Partial Hysterectomy

A hysterectomy is a technique performed by the gynecologist to remove the uterus from the body. It has got two types namely partial and complete. In partial hysterectomy the body of the uterus is removed and the cervical stump is left behind. On the other hand in complete hysterectomy the body, fundus and the cervix are removed. Hysterectomy is usually done following child birth when the couple no longer desire to have kids but there are several other reasons like cervical, uterine or ovarian cancers which may necessitate hysterectomy.Hysterectomy can be done via different techniques. The oldest technique which had been used is through laparotomy. Laparotomy means that the abdomen is opened and the procedure is carried out. It is associated with increased risk of complications and delayed recovery. The incision is similar to that of caesarian section, made over the symphysis pubis. The normal recovery time for complete or partial hysterectomy is around four to six weeks but it may take longer.Vaginal hysterectomy is another technique which can be employed. It is done via the vaginal canal and is associated with less complication rate, shorter hospital stay and quick recovery as compared to the open method. However the open method allows maximum access to the structures.Laproscopic hysterectomy is in vogue these days. In this procedure, laparoscopes are inserted via the abdomen and the uterus is removed through the vaginal canal. This has led to quick recovery and minimal invasiveness. Both complete and partial hysterectomy can be done through this procedure.There is another laparoscopic technique by which the uterus is removed leaving the cervix behind. It is called Laparoscopic-assisted supracervical hysterectomy. In this process morcellator is used to cut the uterus and the pieces are then removed by the laparoscopic ports.There is yet another type of laparoscopic hysterectomy named as Da Vinci method. In this procedure the surgeon controls instruments remotely which have high precision and they also give magnified, three dimensional visual field to the surgeon. Patients prefer this method as it is least invasive and has minimal complications along with quick recovery. However it may not be possible to do laparoscopic procedures on all the patients depending on the extent and nature of the operation and the condition of the patient. In certain cases open surgery may be preferred over laparoscopic methods.One important factor to be considered is the hormonal imbalance which will occur as a result of complete or partial hysterectomy. There is deficiency of two kinds of hormones in the body after hysterectomy namely progesterone and the testosterone. In partial hysterectomy where only the uterus is removed, there is a dramatic fall in progesterone levels followed by decrease in estrogen levels over one to two years.Deficiency of progesterone produces side effects like mood swings, fatigue and headache along with increased risk of developing endometrial cancer. The deficiency of testosterone is related to decreased energy levels, lower sexual drive, depression and thyroid dysfunction, for which medical explanation is unclear.Women who achieve menopause as a result of this surgical procedure should do monitoring of the hormone levels (estrogen, progesterone and testosterone). The patient should take natural supplements of the hormones to cover for the deficiency but one thing should be kept in mind that estrogen and progesterone should be taken together and not estrogen alone.