- Impact on patient's life
- Cultural or regional significance
What kinds of symptoms do patients experience before receiving treatment?
During a hysterectomy, a woman's uterus is removed. Sometimes, the ovaries and tubes are also removed at the same time. This surgery may be required to treat a number of conditions. These include fibroids (non-cancerous growths that cause heavy bleeding), endometriosis, cancer, abnormal vaginal bleeding, and chronic pelvic pain. Many of these conditions develop in older woman. Risk factors include having no children, obesity, and family history of a certain condition.
What is the impact on patients’ lives of living with these conditions?
Symptoms vary depending on the condition. Typical symptoms include heavy bleeding, fatigue, and pelvic pain. These symptoms can significantly impair a woman's normal daily activities.
What cultural or regional factors affect the treatment of these conditions?
This treatment is necessary and has no historical, cultural, or regional significance.
- Impact on patient's life
- Risks and side-effects
What does the treatment process look like?
The patient is admitted prior to surgery to be assessed by the surgeon and anesthetist. Depending on the underlying condition and the size of the uterus, it may be removed through an abdominal incision (called an abdominal hysterectomy) or through the vagina (called a vaginal hysterectomy).
The surgery is usually done under a general anesthesia. Once the medications have taken effect, the anesthetist will insert a tube into the patient's throat to manage her breathing. The patient will lie on her back, and a catheter will be inserted into her bladder. The surgeon will make incisions inside the vagina to access the uterus. Blood vessels on either side of the uterus are clamped with long instruments, and the uterus is separated from the surrounding pelvic tissues. The uterus is removed, and the patient is taken to the recovery area until stable.
What is the impact of this treatment on the patient’s life?
After surgery, most of the patient's symptoms will resolve. She will no longer experience bleeding or pain, though some pain may persist from scarring. The patient will be able to resume her usual lifestyle.
If the patient's ovaries were removed, she will enter menopause. This may require further management, such as hormone replacement therapy.
What potential side effects or risks come with this treatment?
This surgery is common and generally very safe. The risks of undergoing a vaginal hysterectomy are significantly lower than those associated with an abdominal hysterectomy. Risks of an abdominal hysterectomy include heavy bleeding, infection, and damage to surrounding organs.
How accessible is treatment in the area? What is the typical journey like for a patient to receive care?
Surgery is available in most public hospitals throughout the Philippines. However, even with government health insurance, there are still significant out-of-pocket expenses that make surgery inaccessible to patients. Many patients will take natural remedies from traditional healers or wait until symptoms are very severe before seeking medical attention.
What are the alternatives to this treatment?
Some conditions, such as endometriosis and pelvic pain, can be treated with hormonal treatments, such as the combined contraceptive pill or progesterone. The uterus must be removed if it contains an abnormal mass and/or cancer is suspected.