What is vaginal hysterectomy ?
Vaginal hysterectomy is the surgery that is done to remove the uterus through the vagina. The surgeon makes a cut in the vagina to reach the uterine blood vessels, connecting ligaments, Fallopian tubes and ovaries inside the pelvis to incise and separate them from the uterus. The freed uterus is then either cut into small pieces or pulled out whole through the vagina.
Quicker recovery :
A vaginal hysterectomy, where feasible, is more convenient for both the surgeon and the patient. For the patient, it makes for a quicker recovery, therefore a shorter hospital stay, lesser chances of infections and is certainly cheaper than an abdominal hysterectomy.
Cases for a vaginal hysterectomy :
However, not all women can be cases for a vaginal hysterectomy. If the operation is being done for fibroids and the fibroid is large, or if your uterus is bulky it may not be possible to remove the uterus through the vagina. Also in most cases of endometriosis and in cancers of the uterus, cervix, endometrium or ovaries the abdominal route is the better one to take so that all offending tissues can be removed surely and safely. Sometimes, during vaginal surgery the surgeon may have to switch to the abdominal route if he finds adhesions caused by endometriosis or a cancer.
Though vaginal hysterectomy is by and large safe there is a small risk of injury to surrounding pelvic organs like the bladder and bowel. Other risks include as in any surgery, a risk of excessive bleeding, infections, reactions to anaesthesia and formation of thrombus in the leg veins.
You may be given either general anaesthesia for the surgery or a local called spinal block or epidural block. This will block the sensations in the lower half of your body but you will be conscious throughout the surgery. The surgeon will use long instruments to reach the tissues through the vaginal cut. After the uterus is removed absorbable sutures will be given inside the pelvis.
LAVH may be recommended if you have pelvic adhesions :
Vaginal hysterectomy is sometimes done with the help of a laparoscope. This is called a laparoscopic assisted vaginal hysterectomy or LAVH. The surgeon is able to view the pelvic organs while doing the surgery through a laparoscope, a thin viewing instrument. Most of the surgery is done through small abdominal incisions with long, thin surgical instruments inserted through the incisions. The uterus is removed through an incision made in your vagina. LAVH may be recommended if you have pelvic adhesions from previous surgeries, infections or from endometriosis.