What is a hysterectomy?
Some are:
- cancer
- endometriosis
- fibroids
- pelvic pain
- uterine prolapse
- vaginal bleeding
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A hysterectomy is a surgery to remove a woman's uterus. Often times a woman's cervix and possibly her ovaries are removed at the same time that she has her uterus removed. After a hysterectomy a patient will no longer have menstrual cycles and cannot become pregnant. The word hysterectomy means removal of the uterus so if a patient is having a hysterectomy, it does not mean that she is also having her ovaries removed. The surgery to remove the ovaries is a bilateral salpingooophorectomy. Some patients will use terms such as a partial or total hysterectomy, but these are just lay terms.
When I talk about a hysterectomy to my patients, I explain that there are different ways to perform a hysterectomy. The most common way that a hysterectomy is performed in the United States is through a "bikini incision". This is called a total abdominal hysterectomy. 75% of hysterectomies performed in the United States are done in this manner. The next most common way that a hysterectomy is performed is a transvaginal hysterectomy. The entire hysterectomy is done through an approach through the woman's vagina. The next most common way of performing a hysterectomy is a laparoscopic assisted vaginal hysterectomy in which 3 small incisions are placed on the woman's abdomen, one in the bellybutton and one on either side of her lower abdomen, and the top portion of the uterus is detached laparoscopically and the bottom portion of the uterus is removed vaginally.
There are newer ways of performing hysterectomies in which the entire procedure is done in a total laparoscopic manner. This is where the cervix and uterus are removed all through 3 or 4 small incisions on the patient's abdomen. This is a technically challenging procedure, and a lot of doctors do not feel comfortable doing this procedure, which is why it is less common. Many doctors will use the Davincci Robot to help assist in a total laparoscopic hysterectomy. Lastly, the newest procedure in hysterectomies is a single-incision laparoscopic hysterectomy in which all three instruments used to perform a hysterectomy are placed through a small incision in the patient's bellybutton. This is my favorite way of performing a hysterectomy, and this has the least amount of recovery time and has the best cosmetic effect.
During the hysterectomy, your doctor also may remove your fallopian tubes and ovaries. The ovaries produce eggs and hormones. The fallopian tubes carry eggs from the ovaries to the uterus. The cervix is the lower end of the uterus that joins the vagina. These organs are located in a woman's lower abdomen, as shown in the image below.
If you have not yet reached menopause and:
You keep your ovaries during the hysterectomy, you may enter menopause at an earlier age than most women. Your ovaries are removed during the hysterectomy, you will enter menopause. You can talk with your doctor about ways to manage menopausal symptoms, such as hot flashes and vaginal dryness.
Types of hysterectomy:
Partial, subtotal, or supracervical removes just the upper part of the uterus. The cervix is left in place. Total removes the whole uterus and the cervix. Radical removes the whole uterus, the tissue on both sides of the cervix, and the upper part of the vagina. This is done mostly when there is cancer present.
This answer is based upon source information from the National Women's Health Information Center.
There are several different types of hysterectomies. Women undergo this procedure for any of several reasons, though hysterectomies are often performed to treat cancer of the uterus, cervix, ovaries or endometrium (lining of the uterus).
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.