​What kinds of symptoms do patients experience before receiving treatment?

Symptoms vary depending on the condition that requires the total abdominal hysterectomy. If the cause is cervical, uterine, or ovarian cancer, there may not be symptoms, especially if the cancer is early-stage. In more advanced cases of cervical and uterine cancers, abnormal bleeding, unusual discharge, and pelvic or abdominal pain can occur. Symptoms of ovarian cancer may include trouble eating, trouble feeling full, bloating, and urinary abnormality. If the cause is fibroids, symptoms may include heavy bleeding, pain in the pelvis or lower back, and swelling or enlargement of the abdomen.

​What is the impact on patients’ lives of living with these conditions?

Fibroids (tumors in the uterus) can grow large, cause abdominal pain and swelling, and lead to recurring bleeding and anemia. Cancer can cause pain and lead to death.

What cultural or regional factors affect the treatment of these conditions?

Cervical cancer is caused by a sexually transmitted infection called human papillomavirus (HPV), which can often occur alongside an HIV infection. As a result, cervical cancer is the leading cause of cancer death among African women in areas of high HIV prevalence. Cervical cancer is also more prevalent in Africa than in the United States due to the lack of early-detection screening programs. The other conditions treated by a total abdominal hysterectomy are not necessarily more common in Africa.

What does the treatment process look like?

The patient first reports for laboratory testing. The following day, the patient undergoes surgery. After the operation, the patient stays in the hospital ward for three to four days, during which time she is continually monitored. The surgery is considered successful if the wound heals without infection, bleeding, or fever, and if the patient no longer experiences urinary dysfunction.

What is the impact of this treatment on the patient’s life?

In the case of uterine fibroids or early-stage cancer, a total abdominal hysterectomy is curative.

What potential side effects or risks come with this treatment?

If performed early enough, this surgery is low-risk and curative, with few side effects.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

This surgery is available, but many patients cannot afford it. Many women are screened for cervical cancer with a low-cost alternative to a pap smear. This is common in HIV treatment programs. If necessary, the woman is referred for surgery, which she often cannot afford.

What are the alternatives to this treatment?

If cervical cancer is caught early enough, some minor procedures can solve the problem. Women with fibroids who still wish to have children may opt to undergo a surgery that only removes the fibroids, which is called a myomectomy.