Hysterectomy

There are many reasons for a hysterectomy which include bleeding, pain, prolapse, and uterine abnormalities.  Despite being one of the most common operations, there is much confusion about the procedure. 

The internal female organs include the uterus, the fallopian tubes, and the ovaries.  The uterus has two parts; the opening, or cervix, and the body.  The body of the uterus is where the menstrual lining forms and a developing fetus grows. A total hysterectomy is the removal of both the cervix and the body of the uterus.  Almost all hysterectomies performed are total hysterectomies.  Fallopian tubes and ovaries do not have to be removed when a hysterectomy is performed.  Their removal is a separate procedure called a “bilateral salpingo-oophorectomy”, or BSO for short. 

The uterus can be removed through an abdominal incision or through the vagina.  The decision on the safest method to remove the uterus is based on multiple factors, including “the reason” the hysterectomy is being performed.  The procedure is performed in the hospital under an anesthetic and will require a 1-3 day hospital stay.  After the procedure, you are usually able to drive within 2 weeks.  Exercise that increases your heart rate, lifting that causes your abdominal muscles to strain, and intercourse should be limited for 6 weeks.  Depending on the type of work you do, 6 weeks of leave may be necessary.  Other than not having menstrual periods, there should be no long-term effects of a hysterectomy.

The ovaries store eggs for conception and produce hormones.  They do not have to be removed when a hysterectomy is performed.  The decision to remove the ovaries at the same time as a uterus is based on several considerations including ”the reason “ for the hysterectomy and the age of the patient.  Women who are past menopause or close to menopause may elect to have the ovaries removed even if they are normal.  This lowers the concern for future malignant or benign conditions of the ovary. Once the ovaries are surgically removed, menopause will occur.  Although removal of the uterus does not cause menopausal symptoms, many women who have the ovaries removed may experience symptoms due to the loss of hormones.