Hysterectomy
What is hysterectomy and when is it necessary?
Hysterectomy is the surgical removal of the
uterus. It does not necessarily mean that the ovaries or fallopian tubes will be removed. These organs can, however, be removed at the same time as a hysterectomy is being performed. A hysterectomy may be performed as part of treatment for fibroids, endometriosis or chronic pelvic pain, for bleeding problems, for uterine prolapse (uterus is “falling” out through the vagina) and for
cancer of the uterus, ovaries or cervix.
Types of hysterectomy
There are two types of
hysterectomy:
Total (complete) and
Subtotal (supracervical). Total or complete hysterectomy involves removing the uterus and the cervix. Subtotal or supracervical hysterectomy involves removing the uterus without the cervix. In this case, the
cervix remains in place and yearly pap smears are still needed to screen for cervical cancer. Having one type of procedure over another is a personal decision except in certain cases. If you are having your hysterectomy because of
cancer, the cervix is removed to prevent the cancer from spreading to this organ. Many people (doctors and patients) feel that leaving the cervix in adds better support to the vagina and results in less sexual dysfunction after hysterectomy. However, there has been no study to definitively show that having a
supracervical hysterectomy will prevent these problems from occurring. Some women who are ambivalent about having a hysterectomy feel more comfortable knowing that their cervix is left in place. Some doctors advocate
total hysterectomy in an effort to decrease the chance of developing
cervical cancer at a later time. However, with proper screening for cervical cancer (pap smear), abnormalities of the cervix can be detected prior to developing cervical cancer.
How is the hysterectomy done?
There are two main approaches to removing the uterus: through the abdomen or through the vagina. The
abdominal approach is used when a
supracervical hysterectomy is being performed, in cases where the uterus is too large to come through the vagina, in cases where the physician suspects there will be a lot of scaring around the
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