Our Summary

This study looked at the reasons for, and complications of, a surgical procedure called hemostasis hysterectomy. This is a surgery that involves removing a woman’s uterus to stop serious post-birth bleeding.

The study was carried out on 70 patients at the Regional Hospital of Ben Arous between 2003 and 2019. The average age of the patients was 34.5 years. The main reasons for the surgery were placenta accreta (a condition where the placenta grows too deeply into the uterus wall), uterine inertia (where the uterus stops contracting and can’t push the baby out), and uterine rupture.

The study found that 34% of patients experienced complications during surgery. The most common complications were haemorrhagic shock (a severe drop in blood pressure due to blood loss), disseminated intravascular coagulation (a condition that causes blood clots and bleeding), and bladder injuries. There were also six cases where the mother died, a rate of 8%.

The researchers noted that 79% of the patients had a subtotal hysterectomy (where only part of the uterus is removed), and 21% had a total hysterectomy (where the entire uterus is removed). They found that placenta accreta was more common in patients who had a total hysterectomy, and that subtotal hysterectomies were quicker to perform.

In conclusion, the researchers said that hemostasis hysterectomy is a crucial treatment for severe post-birth bleeding. They found that placenta accreta was the main reason for the surgery, and that total hysterectomy did not have a higher risk of complications compared to subtotal hysterectomy.

FAQs

  1. What is a hemostasis hysterectomy and why is it performed?
  2. What were the main reasons for a hemostasis hysterectomy in the study conducted at the Regional Hospital of Ben Arous?
  3. What were the most common complications encountered during a hemostasis hysterectomy according to the study?

Doctor’s Tip

A doctor may advise a patient undergoing a radical hysterectomy to carefully follow post-operative instructions, including taking prescribed medications, attending follow-up appointments, and avoiding heavy lifting or strenuous activity for a certain period of time. It is also important for the patient to communicate any concerning symptoms or changes in their condition to their healthcare provider promptly.

Suitable For

Patients who are typically recommended radical hysterectomy include those with:

  1. Cervical cancer: Radical hysterectomy is often recommended as a treatment for early-stage cervical cancer.

  2. Uterine cancer: Radical hysterectomy may be recommended for the treatment of early-stage uterine cancer.

  3. Severe endometriosis: In cases where endometriosis has severely impacted the uterus and surrounding tissues, radical hysterectomy may be recommended.

  4. Severe pelvic inflammatory disease: Radical hysterectomy may be recommended in cases of severe pelvic inflammatory disease that has not responded to other treatments.

  5. Large uterine fibroids: In cases where large uterine fibroids are causing significant symptoms and have not responded to other treatments, radical hysterectomy may be recommended.

  6. Recurrent pelvic organ prolapse: In cases where pelvic organ prolapse is recurrent and causing significant symptoms, radical hysterectomy may be recommended as a treatment option.

It is important for patients to discuss the potential risks and benefits of radical hysterectomy with their healthcare provider in order to make an informed decision about their treatment options.

Timeline

Before the radical hysterectomy, a patient may experience symptoms such as abnormal vaginal bleeding, pelvic pain, and abnormal discharge. They may also undergo diagnostic tests such as a pelvic exam, Pap smear, and imaging tests to determine the extent of the condition.

After the radical hysterectomy, the patient will likely experience pain, bleeding, and swelling at the surgical site. They may also have restrictions on physical activity and sexual intercourse for a period of time. Follow-up appointments will be scheduled to monitor recovery and address any complications that may arise. In the long term, the patient may experience changes in their hormonal balance, such as menopausal symptoms, and may need hormone replacement therapy. They may also need counseling or support to address any emotional or psychological effects of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a radical hysterectomy?
  2. How will a radical hysterectomy affect my fertility and ability to have children in the future?
  3. What is the recovery process like after a radical hysterectomy?
  4. Are there alternative treatment options to a radical hysterectomy that I should consider?
  5. How will a radical hysterectomy impact my overall health and quality of life?
  6. What are the long-term effects of a radical hysterectomy on my hormonal balance and sexual function?
  7. Will I need any additional follow-up care or screenings after a radical hysterectomy?
  8. How experienced are you in performing radical hysterectomies and what is your success rate with this procedure?
  9. Are there any lifestyle changes or precautions I should take before or after a radical hysterectomy?
  10. Can you provide me with any resources or support groups for women who have undergone a radical hysterectomy?

Reference

Authors: Abidi I, Bettaieb H, Souayeh N, Mbarki W, Frikha M, Bouhmida R, Oueslati H, Hsayaoui N, Mbarki C. Journal: Pan Afr Med J. 2022 Jul 4;42:172. doi: 10.11604/pamj.2022.42.172.34423. eCollection 2022. PMID: 36187026