Overview and symptoms
A hysterectomy is the surgical removal of the uterus (or “womb”). In some cases, your doctor may also remove other reproductive organs, such as your fallopian tubes or ovaries, during a hysterectomy.
Hysterectomy can be a life-saving treatment for gynecologic problems such as uterine cancer and heavy, uncontrollable bleeding. A woman who has had a hysterectomy cannot get pregnant and will no longer have menstrual periods.
For some women, a hysterectomy relieves the pain of health conditions involving the uterus. Others have the surgery to treat uterine cancer or as an emergency procedure to stop heavy bleeding after childbirth.
Some of the most common reasons your doctor might recommend a hysterectomy include:
- Uterine fibroids, or benign (non-cancerous) tumors in the uterus. Uterine fibroids are the most common reason for hysterectomy.
- Consistent, abnormally heavy periods.
- Cancer of the uterus, cervix, or ovaries, or evidence of precancerous growth. In some cases, having a family history of ovarian cancer or testing positive for the BRCA gene (which increases the risk of hormone-sensitive cancers such as ovarian and breast) leads to a hysterectomy recommendation.
- Endometriosis, or uterine tissue growing outside the uterus.
- Chronic pelvic pain.
- Uterine prolapse, a condition occurring mostly in women who have given birth multiple times. The pelvic floor is too weak to support the uterus, so it descends (lowers down) and can protrude from the body.
- Adenomyosis, a condition in which the uterine wall is too thick, or the lining of the uterus grows into the muscle, causing pain or heavy bleeding.
- Infection of the pelvis. Infections in the pelvic region are usually treated with antibiotics, but sometimes a serious infection may lead to hysterectomy if it causes a lot of damage.
- Hyperplasia, a condition in which the uterus grows too thick, causing heavy bleeding and increasing the risk of cancer. Though hyperplasia can often be treated with hormone therapy, some cases may require a hysterectomy.
- Complications of delivery. Some rare events after giving birth, such as severe bleeding or placenta accreta, might also lead to hysterectomy.
A hysterectomy can be performed through the abdomen or the vaginal opening. The types of hysterectomy approach include:
- Abdominal hysterectomy:During an abdominal hysterectomy, an incision is made in the lower abdomen, through which the uterus is removed.
- Laparoscopic hysterectomy: Sometimes an abdominal hysterectomy can be performed using a few tiny incisions, through which a special camera and surgical instruments are inserted. That procedure is called a laparoscopic hysterectomy.
- Vaginal hysterectomy: During a vaginal hysterectomy, the uterus is removed through the vagina.
Vaginal and laparoscopic hysterectomies require much smaller incisions, shorter hospital stays, and shorter recovery periods. Ask your doctor if you are a good candidate for these minimally invasive techniques.