Psycho-social problems of women who had undergone hysterectomy

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3. Neoplastic diseases:Cervical intraepithelial neoplasia: Where family is complete and/or followcheck-up is not possible hysterectomy is indicated. Vaginal hysterectomy ispreferred unless contraindicated by adnexal disease, uterine enlargement, or otherreasons.Early invasive cervical carcinoia: Once the carcinoma becomes invasive,hysterectomy is the treatment of choice.Endometrial adenomatous hyperplasia, adenocarcinoma and sarcoma of uterus areindications for hysterectomy.Ovarian and fallopian tube neoplasms: These are rare cases where hysterectomyshould be preferred.Trophoblastic disease: In high-risk cases, abdominal hysterectomy with bilateralsalpingo-oophorectomy is to be followed by multi-drug therapy.Other causes: Malignant disease of other pelvic organs, in postmenopausalcervical stenosis with recurring pyometra, recurrent hematometra and possiblyendometriosis. *Hysterectomy is also used to be done as part of surgicalsterilization.TYPES OF HYSTERECTOMY:a) According to approachAbdominal hysterectomy: it involves detaching the uterus from the ligamentsthat support it and blood vessels that supply it. It is the most common approach.Vaginal hysterectomy: the surgeon approaches the uterus through the vagina,detaches it from its supports and pulls it out. It is done with women with uterineprolapse.Laproscopic hysterectomy: the approach can be either abdominal or vaginalassisted by a laproscope.
Vaginal hysterectomy is prefered whenever possible. Complications followingabdominal hysterectomy are 70% higher than that following vaginal hysterectomy.In the CREST study (collaborative review of sterilization), overall complicationrate with abdominal hysterectomy was reported as 42.8/100 cases while it was24.5/100 for vaginal hysterectomies. Similarly, the mortality risk for hysterectomyhas been quoted as 17-50/10,000 cases for abdominal; hysterectomy and 13-26/10,000 cases for vaginal hysterectomy (current concepts in treatment offibroids).b) According to organs removedTotal abdominal hysterectomy (TAH): It is the removal of the uterus and cervixthrough an incision in the lower abdomen. The fallopian tubes and ovaries are notremoved.Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO): It is the removal of the ovaries and fallopian tubes along with the uterusand cervix through an incision in the lower abdomen.Subtotal hysterectomy (supracervical hysterectomy): It is the removal of theuterus only and not the cervix.Pelvic repair: This surgery may be done through the abdomen or vagina toimprove muscle and fibrous tissue support for the bladder and/or rectum. Theuterus as well as the fallopian tubes and ovaries may be removed at the time ofrepair.COMPLICATIONS OF HYSTERECTOMY:• Infection• Haemorrhage• Complications of general anaesthesia• Urinary or bowel problems• Vaginal problems such as prolonged healing time or shortening of vagina
Page 1 and 2: ABSTRACTTitle - Psychosocial Proble
Page 3 and 4: PSYCHOSOCIAL PROBLEMS OF WOMEN WHO
Page 5: Dysfunctional uterus bleeding (DUB)
Page 9 and 10: Vaginal bleeding—this should dimi
Page 11 and 12: hospital reported 1547 hysterectomi
Page 13 and 14: ) The study also gathered first han
Page 15 and 16: and found no evidence of hormone di
Page 17 and 18: Any kind of surgical intervention o
Page 19 and 20: esulting absence of ovarian estroge
Page 21 and 22: penetration during intercourse, and
Page 23 and 24: heavy, prolonged and irregular blee
Page 25 and 26: hysterectomy. She complained of wei
Page 27 and 28: Case no: 2Nirmala is 42 years old a
Page 29 and 30: She did not perceive it as a “los
Page 31 and 32: esult of her hysterectomy. She was
Page 33 and 34: miscarriage following tubular pregn
Page 35 and 36: A change was found in the intensity
Page 37 and 38: Depression in the patient before su

Psycho-social problems of women who had undergone hysterectomy

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