Hysterectomy: Procedures and Alternatives

It is a surgery to remove the uterus.

It is a prevalent type of surgery for women around the world. The removal of the uterus means that you can no longer get pregnant.

Why is a hysterectomy done?

Hysterectomy is used to treat the health conditions of many women. Some of these conditions include the following:

  • Uterine fibroids (this is the most common reason for hysterectomy).
  • The endometriosis.
  • Pelvic problems (such as uterine prolapse)
  • Abnormal uterine bleeding.
  • Chronic pelvic pain.
  • Gynecological cancer.

Are there alternatives to hysterectomy?

In some cases, medications or other procedures that allow you to become pregnant now or shortly can be treated before having a hysterectomy.

Some women expect to have a hysterectomy until after they have had children. If you choose another option besides hysterectomy, you should know that you may need additional treatment.

What structures are removed during a hysterectomy?

There are different types of hysterectomy:

Total hysterectomy: the entire uterus, including the cervix.

 

Supracervical (also called subtotal or partial). Only the uterus is removed. This type of hysterectomy can only be done laparoscopically or abdominally.

Radical hysterectomy: this is a total hysterectomy, which also includes the removal of the structures that surround the uterus. It may be advisable if cancer is diagnosed or suspected.

What can other organs besides the cervix and uterus be removed during a total hysterectomy?

One or both ovaries and fallopian tubes can be removed if abnormal (for example, they are affected by endometriosis).

This procedure is called a salpingo-oophorectomy if both tubes and ovaries are removed. Salpingectomy if only the fallopian lines are drawn, and oophorectomy if only the ovaries are removed.

The surgeon can not know if the ovaries and fallopian tubes will be removed until surgery. Women at risk for ovarian cancer or breast cancer may choose to have both ovaries removed even if these organs are healthy to reduce cancer risk.

This is called an elective salpingo-oophorectomy.

What will happen if the ovaries are removed before they have gone through menopause?

The woman will experience signs and symptoms of menopause. You may also be at increased risk of osteoporosis.

Hormone therapy can be given to relieve the signs and symptoms of menopause and may help reduce the risk of osteoporosis.

Hormone therapy can be started immediately after surgery. Other medications can be given to prevent osteoporosis if you are at high risk.

What are the different forms of hysterectomies that can be performed?

A hysterectomy can be done in different ways: through the vagina, abdomen, or laparoscopy.

The choice will depend on who will be subjected to the surgery and other factors. Sometimes, the decision is made after the surgery begins, and the surgeon can see if other problems are present.

How is a vaginal hysterectomy performed?

In a vaginal hysterectomy, the uterus is removed through the vagina. There is no abdominal incision. Not all women can have a vaginal hysterectomy—for example, women who have adhesions due to previous surgery or who have a vast uterus.