Hysterectomy

Hysterectomy is the surgical removal of the uterus. Different portions of the uterus, as well as other organs, may be removed at the same time. For women who have not yet reached menopause, having a hysterectomy means that menstruation will no longer occur, nor will pregnancy be possible.

Reasons for a hysterectomy may include:

  • Fibroid tumors. Non-malignant tumors may grow and become large, causing pressure on other organs and possibly heavy bleeding or pelvic pain.
  • Endometriosis. Endometrial cells sometimes grow outside of the uterus, attach themselves to other organs in the pelvic cavity, and bleed each month in accordance with an ovarian cycle. This can result in chronic pelvic pain, pain during sex, and prolonged or heavy bleeding.
  • Endometrial hyperplasia. A cause of abnormal bleeding, this over-thickening of the uterine lining is often due to the presence of continuous estrogen without progesterone. This is common during perimenopause when hormone levels are changing.
  • Cancer. Approximately 10 percent of hysterectomies are performed to treat cancer—either cervical, ovarian, or endometrial.
  • Blockage of the bladder or intestines. A hysterectomy may be performed if there is a blockage of the bladder or intestines by the uterus or a growth.

Types of Hysterectomy

  • Total hysterectomy. Includes the removal of the entire uterus, including the fundus (the part of the uterus above the openings of the fallopian tubes) and the cervix, but not the ovaries. This is the most common type of hysterectomy.
  • Hysterectomy with bilateral oophorectomy. Includes the removal of one or both ovaries, and sometimes the fallopian tubes, along with the uterus.
  • Supracervical hysterectomy (partial or subtotal hysterectomy). Removal of the body of the uterus while leaving the cervix intact.

Hysterectomy Procedures

Several types of procedures are used to perform hysterectomies. The type of hysterectomy performed and the technique used to perform the procedure will be determined by your physician, based upon your particular situation.

  • Abdominal hysterectomy. The uterus is removed through the abdomen via a surgical incision about six to eight inches long. This procedure is most commonly used when the ovaries and fallopian tubes are being removed, when the uterus is enlarged, or when disease has spread to the pelvic cavity, as in endometriosis or cancer. The main surgical incision can be made either vertically, from the navel down to the pubic bone, or horizontally, along the top of the pubic hairline.
  • Vaginal hysterectomy. The uterus is removed through the vaginal opening. This procedure is most often used in cases of uterine prolapse or when vaginal repairs are necessary for related conditions. No external incision is made, which means there is no visible scarring.
  • Laparoscope-assisted vaginal hysterectomy. Vaginal hysterectomy is performed with the aid of a laparoscope, a thin, flexible tube containing a video camera. Thin tubes are inserted through tiny incisions in the abdomen near the navel. The uterus is then removed in sections through the laparoscope tube or through the vagina.
  • da Vinci Robotic Hysterectomy. da Vinci Robotic surgical technology provides a less invasive option for hysterectomy. It enables a surgeon to use a robotic device to access and remove the uterus in sections through small surgical “ports” measuring one to two centimeters instead of through larger incisions. Benefits of the procedure include reduced pain, faster recovery, shorter hospital stay, and a lower risk of complications.

Resources