  4. Patient may experience pain, fatigue, and emotional changes in the weeks following surgery.
  5. Follow-up appointments are scheduled with the gynaecologist to monitor recovery and address any concerns.
  6. Patient may need to make adjustments to their lifestyle and activities to accommodate the changes in their body post-surgery.

What to Ask Your Doctor

  1. What are the different types of hysterectomy procedures available, and which one is recommended for my specific condition?
  2. What are the potential risks and complications associated with a hysterectomy?
  3. Are there alternative treatment options to consider before proceeding with a hysterectomy?
  4. Will I need to take hormone replacement therapy after the surgery?
  5. How long is the recovery period, and what can I expect in terms of pain and physical limitations?
  6. Will my sexual function be affected by the hysterectomy?
  7. Are there any long-term effects on my health or quality of life that I should be aware of?
  8. Will I still need regular gynaecological screenings after the hysterectomy?
  9. Can I still have children after a hysterectomy?
  10. What is the success rate of hysterectomy in treating my specific condition, and what are the chances of recurrence?

Reference

Authors: Thurston J, Murji A, Scattolon S, Wolfman W, Kives S, Sanders A, Leyland N. Journal: J Obstet Gynaecol Can. 2019 Apr;41(4):543-557. doi: 10.1016/j.jogc.2018.12.006. PMID: 30879487