A hysterectomy is the surgical removal of the uterus. By removing the uterus, a hysterectomy stops the menstrual cycle and prevents pregnancy. It is a permanent procedure that cannot be reversed. Although a hysterectomy is often a treatment of last resort, it can be uniquely effective in treating reproductive conditions. Some of the indications for a hysterectomy include:
- Uterine fibroids
- Uterine prolapse
- Pelvic adhesions
- Persistent pain or bleeding
A hysterectomy can be performed through different methods, depending on the indication and the health and preferences of the patient. Most hysterectomies are performed laparoscopically, which requires small incisions. If the anatomy permits, many hysterectomies can be performed vaginally, without the need for any abdominal incision. Laparoscopy can often be used to augment a vaginal hysterectomy. An open abdominal hysterectomy uses larger incisions.
A total hysterectomy removes the uterus and cervix. A subtotal hysterectomy removes the uterus but leaves the cervix. A radical hysterectomy removes the uterus, cervix, tubes, ovaries and the pelvic lymph nodes; this is only done for patients with gynecologic cancer and is a subspecialist’s operation. Sometimes the patient will benefit by removing the ovaries and/or Fallopian tubes, which is easily done at hysterectomy.
While a hysterectomy is generally safe, there are certain risks involved. Some risks of a hysterectomy include blood loss, bowel or bladder injuries, or problems with anesthesia.