Name of the Procedure:

Vaginal Hysterectomy
Common Name(s): Vaginal Hysterectomy
Technical Term: Vaginal Hysterectomy for uterus 250 g or less

Summary

A vaginal hysterectomy is a surgical procedure performed through the vaginal canal to remove the uterus. It’s for conditions where the uterus is of normal or slightly enlarged size, typically weighing 250 grams or less.

Purpose

This procedure is performed to address various gynecological issues such as uterine fibroids, abnormal bleeding, uterine prolapse, or chronic pelvic pain. The goals are to alleviate symptoms, improve quality of life, and, in some cases, address precancerous or cancerous conditions.

Indications

• Persistent uterine fibroids causing pain or heavy bleeding
• Uterine prolapse
• Severe, chronic pelvic pain
• Abnormal uterine bleeding
• Endometriosis
• Precancerous conditions or early-stage uterine cancer
• Adenomyosis

Preparation

• Patients may be instructed to fast for 8 hours before the procedure.
• Medical history review and physical examination.
• Blood tests, pelvic ultrasound, or other imaging studies as required.
• Adjustments to current medications (e.g., blood thinners may need to be paused).
• Bowel preparation may be necessary the day before surgery.

Procedure Description

1. General or regional anesthesia is administered for patient comfort.
2. The surgeon makes an incision in the vaginal wall to access the uterus.
3. Supportive ligaments, blood vessels, and the uterus are carefully detached.
4. The uterus is then removed through the vaginal canal.
5. The vaginal cuff (sutured vaginal opening) is closed.
6. The procedure may also involve a bladder or rectum repair if necessary.

Duration

Typically, the procedure takes about 1-2 hours.

Setting

• Hospital operating room
• Ambulatory surgical center

Personnel

• Gynecologic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technologists

Risks and Complications

Common Risks:

• Bleeding
• Infection
• Pain Rare Risks:
• Injury to surrounding organs (bladder, bowel)
• Blood clots
• Adverse reaction to anesthesia Complications can be managed with medications, further surgery, or other treatments.

Benefits

• Relief from symptoms such as pain and heavy bleeding.
• Higher quality of life post-recovery.
• Minimally invasive, as the abdominal wall is not incised. Benefits can be realized within days to weeks after the procedure.

Recovery

• Hospital stay of 1-2 days is typical.
• Light activities may resume within a few days.
• Full recovery usually takes about 4-6 weeks.
• Follow-up appointments to monitor healing.
• Restrictions include no heavy lifting or vigorous activity during the recovery period.

Alternatives

• Medication management (hormonal therapy, pain relief)
• Less invasive procedures (e.g., uterine artery embolization, endometrial ablation)
• Abdominal or laparoscopic hysterectomy Pros and Cons compared to Vaginal Hysterectomy:
• Medications may offer symptom relief without surgery but not always effective.
• Less invasive procedures may not be suitable for all conditions.
• Abdominal or laparoscopic hysterectomies are more invasive with longer recovery times.

Patient Experience

Patients are under anesthesia and will not feel the procedure itself. Post-procedure, they may experience discomfort, pain, and fatigue managed with prescribed pain relievers and rest measures. Most patients gradually return to normal activities over several weeks with significant symptomatic relief.

Pain management involves prescribed medications, and comfort measures include avoiding strenuous activity and following post-operative care instructions.