(Hysterectomy Questions and Answers by Dr. Yvette Brown, assistant chief of obstetrics and gynecology at Keystone Women’s Care first appeared in the Public Opinion Newspaper in 2012. To read it online, visit www.publicopiniononline.com.)
In the United States, hysterectomy is the second most common surgery for women following childbirth by cesarean section. Why are hysterectomies performed and what do women need to know about this common procedure?
What is a hysterectomy?
A hysterectomy is the removal of the uterus, or womb, performed by a gynecologist or gynecologist oncologist. Sometimes people will refer to a hysterectomy as complete or partial. This is a misnomer. What individuals mean when they say complete or partial is whether or not other organs, such as the ovaries or cervix, are removed along with the uterus.
Is hysterectomy the only treatment available?
There are many reasons why a woman might need a hysterectomy including excessive bleeding, endometriosis, fibroids, or cancer of the uterus, ovaries or cervix. However, hysterectomy is not always necessary. Endometriosis, which causes pelvic pain, can be controlled with hormones and pain control. Excessive bleeding can be controlled with hormones or a same day surgical procedure called an endometrial ablation. Uterine and ovarian cancers are almost always treated with a hysterectomy if the patient is physically able. Cervical cancer is treated with radiation or hysterectomy depending on the stage of the cervical cancer.
How is it performed?
Hysterectomies can be performed in several different ways – abdominally (done through a incision in the lower part of the belly), vaginally (done through a cut in the vagina) laparoscopically (done by making small cuts in the belly and removed by using a laparoscope), laparoscopically assisted vaginal hysterectomy (done by making small cuts on the belly and removing the uterus through the vagina) and robot assisted (the physician uses a robotic machine through small cuts on the belly and removes the uterus through the vagina, much like a laparoscopically assisted vaginal hysterectomy.)
What are the risks?
There are surgical risks to hysterectomy that may include bleeding, infection, and damage to major organs such as bowel, bladder, nerves or blood vessels. Hysterectomies could change the orgasmic perception for women whose response was internal rather than clitoral. The recovery time for a hysterectomy can vary depending on the way it was performed. Traditional abdominal hysterectomies can have a recovery time of 6 weeks whereas robotic assisted hysterectomy can heal in as little as 3 weeks.
There is no major detrimental side effect after hysterectomy, however, if the ovaries are also removed with the uterus and a woman has not previously gone through menopause, she will instantly become menopausal. She may have symptoms such as hot flashes, mood swings, bone loss, vaginal dryness, and insomnia.
Remember, it’s important to see your doctor annually and report any problems right away if you have health concerns between visits.
Dr. Yvette M. Brown is an Ob/Gyn and the assistant chief obstetrics and gynecology officer at Keystone Women’s Care in Chambersburg.
