A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen. 
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have. 
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewelry.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38  C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Surgery For Womb Removal - What You Need To Be Aware Of?

Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.

Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient s age, weight, overall health etc.

Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.

Surgery For GERD - Types, Results and Recovery

While you cannot cure breast diseases, family history and maturing, but there are some hazards or risks that you can control. Keeping in mind the fact that there is no certain approach to forestall breast cancer, there are things you can do that may bring down the hazard. Here are five approaches to ensure your breast's well-being:

Watch your weight: Being overweight or hefty expands breast cancer chances. This is particularly true after menopause and for women who have put on weight as grown-ups. After menopause, the vast majority of your estrogen originates from fat tissue. Having more fat tissue can heighten your chances of getting breast cancer by raising the estrogen levels. Additionally, women who are overweight have a tendency to have more elevated amounts of insulin, than other hormones. Higher insulin levels have been associated with a few tumors, including breast cancer.
Exercise routinely: Many reviews have found that exercise is the sign of having a healthy breast. Studies show that one to two hours of energetic walking each week, lessened a woman s cancer risk by eighteen percent. Walking ten hours seven days decreased the hazard all the more.
Constrain liquor: Women who have two to five mixed beverages every day have a higher danger of breast cancer than women who have just one drink a day or none . As much as three to six glasses of wine seven days have been found to somewhat increase breast cancer chances. It is not clear how or why liquor raises the hazard. In any case, constraining liquor is particularly essential for women who have other hazard variables for breast cancer, like, breast cancer running in their families.
Restrain time spent sitting: Research has shown that sitting time, regardless of how much exercise you get when you are not sitting, increases the probability of growing cancer, particularly for women. Women who sit six hours or more a day outside of work have a ten percent more serious risk for breast cancer compared to the ladies who sit under three hours a day, and an increased hazard for other cancer types as well.
Stay away from or confine hormone substitution treatment: Hormone Replacement Treatment (HRT) was utilized frequently in the past to control night sweats, hot flashes, and other troublesome manifestations of menopause. In any case, specialists now realize that postmenopausal ladies who take a blend of estrogen and progestin might probably create breast tumors or cancer. Breast cancer disease seems to come back within five years in the wake of ceasing the blend of hormones. Therefore, get a breast cancer test even if you feel a small lump.

5 Ways to Decrease The Chance of Breast Cancer 

An anorectal abscess is a painful swelling near the anus or in the buttock. The swelling contains pus. 60% anorectal abscesses are superficial and resulting from infection in small anal glands present in between internal and external anal sphincters (intersphincteric space). They are known as a perianal abscess. 30% of anorectal abscesses are deep-seated and results in systemic infection. They are call Ischiorectal abscess. Submucous abscess, pelvirectal abscess and pilonidal abscess developed from versatile cause are comparatively less common. Inadequate and improper management of anorectal abscess may potentially cause complication like fistula formation.


Fast facts on Anorectal abscess-

* Anorectal abscess should be drained at the earliest.
* Conservative medical management almost invariably invites complication like fistula formation.
* Surgical drainage of pus reduces the chance of fistula formation by 50%.


What causes Anorectal abscess?

* Blocked and infected anal glands (cryptoglandular infection).
* Untreated anal fissure that becomes infected.
* Sexually transmitted infections.
* Penetrating injury of the perianal or buttock region.
* Crohn s disease.
* Colon cancer.
* Tuberculosis.



What are the symptoms of Anorectal abscess?

Superficial abscess-

* Constant and throbbing pain that worsens on sitting down.
* Swelling, redness and tenderness of the skin around the anus.
* Discharge of pus.
* Pain is often associated with bowel movement.

Deep abscess-

* All or some of the symptoms of a superficial abscess.
* Fever with chill and rigor.
* General weakness.
* Sometimes fever is the only symptom of the deep abscess.

The anorectal abscess should preferably be explored under general or spinal anesthesia. Medical management often fails and subsequently fistula is formed.

Anorectal Abscess - Know In Detail About It!

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

Colorectal surgery is the broad term for surgical procedures performed on the colon, the rectum and the anus. There are various different surgical procedures which fall under colorectal surgery and these are used to treat a vast array of disorders, such as:
1. Anal cancer
2. Colorectal cancer
3. Severe complications related to constipation
4. Anal injuries
5. Inflammatory conditions of the gastrointestinal tract
6. Congenital defects

Procedures
The surgeries under colorectal surgery are performed after diagnostic tests such as proctoscopy, sigmoidoscopy and defecating proctography. The most common diagnostic test is colonoscopy. These help to identify the origin and nature of the problem and decide which surgical procedure is to be followed. The procedures under colorectal surgery are as follows:

Colectomy
This procedure involves removal of a section of the large intestine. This is known as partial colectomy. In extreme cases, such as advanced cancer or severe gastrointestinal infection, the entire colon is removed and this is called total colectomy. Sometimes, the rectum is also taken out along with the colon and this is called proctocolectomy.

Colonic polypectomy
An abnormal growth of tissues in the inner lining of an organ is known as a polyp. Colonic polypectomy is done to eliminate polyps from the colon and rectum before they become malignant. This can be done endoscopically. Surgery is required in case of large polyps.

Strictureplasty
Chronic or repeated bowel inflammation causes scar tissue to accumulate in the large intestine. This results in the narrowing of the colon. Stricturoplasty removes the scar tissue so that proper flow of digestive contents is resumed.

Colostomy or ileostomy
A damaged section of the colon is removed and the shortened intestine is then attached to another opening (stoma) in the anterior wall of the abdomen.

Hemorrhoidectomy
This surgical process is used for swollen hemorrhoids or blood vessels, which form in the anal canal. Hemorrhoidectomy is extremely effective in removing hemorrhoids, but the surgery also involves a number of complications.

Anoplasty
Anoplasty or imperforate anus correction is done to correct birth defects in the rectum and the anus. The structural flaw does not allow the stool to pass properly from the rectum and so it is repaired through surgery.

All About Colorectal Surgery

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