Hysterectomy Health Article

Definition

A hysterectomy is a surgical removal of the uterus, resulting in the inability to become pregnant (sterility). It may be done through the abdomen or the vagina.

Alternative Names

Vaginal hysterectomy; Abdominal hysterectomy; Supracervical hysterectomy; Radical hysterectomy; Removal of the uterus

Description

Hysterectomy is an operation that is commonly performed. There are many reasons a woman may need a hysterectomy. However, there are nonsurgical approaches to treat many of these conditions. Talk to your doctor about nonsurgical treatments to try first, especially if the recommendation for a hysterectomy is for a cause other than cancer.

During a hysterectomy, the uterus may be completely or partially removed. The fallopian tubes and ovaries may also be removed. A partial (or supracervical) hysterectomy is removal of just the upper portion of the uterus, leaving the cervix intact.

A total hysterectomy is removal of the entire uterus and the cervix. A radical hysterectomy is the removal of the uterus, the tissue on both sides of the cervix (parametrium), and the upper part of the vagina.

A hysterectomy may be done through an abdominal incision (abdominal hysterectomy), a vaginal incision (vaginal hysterectomy), or through laparoscopic incisions (small incisions on the abdomen -- laparoscopic hysterectomy).

Your physician will help you decide which type of hysterectomy is most appropriate for you, depending on your medical history and the reason for your surgery. Robotic hysterectomy surgery is not yet widely available in the United States.

Indications

Hysterectomy may be recommended for:

• Tumors in the uterus like uterine fibroids or endometrial cancer
• Cancer of the cervix or severe cervical dysplasia (a precancerous condition of the cervix)
• Cancer of the ovary
• Endometriosis, in those cases in which the pain is severe and not responsive to nonsurgical treatments
• Severe, long-term (chronic) vaginal bleeding that cannot be controlled by medications
• Prolapse of the uterus
• Complications during childbirth (like uncontrollable bleeding)

Risks

The risks for any anesthesia are:

• Reactions to medications
• Problems breathing

The risks for any surgery are:

• Bleeding
• Infection

Other risks that are possible from a hysterectomy include:

• Injury to nearby organs, including the bladder or blood vessels
• Injury to bowel
• Pain with intercourse