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The Truth About Hysterectomies

The Truth About Hysterectomies

Here are three things you must know about this rapidly evolving procedure.

Roughly one in nine women in the U.S. will have a hysterectomy, or surgery to remove the uterus, at some point in their lifetime. A healthcare provider (HCP) might recommend the procedure to treat cancer, for example, or to relieve chronic pelvic pain. 

While they’re considered to be very safe, hysterectomies are still major surgeries—and having one isn’t a decision to take lightly. Here are three facts to consider.

1. You may not need one.
Hysterectomies are a common surgery in women, with more than 400,000 performed annually in the U.S., according to a 2013 study published in Obstetrics & Gynecology. The procedure can be lifesaving in some women with gynecological cancers, such as uterine, ovarian or cervical cancer. But HCPs may also recommend them for non-life-threatening conditions including fibroids, endometriosis, pelvic organ prolapse and even abnormal bleeding.

A hysterectomy might be warranted if these problems affect a person’s lifestyle, says Stephen K. Montoya, MD, an OBGYN at Sunrise Hospital & Medical Center in Las Vegas. But it’s important to talk to your HCPs about all your options before undergoing surgery that may not be medically necessary. In some cases, medication or different procedures may be enough to successfully treat your condition.

2. There are different types you should know about.
Edmond Pack, MD, an OBGYN at Southern Hills Hospital in Las Vegas, says you should speak to your HCP about the kinds of hysterectomy, and the way in which yours might be done. Common types include:

  • Partial: The upper portion of the uterus is removed.
  • Total: The uterus and the cervix are removed. 
  • Radical: The uterus and cervix are removed, along with a few lymph nodes, the upper one-third to one-half of the vagina and some tissue surrounding the area. Radical hysterectomies often involve a diagnosis or suspicion of cervical or uterine cancer.

Surgical technique may be traditional or minimally invasive, in which the procedure is performed through small incisions instead of one large opening. Laparoscopic hysterectomy is minimally invasive, and the most common hysterectomy procedure in the U.S. 

No matter which surgery your HCP recommends, make sure to learn the details—and whether you have other options—so you’re fully informed. Ask questions about what the hysterectomy entails, your expected recovery time, the post-surgery care and any potential complications. Keep an open line of communication throughout the process in case you have additional questions or concerns.

3. You may not need your ovaries removed.
Sometimes during a total or radical hysterectomy, the ovaries and fallopian tubes are removed. But the younger you are, the less likely your HCP is to recommend this. Research suggests that the reduced risk of ovarian cancer may be outweighed by other health risks incurred from removing the ovaries, particularly at an early age.

However, some HCPs advise removal of the ovaries for women who are nearing or past menopause. For women nearing menopause, suddenly not having ovaries means experiencing the symptoms of menopause right after surgery. Hormone replacement therapy can help; just be sure you’ve discussed risks and benefits with your HCP.

Medically reviewed in June 2019.

Sources:
Medline Plus: “Hysterectomies.”
Wright, J. D., Herzog, T. J., Tsui, J., Ananth, C. V., Lewin, S. N., Lu, Y. S., … Hershman, D. L. (2013). Nationwide trends in the performance of inpatient hysterectomy in the United States. Obstetrics and gynecology, 122(2 Pt 1), 233–241.
American College of Obstetricians and Gynecologists: “Hysterectomy.”
Cleveland Clinic: “Hysterectomy.”
WomensHealth.gov: “Hysterectomy.”
Uptodate.com: “Radical Hysterectomy,” “Laparoscopic Hysterectomy.”
Mayo Clinic: “Hormone therapy: Is it right for you?”

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