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Gynecology

Why Hysterectomy Is Sometimes Your Only Option

Hysterectomy. What is it?

Years ago, I worked in a gynecology operating room where I assisted in a large number of hysterectomies and have added experience working with these women on the post-surgical unit during their recoveries. I’ve tried to make this discussion as patient-friendly as possible.

If you are facing this surgery, print a copy of this article and take it with you on your next visit with your doctor should you have more questions.

Image: National Cancer Institute A hysterectomy is an operation to remove a woman's uterus (womb). The uterus is where a baby grows when a woman is pregnant. Sometimes the ovaries and fallopian tubes also are removed. These organs are found in a woman’s lower abdomen (see image).

The cervix is the lower end of the uterus. The ovaries are organs that produce eggs and hormones. The fallopian tubes carry eggs from the ovaries to the uterus.

There are several types of hysterectomies:

  • Complete or total. Removes the cervix and the uterus. (This is the most common type)
  • Partial or subtotal. Removes the upper part of the uterus and leaves the cervix in place.
  • Radical. Removes the uterus, the cervix, the upper part of the vagina, and supporting tissues. (This is done in some cases of cancer.)
Unless you’ve reached menopause (that’s when you haven't had a period for 12 months in a row), this surgery will stop your monthly periods. You also won't be able to get pregnant however you may have menopausal symptoms, such as hot flashes and vaginal dryness. If both ovaries are removed as well, you will suddenly enter menopause.

One in three women in the United States has had this surgery by age 60.

The procedure is done through a cut in the abdomen or the vagina. Occasionally an instrument called a laparoscope is used to help see inside the abdomen during vaginal hysterectomy. The type of surgery that is done depends on the reason for the surgery.

If you have cancer, removing the uterus might be the only option. But if you have uterine fibroids, endometriosis or uterine prolapse, there are other treatments you can try first.

Jot down the following and discuss these alternatives with your doctor: drug therapy, endometrial ablation, uterine artery embolization, myomectomy and vaginal pessary.

Talk to your doctor about non-surgical treatments to try first. This is really important if the recommendation for a hysterectomy is for a reason other than cancer.

What if my doctor says I need a hysterectomy?

  • Talk to your doctor about your options. Ask about other treatments for your condition.
  • Consider getting a second opinion from a different doctor.
  • Ask about possible complications of surgery.
  • Keep in mind every woman is different as is her situation. A good treatment choice for one woman may not be good for another.

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