Types of Hysterectomy:

1. Total Hysterectomy: In a total hysterectomy, Dr. Murthy removes the uterus and cervix. This procedure is commonly performed for conditions such as uterine fibroids, endometriosis, abnormal uterine bleeding, pelvic organ prolapse, or cancer of the uterus.
2. Subtotal or Partial Hysterectomy: In a subtotal or partial hysterectomy, only the upper part of the uterus is removed, while the cervix is preserved. This procedure may be recommended for certain benign conditions of the uterus, such as fibroids or adenomyosis, where preservation of the cervix may offer potential benefits.
3. Total Hysterectomy with Salpingectomy: This involves removal of the uterus, cervix, and fallopian tubes. It may be recommended for women at increased risk of ovarian cancer or for those undergoing surgery for other gynecological conditions.
4. Total Hysterectomy with Bilateral Salpingo-Oophorectomy (BSO): In this procedure, Dr. Nirmala Murthy removes the uterus, cervix, fallopian tubes, and both ovaries. It is often performed for conditions such as ovarian cancer, endometriosis, or to reduce the risk of ovarian cancer in women with a high genetic risk.

Indications for Hysterectomy:

1. Uterine Fibroids: Hysterectomy may be recommended for women with symptomatic fibroids that cause heavy menstrual bleeding, pelvic pain, or pressure symptoms that do not respond to conservative treatments.
2. Endometriosis: In cases of severe endometriosis that do not respond to medical management, hysterectomy may be considered as a treatment option to alleviate symptoms and improve quality of life.
3. Uterine Prolapse: Hysterectomy may be recommended for women with uterine prolapse, a condition where the uterus descends into the vaginal canal, causing discomfort, urinary symptoms, or difficulties with bowel movements.
4. Gynecological Cancers: Hysterectomy is often performed as part of the treatment for gynecological cancers such as uterine cancer, cervical cancer, or ovarian cancer, especially in cases where conservative treatments are not feasible or effective.
5. Chronic Pelvic Pain: In some cases of chronic pelvic pain that cannot be alleviated with conservative treatments, hysterectomy may be considered as a last resort to relieve symptoms and improve quality of life.

Considerations and Alternatives:

Before undergoing a hysterectomy, Dr. Nirmala Murthy discusses the potential risks, benefits, and alternatives with her patients. Depending on the individual circumstances, alternatives to hysterectomy may include hormonal therapy, conservative surgery, uterine artery embolization (for fibroids), or other minimally invasive procedures.

Conclusion:

Hysterectomy is a major surgical procedure that may be recommended for various gynecological conditions. Dr. Nirmala Murthy evaluates each patient's unique situation and provides personalized recommendations to ensure the best possible outcomes for her patients.