A hysterectomy is the surgical removal of a person's uterus. The uterus, or womb, is where the fetus grows during pregnancy. During a hysterectomy, the surgeon typically removes the whole uterus and may also remove the ovaries and fallopian tubes. Once the uterus is removed, the patient will stop having menstrual periods and can no longer become pregnant.
There are several reasons for having a hysterectomy. The purpose of having the surgery may be different from patient to patient, based on which condition is being treated and the desired outcome.
The most common reason to have a hysterectomy is to treat uterine fibroids, which are tumors that grow on the wall of the uterus. While fibroids are usually benign (not cancerous), they can cause problems such as heavy bleeding, painful periods, discomfort during intercourse, lower back pain and frequent urination. In this case, the goal of removing the uterus is to stop these symptoms.
Hysterectomy is also used as a treatment for:
- Abnormal bleeding. Some people experience extremely heavy flow during periods or bleeding between their monthly periods, which is defined as abnormal uterine bleeding.
- Adenomyosis. There are many reasons why people experience persistent pain or discomfort around the pelvis, including adenomyosis. This is a condition in which tissue that lines the uterus grows into the uterus itself, causing the walls to thicken and resulting in significant pain and heavy bleeding.
- Endometriosis. Like adenomyosis, endometriosis is an abnormal growth of tissue that lines the uterus. In this case, the tissue grows outward onto the ovaries, which also causes significant pain and bleeding.
- Gynecologic cancer. This can include cancer or precancerous growth inside the uterus or on the walls lining the uterus (endometrium), as well as in or on the ovaries or cervix.
- Uterine prolapse. Sometimes the uterus slips out of its normal place and falls down into the vagina. This is common after pregnancy. There are many conservative, nonsurgical treatments that can address uterine prolapse, although hysterectomy may be recommended in severe cases.
Types of Hysterectomies
There are different types of hysterectomy based on how much is being removed.
- Partial hysterectomy is the removal of just the upper part of the uterus, and the cervix remains in place.
- Total hysterectomy involves removing the entire uterus and the cervix, and in some cases the ovaries and fallopian tubes will also be removed.
- Radical hysterectomy is a total hysterectomy with the additional removal of the tissue on both sides of the cervix and the upper part of the vagina.
Vaginal & Abdominal Hysterectomy
Hysterectomy also varies depending on the approach that is taken to access the surgical area or perform the surgery. Surgical approaches may be vaginal (through the vaginal opening) or abdominal (through small incisions in the lower belly).
Vaginal hysterectomy is considered less invasive because it doesn’t require any incisions. Patients typically recover more quickly. However, not all people are eligible for vaginal hysterectomy, including women who have a very large uterus or adhesions from previous surgery.
Both abdominal and vaginal hysterectomy can be performed laparoscopically. This involves using a laparoscope, which is a surgical instrument that helps give surgeons a more direct view of the surgical area.
Robotic-Assisted Laparoscopic Hysterectomy
Surgeons can also perform hysterectomies robotically through the abdomen. During a robotic-assisted laparoscopic hysterectomy, the surgeon controls the surgical instruments using a computer. This is considered less invasive than traditional abdominal hysterectomy, because it requires smaller incisions and can allow the surgeon to be more precise.
Why Temple Health?
Temple OB/GYN & Reproductive Endocrinology is the region’s leader in treating gynecologic diseases and disorders. We offer the latest advances in surgical treatments, including minimally invasive and robotic-assisted hysterectomy. Our team of gynecologists, gynecologic oncologists and gynecologic surgeons provides comprehensive care for uterine issues such as prolapse, fibroids and cancer.
Our multidisciplinary team works collaboratively to specifically manage gynecologic problems and provide the right treatment plan for each patient, whether it involves conservative measures such as lifestyle changes or aggressive treatments such as radical hysterectomy.
Because we understand the complex problems associated with uterine issues, we help women receive the most appropriate treatment for their needs, following the latest evidence-based surgical techniques and approaches to care.