Hysterectomy
What is Hysterectomy ?
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Why do you need Hysterectomy ?
Hysterectomy is indicated for:
- Benign conditions:
- Uterine fibroids: Causing heavy bleeding, pain, or pressure symptoms.
- Endometriosis: Severe pain or bleeding unresponsive to medical treatment.
- Adenomyosis: Endometrial tissue in the uterine wall, causing pain and bleeding.
- Uterine prolapse: Descent of the uterus into the vagina.
- Chronic pelvic pain: When other causes (e.g., infections) are ruled out.
- Abnormal uterine bleeding (AUB): Unresponsive to medical or minimally invasive treatments (e.g., endometrial ablation).
- Malignant conditions:
- Endometrial cancer: Often early-stage, requiring hysterectomy with salpingo-oophorectomy.
- Cervical or ovarian cancer: As part of staging or treatment.
- Uterine sarcomas: Rare, aggressive cancers.
- Emergency situations:
- Severe postpartum hemorrhage: Uncontrolled bleeding after delivery.
- Uterine rupture: Rare, during labor or trauma.
The procedure aims to alleviate symptoms, treat underlying conditions, or prevent cancer progression. It ends menstruation and fertility, and if ovaries are removed, induces menopause.
Why Do Hysterectomy Costs Vary in Philippines?
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Hysterectomy Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Ultrasound (transvaginal): Assesses fibroids, adenomyosis, or uterine size.
- Endometrial biopsy: Rules out cancer in AUB or postmenopausal bleeding.
- MRI/CT (if cancer): Evaluates spread (e.g., endometrial or cervical cancer).
- Blood tests: Checks hemoglobin (for anemia), clotting profile, and kidney/liver function.
- Pap smear/HPV test: Ensures no cervical abnormalities.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior; antibiotics (e.g., cefazolin) pre-surgery.
- Consent: Risks, including infection and early menopause (if ovaries removed), are explained.
- Diagnosis:
- Surgical Techniques:
- Abdominal Hysterectomy:
- Performed under general anesthesia, lasting 1–2 hours.
- A horizontal (Pfannenstiel) or vertical midline incision (5–15 cm) is made in the abdomen.
- The uterus is detached from surrounding ligaments and blood vessels; removed with or without cervix/ovaries.
- The vaginal cuff (top of the vagina) is sutured; abdominal layers closed with sutures/staples.
- Vaginal Hysterectomy:
- Done through the vagina (no abdominal incision), lasting 1–1.5 hours.
- Preferred for prolapse or smaller uteri; general or spinal anesthesia.
- The uterus is detached and removed vaginally; vaginal cuff sutured.
- Laparoscopic Hysterectomy:
- Minimally invasive, lasting 1–3 hours, under general anesthesia.
- Small incisions (0.5–1 cm) in the abdomen; a laparoscope (camera) guides the procedure.
- The uterus is detached using laparoscopic tools, removed vaginally or morcellated (if large).
- Less pain, faster recovery than abdominal approach.
- Robotic-Assisted Hysterectomy:
- Similar to laparoscopic but uses robotic arms for precision; less common in India due to cost.
- Intraoperative Tools:
- Laparoscope (laparoscopic): Visualizes pelvic structures.
- Uterine manipulator: Assists in positioning the uterus.
- Hemostatic agents: Control bleeding (e.g., during fibroid-related surgery).
- Abdominal Hysterectomy:
- After Surgery:
- Hospital stay: 1–2 days (laparoscopic/vaginal); 3–5 days (abdominal).
- Pain management: IV analgesics (e.g., morphine) for 1–2 days, then oral (e.g., ibuprofen).
- Antibiotics: For 1–3 days to prevent infection.
- Catheter: Removed after 1–2 days (abdominal); same day (laparoscopic/vaginal).
- Pathology report: Within 5–7 days (for cancer or diagnostic cases).
Recovery After Hysterectomy
- Hospital Stay: 1–2 days (laparoscopic/vaginal); 3–5 days (abdominal).
- Post-Surgery Care:
- Pain: Incision pain for 1–2 weeks (abdominal) or 3–5 days (laparoscopic/vaginal), managed with analgesics.
- Activity: Walking within 24 hours to prevent clots; avoid heavy lifting (>5 kg) or strenuous activity for 6–8 weeks.
- Bleeding: Light vaginal spotting for 2–4 weeks; heavy bleeding is abnormal.
- Menopause (if ovaries removed): Hot flashes, mood changes; hormone replacement therapy (HRT) may be considered (if no contraindications, e.g., cancer).
- Intercourse: Avoid for 6–8 weeks until vaginal cuff heals.
- Bowel/bladder: Normal function resumes in 1–2 weeks; laxatives if constipated.
- Diet: Start with liquids, progress to solids; high-protein foods (e.g., eggs, lentils) and fiber (e.g., fruits) aid healing; 2–3 liters water daily.
- Follow-Up:
- Visit at 1–2 weeks for wound check; 6 weeks for full recovery check.
- Pathology discussion (if cancer); oncology referral if needed.
Most resume normal activities in 4–6 weeks (laparoscopic/vaginal) or 6–8 weeks (abdominal). Symptom relief: 90–95% for benign conditions (e.g., fibroids, AUB); cancer outcomes depend on stage (e.g., endometrial cancer, 80–90% 5-year survival for early stage).
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): 1–2% may need transfusion; rare reoperation.
- Infection (3–5%): Wound, urinary tract, or pelvic; treated with antibiotics.
- Blood clots (1–2%): Deep vein thrombosis (DVT); early ambulation reduces risk.
- Organ Injury:
- Bladder/ureter injury (1–2%): More common in laparoscopic; may need repair.
- Bowel injury (<1%): Rare, requires surgical correction.
- Long-Term:
- Vaginal cuff dehiscence (0.5–1%): Cuff reopening, often after early intercourse; needs surgical repair.
- Pelvic adhesions (5–10%): Scar tissue causing pain; may need adhesiolysis.
- Early menopause (if ovaries removed): Hot flashes, osteoporosis risk; HRT may help.
- Emotional impact: 5–10% experience grief/loss of fertility; counseling helps.
- Cancer-Specific: Recurrence (e.g., endometrial cancer, 10–20% if advanced stage); requires adjuvant therapy (radiation/chemotherapy).
Report fever, severe pain, heavy bleeding, or difficulty urinating promptly.
Frequently Asked Questions (FAQs)
Why might I need a hysterectomy?
For fibroids, endometriosis, adenomyosis, prolapse, cancer, or uncontrolled bleeding unresponsive to other treatments.
Will I go into menopause after hysterectomy?
Only if ovaries are removed; if ovaries are retained, menstruation stops, but hormonal function continues until natural menopause.
Can I avoid hysterectomy?
Yes, for benign conditions: 50–70% improve with medical treatment (e.g., hormonal therapy), endometrial ablation, or myomectomy (fibroid removal).
How soon can I resume activities?
Light activities in 1–2 weeks; normal routines in 4–8 weeks, depending on the approach.
Is hysterectomy covered by insurance in India?
Yes, for medical indications; confirm with your provider.
Signs of complications?
Fever, severe pain, heavy bleeding, difficulty urinating, or leg swelling.
Will I lose sexual function?
Most women (80–90%) report no change or improved sexual function (due to symptom relief); 5–10% may experience reduced sensation or dryness (HRT helps if menopausal).
Lifestyle changes post-surgery?
Avoid heavy lifting for 6–8 weeks, maintain a balanced diet, consider HRT (if menopausal), attend follow-ups, and seek counseling if needed.
Conclusion
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Looking for Best Hospitals for Hysterectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.