Hysterectomy is performed for a wide range of benign and malignant conditions, such as fibroids, menorrhagia and pelvic pain, and gynaecological malignancies.
Renowned sitar player Anoushka Shankar has recently revealed that she “no longer has a uterus”.
In a detailed Twitter and Instagram post, the 38-year-old music composer said that she had a double uterus surgery last month. In a post titled “Lady-Bits”, she wrote: “As of last month, I no longer have a uterus. I had a double surgery: a gynaecological-oncologist performed a hysterectomy due to my large fibroids, which made my uterus as big as if it were six months pregnant, and an incredible surgeon removed multiple further tumours from my abdomen (which I blessedly then heard were all benign). One tumour had grown through my muscles and was visibly protruding from my stomach. There were 13 tumours in all.”
Anoushka, who is the daughter of sitar maestro Ravi Shankar, revealed that she went into a short-term depression when she first heard the news. “The news triggered fears about my womanliness, my possible desire to have more children in the future, the fear of dying in surgery and leaving my kids without a mother, the effect the changes may have on my sex life and more,” she listed everything that worried her.
She further wrote, “I wondered why the surgery wasn’t talked about more if it was so common. When I asked, one woman, said in response, ‘Well, we aren’t exactly going to flash our lady-bits everywhere, are we?’”
What is hysterectomy?
A hysterectomy is an operation to remove a woman’s uterus. An abdominal hysterectomy is a surgical procedure that removes the uterus through an incision in the lower abdomen. Uterus or the womb is where a fetus grows during pregnancy. While a partial hysterectomy removes just the uterus, leaving the cervix intact, a total hysterectomy removes the uterus and the cervix.
Why is there a need to perform hysterectomy?
Hysterectomy is performed for a wide range of benign and malignant conditions, such as fibroids, menorrhagia and pelvic pain, and gynaecological malignancies. A woman may have a hysterectomy for other reasons such as Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal; Cancer of the uterus, cervix, or ovaries; Endometriosis (a painful disorder in which a tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus)or a thickening of the uterus.
Removal of the uterus renders the patient unable to bear children (as does removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended only when other treatment options are not available or have failed. It is expected that the frequency of hysterectomies for non-malignant or non-cancerous reasons will continue to fall as there are good alternatives in many cases.
How is hysterectomy performed?
Besides an incision in the lower abdomen, a hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses long, thin instruments passed through small abdominal incisions.
How prevalent it is?
Data shows that Indian women are getting their uterus removed at an early age as per the National Family Health Survey (2015-2016), that studied the prevalence of hysterectomy for the first time. According to it, 3.2 per cent women, between 15-49 years had had a hysterectomy. The prevalence of the procedure among women in the age of 30-39 years was found to be 3.6 per cent.
In many countries, hysterectomy, or the surgical removal of uterus, is the second most frequently performed non-obstetric surgery after cesarean sections. The surgery is often accompanied by removal of ovaries to reduce the risk of ovarian cancer.
While a hysterectomy is generally considered safe, a surgery comes with its own set of risks. Some of them include:
*Adverse reaction to anesthesia
*Damage to your urinary tract, bladder, rectum or other pelvic structures during surgery, which may require further surgeries
*Earlier onset of menopause even if the ovaries aren’t removed
How to prepare yourself?
Like Anoushka mentioned in her post, it is normal to feel anxious about the effects of such a major surgery on sexual and reproductive health among other issues. Here’s what you can do:
*Read and enquire as much as possible: Before surgery, get all the information you need to feel confident about your decision to have a hysterectomy. Ask questions to your doctor and surgeon and learn about the procedure, including all the steps involved if it makes you feel more comfortable.
*Be thorough with medication: Follow your doctor’s instructions. Be sure to know whether to change your usual medication routine in the days leading up to your hysterectomy. Always ask your doctor about any over-the-counter medications, dietary supplements or herbal preparations that you’re taking.
*Know about the type of anesthesia: Abdominal hysterectomy requires you to have general anesthesia, which makes you unconscious during surgery.
*Plan for recovery: How long you’ll be in the hospital depends on what type of hysterectomy you have and what your doctor recommends. Generally, abdominal hysterectomy requires a hospital stay of at least one to two days. But full recovery could take several weeks. Your doctor may recommend restricting your activities during your recovery, such as avoiding driving or lifting heavy objects.
Arrange for help at home if you think you’ll need it.