58262 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)

Name of the Procedure:

Vaginal Hysterectomy with Salpingo-Oophorectomy

• Common name: Vaginal hysterectomy
• Technical terms: Hysterectomy, Salpingo-Oophorectomy

Summary

A vaginal hysterectomy is a surgical procedure to remove the uterus through the vagina. When performed with salpingo-oophorectomy, it also includes the removal of one or both fallopian tubes and ovaries. The uterus removed weighs 250 grams or less.

Purpose

This procedure addresses medical conditions such as uterine fibroids, endometriosis, chronic pelvic pain, uterine prolapse, and cancer. The goals are to alleviate symptoms, prevent disease progression, and improve the patient’s quality of life.

Indications

• Severe uterine fibroids causing bleeding or pain
• Endometriosis unresponsive to other treatments
• Chronic pelvic pain not relieved by other methods
• Uterine prolapse
• Uterine, ovarian, or tubal cancer
• Heavy or abnormal uterine bleeding

Preparation

• Fasting for at least 8 hours prior to surgery
• Adjustments or temporary cessation of certain medications as instructed by the surgeon
• Preoperative diagnostic tests, such as pelvic ultrasound, MRI, or CT scan
• Blood tests to check overall health and readiness for surgery

Procedure Description

1. Anesthesia: General or spinal anesthesia is administered.
2. Incision: A small incision is made inside the vaginal wall, exposing the uterus.
3. Uterus Removal: The uterus is detached from surrounding structures and removed through the vaginal canal.
4. Salpingo-Oophorectomy: If applicable, the tubes and ovaries are also detached and removed.
5. Closure: The vaginal incision is sutured closed.

Specialized surgical tools like laparoscopes, electrosurgical devices, and suture materials are used.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Gynecologist or gynecologic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technician

Risks and Complications

• Infection
• Bleeding
• Injury to surrounding organs like the bladder or intestines
• Blood clots
• Anesthesia-related risks
• Postoperative pain or discomfort

Benefits

• Relief from the symptoms causing pain or discomfort
• Prevention of cancer progression (if applicable)
• Improvement in quality of life Benefits are often realized within several weeks post-surgery, with full recovery happening within a few months.

Recovery

• Hospital stay of 1-2 days post-surgery may be required
• Rest and limited physical activity for 4-6 weeks
• Avoidance of heavy lifting and strenuous activities
• Follow-up appointments to monitor healing

Alternatives

• Medication management for symptoms
• Uterine artery embolization
• Myomectomy (removal of fibroids)
• Hormonal treatments
• Non-surgical therapies like physical therapy or acupuncture Pros and cons depend on the patient’s specific condition and overall health.

Patient Experience

During the procedure, the patient will feel nothing due to anesthesia. Postoperatively, they may experience discomfort, cramping, and some vaginal bleeding. Pain management strategies include medication, rest, and gradual resumption of normal activities. Full recovery usually takes 6-8 weeks, with some patients experiencing improvements sooner.