What is a hysterectomy, when is removal of the uterus necessary and what are the hospital stays?

The duration of hospital stay (expected 10-14 days) leaves room for some hypotheses. The most cited by English newspapers is precisely that of a hysterectomy, the reasons for which remain unknown.

When is it necessary?

Which ones are they the cases in which it is necessary a hysterectomy? The premise that, if there is a choice, is carried out on women in menopause or who no longer intend to have children (Kate Middleton mother of three children).

– Among the possible causes we have already mentioned the Uterine cancer and cervical cancerwhich are the two malignant tumors which affect the site of the uterus and may make surgery necessary. However, the British Royal Household has ruled out that the cause of Kate's hospitalization is linked to a form of cancer.

– Then there are the pre-cancerous lesions of the uterus: sometimes following a Pap (or HPV) test, changes in the cells of the cervix are identified before they transform into cancer. Most regress on their own over time in women under 30, but in some cases they could lead to hysterectomy.

– The most frequent indication for uterine removal surgery is currently menometrorrhagia (heavy bleeding during menstruation or between periods) that does not respond to medical therapies or conservative surgery.

– Then there are fibroids: statistically they are very common (affecting 2 out of 10 women), they are benign tumors of the uterus which however can take on significant dimensions (and number), causing vaginal bleeding (and possible anemia) and pain.

-Severe forms of endometriosis, which involves the growth of the endometrial glands outside the uterine cavity, a source of inflammation and chronic pain and the adenomyosis (also known as internal endometriosis).

– There are also the chronic pelvic pain and uterine prolapse, all associated with complications and failure to respond to alternative therapies.

How is the operation carried out?

The operation itself can be carried out abdominally (therefore with incision of the abdomen), laparoscopic (with minimally invasive surgical technique) or via vaginal. Currently the majority of hysterectomies are performed laparoscopically with short hospital stays. The only current indication for laparotomy surgery, that is, with the opening of the abdominal wall, in the open, is the presence of fibromatous uteri very large whose dimensions occupy a large part of the abdominal cavity, clarifies al Courier
Nicola Colacurciformer Full Professor of Gynecology and Obstetrics at the University of Campania Luigi Vanvitelli.

What are the hospitalization and recovery times?

What can they be? hospitalization times? Even laparotomy operations still require hospitalization, in uncomplicated cases, no longer than 4-5 days – replies Colacurci -. An expected hospital stay of 10-14 days (
like the one proposed in the case of Princess Kate, ed
) poorly adapts to hypotheses of planned interventions (
as it would have been for Kate, ed
) if they do not require presurgical therapies, as in the case of severe anemia or sepsis
presurgical.

Hysterectomy without removal of the ovaries does not lead the woman to menopause, but only to the loss of menstrual flow. Menopause, on the other hand, would be the consequence of the simultaneous removal of both ovaries, concludes the expert.