Hysterectomy: An Overview

Doctor with PatientWhether faced with an option to think the procedure through for a while or given the diagnosis that surgery is imperative, get the facts on how it will change your body and your life. Let’s first take a look at why a hysterectomy may be recommended.

Usually, a hysterectomy is proposed for uterine fibroids, abnormal uterine bleeding, severe endometriosis, uterine prolapse, or cancer. The most common diagnosis leading to a hysterectomy in the United States is uterine fibroids. According to the CDC’s latest information published in 2009, over 600,000 hysterectomies are performed each year.

Many physicians now believe that most hysterectomies are not medically necessary unless there is a diagnosis of cancer or the uterine bleeding is uncontrollable. A hysterectomy is major surgery and should be considered (like any major surgery) to be very serious and possibly dangerous.

The surgery techniques for hysterectomies are varied, and everyone should get the facts before they agree to this surgery. Know what to expect, what will be removed, what the recovery time will be, and what adaptations and medications, if any, you will require post-surgery. This surgery doesn’t have to be difficult, but it will be life changing.

Types of Hysterectomies

  • Supracervical Hysterectomy (referred to as a Subtotal Hysterectomy) is the removal of the uterus and the ovaries but not the cervix. Leaving the cervix is desirable for increased sexual pleasure and for added vaginal support.
  • Total Hysterectomy is the removal of the whole uterus and the cervix. Ovaries and Fallopian tubes may also be removed.
  • Radical Hysterectomy is the removal of the whole uterus along with the cervix, the top part of the vagina, and the tissue around the uterus. A radical hysterectomy is usually only considered in the case of cancer.

Types of Surgical Techniques

  • Abdominal Hysterectomy is the most common procedure and requires the longest recovery and rehabilitation. The surgeon makes an incision in the abdomen, either vertically or horizontally, and removes the uterus through the incision.
  • Vaginal Hysterectomy is when the surgeon cuts the uterus away from the cervix and removes it through the vagina.
  • Laparoscopic Hysterectomy is a less invasive technique. Here, the surgeon uses special tools inserted through several small incisions in the abdomen to perform the hysterectomy. The surgeon also uses a tube with a lighted camera for a guide so that the procedure can be done while looking at a video monitor.
  • Laparoscopic Assisted Vaginal Hysterectomy is similar to the procedure above but the uterus is removed through the vagina. This procedure is usually recommended for benign conditions that warrant a hysterectomy.
  • Robot Assisted Hysterectomy is a procedure often referred to as the “da Vinci Surgical System.” Here, the surgeon guides a robot through remote control, and the robot handles all instruments directly.

Regardless of the type of procedure elected, any hysterectomy will stop your periods. As you will no longer have a uterus, you will no longer have any uterine lining to slough off each month. Accordingly, you will not be able to bear children after a hysterectomy, and your hormones levels may drop. If your ovaries are not removed, you will still produce estrogen; if they are removed, you will still get some estrogen production from other organs. However, for many, surgical menopause will ensue. Consult with your physician before your surgery on your options and regarding hormone replacement post-surgery.

Also, please refer to our Directory of Physicians for practitioner referrals in your area.