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[LostGal]

Laparoscopic Supra-cervical Hysterectomy (LSH): This type of hysterectomy means that the opening of the uterus was cut from the uterine body and left attached to the vagina. It is touted as preserving a woman’s sexual function and preventing prolapse, but research shows that it does neither. Studies comparing women with total hysterectomy compared to supra-cervical hysterectomy had similar sexual function, satisfaction and frequency. Research results on many women confirm that there is no benefit for sexual enjoyment or prevention of urinary incontinence or saggy vagina. The women with supra-cervical hysterectomies had more monthly bleeding (their periods), and needed the progesterone supplements in their menopause to prevent hyperplasia and cancer of the cervix. Many had to have their cervix removed later to alleviate pain or bleeding that persisted after hysterectomy. A few have developed fibroids, adenomyosis or cervical carcinoma. Dr. O’Hanlan has reviewed all of this literature and does not recommend or perform this procedure.

This is the newest way (since 1989 or so):
Total Laparoscopic Hysterectomy: This procedure involves removing the uterus by operating through the scopes and passing the tissue out through the vagina or through one of four of the tiny half-inch abdominal incisions. Massive uteruses and ovarian cysts, cancer and pre-cancer can all be treated by laparoscopic hysterectomy. Because there is no operating through the vagina (though tiny pieces of tissue can be passed down through it), there is no requirement for a wide vagina or loose ligaments from childbirth, and no problem with increased urinary incontinence risk later. Hospital stays are shorter and blood loss is about half. Pain is less and time off from work is only two weeks, not six. There is no increase in risk of urinary leakage after this type of procedure, and some report that mild leakage was corrected. This is because Dr. O’Hanlan connects the inner end of the vagina where the uterus was attached to the three ligaments that originally held up the uterus (Round ligament, Uterosacral ligament and Cardinal ligament). Dr. O’Hanlan uses this technique as often as is safe and effective.

[image]http://www.ohanlan.com/newpix/total_lap_body.jpg[/image] B. These are the usual incisions for a laparoscopic hysterectomy. The fourth incision is inside the bellybutton

[image]http://www.ohanlan.com/newpix/total_lap_docs.jpg[/image] web page