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A partial hysterectomy is a very common surgery that involves removing a section of a woman's uterus. Hysterectomies are performed to prevent or treat a number of different health problems, including uterine fibroids, cancerous tumors, dysplasia, and endometriosis. The procedure is usually performed on an inpatient basis, requiring a woman to stay in the hospital for one to three days so doctors can monitor recovery. Thanks to modern technology and skilled surgeons, the success rate is nearly 100 percent, and patients are usually able to experience full recoveries in a matter of weeks.
Before considering a partial hysterectomy, a patient's doctor typically tries to treat her condition with medications and minimally invasive procedures. Partial hysterectomies are typically reserved for conditions that are confined to the uterus and do not respond to conservative treatment measures. If the ovaries, fallopian tubes, cervix, or other structures show signs of disease or cancer, a total hysterectomy may be required to remove them as well.
There are several different approaches that a surgeon can take to remove part of the uterus. Based on the surgeon's experience and the patient's specific condition, a partial hysterectomy by be performed through an abdominal incision or the vaginal opening. Procedures are usually performed in hospital operating rooms under general anesthesia, and take less than three hours to complete.
During an abdominal partial hysterectomy, the surgeon first makes a long cut across the lower abdomen and uses surgical instruments to hold the cavity open. He or she carefully identifies the upper section of the uterus and severs it from the cervix and surrounding structures. With the section removed, the surgeon can reattach internal structures, administer pressure and medication to control bleeding, and close incisions with stitches or glues. The abdominal cut is treated with antibiotics, stitched, and covered with a bandage.
Some abdominal hysterectomies can be performed without leaving a large, permanent scar. Instead, the surgeon can make many small incisions and manipulate precision instruments and cameras to cut away the uterus internally. Called a laparoscopic procedure, the surgery is often preferred when very small, easily identifiable polyps or tumors need to be removed.
Another option for a partial hysterectomy involves excising part of the uterus through the vagina. As with the laparoscopic procedure, the surgeon relies on a camera feed and tiny instruments to locate and remove tissue. Vaginal procedures are generally considered safer than abdominal surgeries, though they may not be possible if swelling or bleeding impair the surgeon's ability to locate problem areas.
Following any type of partial hysterectomy, a patient can expect to stay in the hospital for up to three days. She receives pain medications and fluids to aid in recovery, and a doctor periodically checks to ensure that tissue is healing appropriately. After leaving the hospital, a woman usually needs to attend regular checkups and take medications for several weeks. Full recovery after a successful hysterectomy is possible in as little as one month.
Can You Get Pregnant After a Partial Hysterectomy?
Deciding to have a partial hysterectomy can be a difficult decision for a woman and her partner to make. The most obvious reason would be the inability of the woman to become impregnated following the procedure. During a partial hysterectomy, a woman loses important parts of the reproductive cycle.
The first issue would be that the woman no longer has a complete uterus which provides the necessary environment for a fetus to grow. A fertilized egg must first attach itself to the lining of the uterus in a process called implantation. However, there is no wall to attach to when the uterus is removed.
Another issue would be that the fallopian tubes no longer connect a woman's ovaries to the uterus. It is from the ovaries that eggs travel to the fallopian tube for fertilization and then to the uterus for implantation. As this path no longer exists, fertilization of the egg is no longer possible.
While it will no longer be feasible for a woman who has had a hysterectomy to carry a child to term, that doesn't mean she can't still have children of her own. If a woman thinks she may want to have children in the future, but a partial hysterectomy is absolutely necessary, she has the option of preserving some of her eggs.
In Vitro Fertilization
When eggs are harvested from the woman's ovaries they are frozen and stored for a period of up to ten years, however, an extension can be obtained if needed. Once the woman decides she is ready to become a mother, the eggs are thawed and fertilized in a laboratory setting.
Once the eggs are fertilized, they are implanted into a surrogate mother in a process known as in vitro fertilization. The surrogate would be a woman of child-bearing age who still has her reproductive organs fully intact. This is the only chance a woman has of producing biological children following a partial hysterectomy.
What Are the Side Effects of Having a Partial Hysterectomy?
The side effects of having a partial hysterectomy are mostly short-term and will vary depending upon the procedure. A woman who has a laparoscopic partial hysterectomy will usually have a faster recovery time since the incisions were small.
During an abdominal hysterectomy, the wound is larger and included a cut through the abdominal wall. This requires more time to heal so will also require an extended rest period.
There will also be a period of vaginal bleeding that can last anywhere from a few days to several weeks. Sanitary pads will be necessary during this time.
Another side effect of surgery will be pain. The level of pain will vary from patient to patient, but a woman who had a laparoscopic or robotic hysterectomy will generally experience less pain.
Following any hysterectomy, a woman can expect a recovery period of 2 to 6 weeks. The longer recovery is usually following an abdominal hysterectomy which would happen if the woman were not a candidate for the easier laparoscopic hysterectomy.
What To Expect After a Partial Hysterectomy
Following a partial hysterectomy, a woman can expect to be back to her usual activities after the full recovery period of 2 to 6 weeks. She will no longer have periods and may experience symptoms of menopause, including hot flashes.
The stage of experiencing menopausal symptoms is temporary. As long as a woman still has her ovaries she will not go into immediate menopause, as would be the case for someone who experienced a full hysterectomy. However, there is a chance menopause could occur earlier than would have happened had the hysterectomy not occurred.
Your body will continue to release eggs once a month, but instead of traveling through the fallopian tubes to the vagina, they will simply be absorbed through the body. This means a woman will continue to feel the hormonal changes that occur every 30 days when she would menstruate, though any noticeable effect may be reduced.
The doctor will want to have a post-surgery visit to make sure all wounds are healing properly and to answer any questions the patient might have. Whether or not a woman continues to have Pap tests will largely depend on whether or not her cervix was removed during the partial hysterectomy.
Since the Pap screens for cervical dysplasia, it may not be necessary to perform these types of exams if there is no cervix. A woman should always follow the advice of her physician first.