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Reasons for a Total Vaginal Hysterectomy

A vaginal hysterectomy is a less-invasive procedure than other methods of hysterectomy, such as abdominal or radical hysterectomy. With vaginal hysterectomy, the uterus is removed through the vagina. A laparoscope may be used to see in the pelvis. Small cuts are made in the abdomen for the insertion of surgical instruments, and an incision is made in the vaginal canal to allow for the removal of the uterus through the vagina.

  1. Endometriosis

    • The inner lining of the uterus is called the endometrium. This inner lining is shed each month during menstruation and proliferates throughout the menstrual cycle. Endometriosis occurs when the endometrial tissue grows outside of the uterus. It often attaches to the ovaries and surrounding bowel. Since endometriosis does not enlarge the uterus, the uterus may most likely be removed vaginally.

    Adhesions

    • Adhesions may be a cause of pelvic pain. An adhesion is scar tissue that acts as an attachment between the uterus, ovaries and bowel. Adhesions are the result of the healing process resulting from surgery. Pelvic infection may also result in adhesions. The adhesions must be cut during the hysterectomy to free the uterus for removal.

    Fibroids

    • Fibroids are muscle tumors within the uterus. They can be small and without symptoms, or they can be quite large, sometimes the size of a grapefruit. Fibroids may cause irregular bleeding such as prolonged menstruation and spotting between periods. They may also cause cramping and pain. A uterus with small fibroids may be removed vaginally.

    Uterine Prolapse

    • The uterus is supported by muscles and ligaments within the pelvis. The muscles and ligaments may weaken and stretch, which is a possible complication of childbirth and menopause. This may cause the uterus to drop lower in the pelvis and into the vaginal canal. If the uterus is not enlarged, it may be removed vaginally.

    Endometrial Hyperplasia and Cancer

    • Endometrial hyperplasia is the excessive thickening of the endometrium. This may be the result of endometrial polyps or cancer, which may cause irregular or heavy bleeding. Cancer may also occur in the muscular wall of the uterus called the myometrium. If the tumor does not cause significant uterine enlargement, the uterus may be removed vaginally.

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