Colpohysterectomy in Milan
What does colpohysterectomy consist of?
Strohysterectomy, also known as vaginal hysterectomy, represents a surgical procedure aimed at removing the uterus through the vagina. This procedure is considered less invasive than traditional hysterectomy, which is performed through an abdominal incision, and offers the advantage of a generally shorter recovery period and less likelihood of postoperative complications. During the procedure, the surgeon makes an incision in the upper part of the vagina to access and remove the uterus. In some cases, other surrounding organs or tissues, such as the fallopian tubes or ovaries, may also be removed, depending on the patient’s specific clinical needs.
What is it for?
Vaginal hysterectomy, or colpohysterectomy, proves to be a therapeutic solution for several gynecological conditions that have not responded to less invasive treatments. This procedure may be indicated for the treatment of uterine fibroids, prolonged or severe vaginal bleeding, uterine prolapse, endometriosis, adenomyosis, or cancer of the uterus, cervix, or ovaries. Specifically, it serves to eliminate debilitating or painful symptoms associated with these conditions, thereby improving the patient’s quality of life. The decision to proceed with a colpohysterectomy is made after careful medical evaluation, considering both the severity of the patient’s condition and her overall health status, to ensure that the benefits of the procedure outweigh the associated risks.
How is a colpohysterectomy performed?
The colpohysterectomy surgery involves hospitation of the patient. Generally, general anesthesia is given, although in some cases spinal or epidural anesthesia can be opted for. The specialist begins by making an incision inside the vagina around the cervix, separating the uterus from surrounding tissues and organs, such as ovaries and fallopian tubes, if necessary. Next, the uterus is gently extracted through the vaginal opening. If the uterus is particularly large, it may need to be dissected into smaller pieces before removal. At the end of the procedure, the incisions are sutured. The vaginal approach reduces the risk of infection and allows faster healing than traditional hysterectomy techniques. In addition to this, it allows a normal human body cavity to be used to conceal the sutures. For this reason, this surgery, when performable, is the absolute best surgery for the removal of the uterus and adnexa (tubes and ovaries).
What pathologies does colpohysterectomy treat?
Colpohysterectomy is used to treat a number of gynecological conditions, as mentioned above. Among these, uterine fibroids are one of the most common causes leading to the decision to surgically remove the uterus. These benign tumors can grow inside the uterus causing profuse bleeding, pelvic pain, and pressure. Other conditions treated include uterine prolapse, which can lead to discomfort, difficulty with urination and defecation, and a feeling of heaviness in the lower abdomen; endometriosis and adenomyosis, which cause chronic pelvic pain, irregular bleeding, and sometimes infertility; and cancer or precancerous tumors of the uterus, cervix, and ovaries. Vaginal hysterectomy offers a definitive treatment option for women suffering from these conditions, helping to significantly improve their quality of life.
Risks and complications of colpohysterectomy
As with any surgical procedure, colpohysterectomy carries potential risks and complications. Although it is considered safe and generally involves fewer complications than abdominal hysterectomy, it is important to be aware of the possible risks. These include bleeding, infection, damage to nearby organs such as the bladder or bowel, and complications related to anesthesia. There is also a risk of blood clots forming in the legs or lungs (venous thromboembolism). Another possible complication is pelvic floor dysfunction or the formation of fistulas, which are abnormal passages between neighboring organs, such as between the vagina and the bladder (vesico-vaginal fistula) or between the vagina and the rectum (recto-vaginal fistula). It is crucial to discuss the potential risks and benefits thoroughly with your doctor before undergoing the procedure to make an informed decision.
The consequences of a colpohysterectomy
After a colpohysterectomy, patients can experience a variety of consequences, both physical and emotional. Physically, the surgery leads to cessation of menstruation and inability to conceive. This can have a significant emotional impact, especially for those women who desired to have children. Some patients may experience a change in sensations during sexual intercourse, although many report improved sexual well-being after resolution of the symptoms that necessitated the hysterectomy.
Removal of the ovaries along with the uterus induces surgical menopause, which can cause typical menopausal symptoms such as hot flashes, night sweats, and vaginal dryness. These consequences often require an individualized management approach, which may include hormone replacement therapies, if not contraindicated.
Psychologically, support is critical; coping with the loss of fertility and adjusting to bodily changes can be difficult.
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