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Celebrity Health: Dolly Parton

Dolly Parton has spoken for the first time about the suicidal feelings that seized her after she received a life-saving operation.

The country legend was plunged into depression upon discovering she would never be able to give birth following a hysterectomy.

Speaking to reporters last week she said: "It was an awful time for me. Every day I thought, 'I wish I had the nerve to kill myself'."

A hysterectomy is the surgical removal of the uterus. The operation is most often carried out as a way of preventing the spread of uterine cancer. The success rate is high, but the emotional consequences can be devastating as the woman will never be able to have children.

Yet, while cancer is the most common reason for a hysterectomy, it isn't the only one. The procedure may, in addition, be recommended in the case of endometriosis, a condition in which the tissue on the inside of the uterus starts to grow outside it and on the ovaries and fallopian tubes.

And doctors will, in rare cases, advocate hysterectomies to counter severe vaginal bleeding and pelvic pain.

Broadly speaking, there are two main kinds of hysterectomy. During an abdominal hysterectomy, surgeons reach the uterus by cutting through the skin and connective tissues in the lower abdomen.

This has the benefit of affording the doctor a full view of the uterus and surrounding organs, and is recommended in the case of larger tumours.

However, there is a risk of scarring and post-operation discomfort. The patient will also have to spend longer in hospital.

The second kind is the vaginal hysterectomy. Here, the surgeon makes a circular incision around the cervix, through which he or she accesses the uterus. This is normally the procedure in the case of relatively 'benign' conditions, such as a uterine prolapse.

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There is no external scarring and recovery is also speedier than in the case of an abdominal hysterectomy. On the other hand, the surgeon has far less room to manoeuvre.

On the whole, the hysterectomy is considered a 'safe' operation. That said, complications are always possible. The most significant side-effect, of course, is that the woman can no longer have children. For this reason, a hysterectomy is only carried out after all other options have been ruled out.

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