Dr Komalas Women Clinic - Hysterectomy - Abdominal


The abdomen is the area of the body between the thorax and the pelvis. The diaphragm is responsible for the upper surface of the abdomen. The abdomen ends, and the pelvis begins at the level of the pelvic bones. The stomach, small and large intestines, pancreas, liver, and gallbladder are located in the abdomen. 

These organs are joined by connective tissues that allow them to expand and slide against one another. The kidneys and spleen are likewise housed in the abdomen. Many vital blood arteries, including the aorta, inferior vena cava, and dozens of lesser branches, pass through the abdomen. The abdomen is protected at the front by a thin, durable layer of tissue called fascia. The abdominal muscles and skin are located in front of the fascia. The back muscles and spine are located in the back of the abdomen.

About the Uterus and Hysterectomy

The uterus is a part of the abdomen as well. During pregnancy, the uterus or womb carries a fetus and matures into a baby. A hysterectomy is a medical procedure that removes the entire uterus from the body. Gynecologists may remove the fallopian tubes and ovaries in addition to the uterus. 

Causes and Symptoms

Uterine disorders are conditions that affect the uterus or any other part of your reproductive system. Uterine fibroids, endometriosis, uterine prolapse, and uterine tuberculosis are types of uterine issues. Some symptoms are:

  • Pain in the uterine region
  • Abnormal or heavy vaginal bleeding
  • Irregular menstrual cycle
  • Abnormal vaginal discharge
  • Pain in the pelvis, lower abdomen, or rectal area
  • Increased menstrual cramping
  • Increased urination
  • Pain during intercourse
  • Bleeding after intercourse
  • Prolonged menstruation
  • Abdominal swelling
  • Constipation
  • Discomfort during bowel movements
  • Recurrent bladder infections
  • Fatigue and fever

The following are indications that a hysterectomy might be needed:

  • Heavy periods, which can be caused by fibroids.
  • Pelvic pain, which may be caused by endometriosis, unsuccessfully treated pelvic inflammatory disease (PID), adenomyosis, or fibroids.
  • Prolapse of the uterus
  • Cancer of the womb, ovaries, or cervix

Tests for Diagnosis

  • Physical examination: During a physical examination, a gynecologist will inspect the abdomen.
  • Upper and lower endoscopy: The GI tract is examined with a fiber-optic camera known as an endoscope, which is inserted through the mouth (upper) to scan the esophagus, stomach, and small intestines, or the anus (lower) to examine the large intestine, colon, and rectum. 
  • Abdominal x-ray: Abdominal x-rays produce images of the inside of the abdominal cavity using a small amount of ionizing radiation. It is used to assess the stomach, liver, intestines, and spleen. It may be used to aid in the diagnosis of unexplained pain, nausea, or vomiting. A KUB x-ray is a type of x-ray used to evaluate the kidneys, ureters, and bladder. Abdominal x-rays are quick and easy. Hence, they are frequently used.
  • Abdominal ultrasound: Your doctor might order an abdominal ultrasound. Ultrasound is a non-invasive technology that uses sound waves to “see” within your body. The scan can aid in the diagnosis of illnesses such as abdominal tumors, gallbladder disease, gallstones, liver issues, kidneys, pancreas, or spleen.


The lower abdomen is specifically addressed in this section. Hysterectomy causes menopause, after which females are unable to become pregnant and will never have periods. Abdominal, laparoscopic, vaginal, and robotic hysterectomies are some of the methods used to perform hysterectomies. Although standard practice guidelines prescribe that a Vaginal Hysterectomy (VH) be the primary line of therapy, it can be difficult in cases of non-descendent and big uteruses. In the following situations, a hysterectomy is required: 

  • Uterine fibroids: These are noncancerous growths on the uterine wall. They can cause pain or severe bleeding in some women. 
  • Heavy or unusual vaginal bleeding: This might be caused by changes in hormone levels, infection, cancer, or fibroids. 
  • Uterine prolapse: This occurs when the uterus moves from its normal position down into the vagina. This is more frequent in women who have had several vaginal births. However, it can also occur after menopause or as a result of obesity. Urinary and gastrointestinal issues and pelvic pressure can result from prolapse. 
  • Endometriosis: This occurs when the tissue that normally borders the uterus grows outside of the uterus on the ovaries (where it is not supposed to be). This might result in excruciating pain and bleeding between periods. 
  • Adenomyosis: This is a disorder in which the tissue that lines the uterus develops inside the uterine walls where it does not belong. The uterine walls thicken, resulting in excruciating discomfort and profuse bleeding. 
  • Uterine, ovarian, cervix, or endometrial cancer (or precancer) (the lining of the uterus): If you have cancer in one of these locations, a hysterectomy might be your best option. Chemotherapy and radiation therapy may also be alternatives. 

Risks of Hysterectomy

Most women who undergo hysterectomy have no substantial difficulties or consequences as a result of the procedure. Nonetheless, a hysterectomy is an operation with significant risks. Urinary incontinence, vaginal prolapse, vaginal fistula formation, and chronic pain are some of the risks. Other risks of hysterectomy include wound infections, blood clots, hemorrhage, and harm to adjacent organs, though these are rare.


If the ovaries were also removed during hysterectomy, you would be in menopause. If your ovaries were not removed, you may experience menopause at a younger age than you would have otherwise. Most people are advised to avoid sex and heavy lifting for six weeks following a hysterectomy. The majority of women polled after a hysterectomy believed the procedure was successful in improving or curing their condition. 

  • Vaginal hysterectomy
  • Abdominal hysterectomy
  • Laparoscopic hysterectomy
  • Laparoscopic-assisted vaginal hysterectomy
  • Robotic hysterectomy

Minimally invasive techniques include laparoscopic and robotic-assisted hysterectomies and vaginal hysterectomy.

The decision for hysterectomy will be jointly taken by you and your doctor. Some factors that may influence your decision include the reason for the operation, whether other treatments are required at the time of surgery, a history of previous surgeries, other medical issues such as obesity, the availability of resources, and the physician’s expertise and skill.

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