A hysterectomy refers to the removal of a women’s uterus (womb) and possibly the cervix. Hysterectomy is one of the most common surgeries in the United States, with approximately 600,000 performed annually . Reasons for performing a hysterectomy include pelvic pain, heavy vaginal bleeding, fibroids, pelvic organ prolapse and cancer. There are two main types of hysterectomies: total and supracervical. A total hysterectomy refers to removal of the uterus and the cervix (It is a common misconception that a total hysterectomy includes removal of the ovaries. If the ovaries are to be removed, your surgeon will refer to that as a bilateral salpingoophorectomy or BSO.). A supracervical hysterectomy refers to removal of just the uterus with the cervix being left in place. Your surgeon may give you the option to keep or remove your cervix, but in some circumstances removal of the cervix is medically warranted. Hysterectomies that are performed for treatment of cancer generally will involve removal of both the uterus and cervix. Women having a hysterectomy for any of the first three reasons may elect to have either a total or supracervical hysterectomy (Figure 1). If the hysterectomy is for pelvic organ prolapse, the cervix may or may not need to be removed based on the type of prolapse repair that you need. In the United States in 2003, six percent of all hysterectomies performed were supracervical . ( READ MORE )
For women who wish to preserve their fertility or preserve their uterus regardless of fertility issues, hysterectomy should be a last resort.
When fertility preservation is the goal, it is important for the gynecologist to know the number, sizes and exact positions of the fibroids in order to guide the best treatment. Fibroids that change the shape of the uterine cavity can decrease fertility and will be best detected using saline-infusion ultrasound, hysteroscopy (telescope looking into the uterine cavity) or MRI (most accurate). ( READ MORE )
Do you need a hysterectomy for bleeding, pain, fibroids, prolapse, or uterine cancer? Why settle for a large incision if you can have smaller incisions or no incision? Why have more pain if there is a less invasive approach? Why spend more time in the hospital and more time for recovery if you can go home the same day or next day and return to your favorite activities sooner? ( READ MORE )