What is a Hysterectomy?
A hysterectomy is the surgical removal of a woman’s uterus, or womb. It is the most common non-obstetrical female surgery in the U.S., with 600,000 procedures performed each year.
Who needs a Hysterectomy?
Women suffering from problems of the reproductive organs, and who have been treated with more conservative measures without relief, may need a hysterectomy. The most common conditions, in order, that may ultimately lead to hysterectomy include:
• Uterine fibroids
• Abnormal bleeding
• Uterine prolapse
• Cancer of the uterus, cervix, ovaries or fallopian tubes - Only 10% of hysterectomy is performed for cancer.
Your physician may order one of several tests to determine the best course of your treatment. These will include a complete pelvic exam and evaluation of the ovaries and uterus, and a pap smear. Pelvic ultrasound may also be necessary. For women with abnormal uterine bleeding, endometrial sampling via laparoscopic surgery may also be indicated.
Types of Hysterectomy
Hysterectomies vary in the extent that the reproductive organs are removed.
• A superacervial hysterectomy involves removal of the uterus, leaving the cervix intact.
• A total hysterectomy removes the uterus and cervix.
• A radical hysterectomy removes the uterus, cervix, upper part of the vaginal and adjacent tissue.
In addition, oophorectomy removes one or both ovaries. salpingo-oophorectomy is the removal of the ovary and its adjacent fallopian tube. These two procedures are performed for cancer of the ovary, removal of suspicious ovarian tumors, or Fallopian tube cancer (which is very rare).
What Happens During a Hysterectomy?
There are a variety of surgical techniques for performing hysterectomies. Total Abdominal Hysterectomy, as the name implies, is performed through an incision in the abdomen. Vaginal Hysterectomy refers to removal of the organs through the vagina. Your medical condition, and your doctor’s evaluation, will determine the best course of treatment for you. In addition, hysterectomy is now being performed laparoscopically, on a minimally invasive basis. The advantages are a shorter recovery period, less pain and scarring, and a quicker return to normal activities. At Loma Linda University Medical Center, we have found the benefits to patients include:
• Over 90% of our patients following laparoscopic hysterectomy or myomectomy leave the hospital the day of, or the day after surgery
• Nearly all patients can return to normal activities within 1-2 weeks, including back to work
• Short duration of narcotic requirements – many patients go home on ibuprofen or acetaminophen alone-- even after major cancer surgery.
What Happens After Surgery?
Pre-menopausal women who have their uterus removed will not longer have periods or be able to bear children. If the ovaries are removed as well, a woman will immediately enter menopause. The treatment decisions a woman makes at this stage are similar to those of women who enter menopause naturally.