Hysterectomy Surgery for Gynecologic Conditions

Many women experience pelvic pain and abnormal bleeding because of fibroids, ovarian cysts, endometriosis and other conditions. There are many ways to treat these gynecological problems, including hysterectomy.

Hysterectomy is one of the most frequently performed major surgeries among reproductive-age women.

The hysterectomy surgery removes the uterus and cervix. The surgeon may also remove one or both ovaries and fallopian tubes. In some cases, other parts of the reproductive system may be removed. If you have not yet reached menopause, a hysterectomy means you will no longer have a period or be able to get pregnant.

If your gynecologist recommends a hysterectomy, it’s important that you learn about the range of surgical options. Your doctor will talk with you about the best method for your hysterectomy based on your personal needs and goals.

• Laparoscopic hysterectomy: A laparoscope – which is a thin, flexible tube with a video camera on it – is inserted through tiny incisions near the belly button, then the uterus is removed in sections through the laparoscope tube or vagina.
• Da Vinci Robotic-Assisted Hysterectomy: A robotic hysterectomy at UH, using the da Vinci surgical system, involves a few small incisions through which all of the surgical instruments are inserted. This technology gives surgeons a 3-D, high definition view of the surgical field and greater surgical precision and range of motion. Da Vinci robotic hysterectomy surgery offers many benefits to patients compared to traditional hysterectomy, such as faster recovery and return to daily activities, less scarring, less pain and lower risk of complications.
• Vaginal hysterectomy: With this approach, the gynecologic surgeon removes the uterus through the vaginal opening. This technique is most often used for uterine prolapse, or when vaginal repairs are needed. No incision is needed. This means there is no visible scarring, and many women can go home the same day or the next morning.

Hysterectomy Types

The uterus is always removed during a hysterectomy. In some cases, though, surgeons may also need to remove one or both ovaries, the fallopian tubes or other parts of the reproductive system.

Your gynecologist will discuss the best type of hysterectomy for you. Some of the types of hysterectomy include:

• Hysterectomy with salpingo-oophorectomy: Removal of one or both ovaries and the fallopian tubes along with the uterus.
• Radical hysterectomy: Removal of the uterus, cervix and the top part of the vagina. The pelvic lymph nodes may also be removed for women with cancer.
• Supracervical hysterectomy: Also called subtotal or partial hysterectomy, the surgeon removes the body of the uterus while leaving the cervix whole.
• Total hysterectomy: This is the most common type of hysterectomy. The gynecologic surgeon removes the whole uterus including the cervix, but not the fallopian tubes or ovaries.

Conditions that May Require Hysterectomy

There are many different reasons for hysterectomy women may consider, including:

• Abnormal uterine bleeding: Also called menorrhagia, this is often due to endometrial hyperplasia – which is an over-thickening of the uterine lining that may cause abnormal bleeding.
• Blockage: The uterus or a growth blocks the bladder or intestines so it needs to be removed to improve function of other organs.
• Gynecologic cancers: A hysterectomy procedure may be performed to remove cancerous tissue with cervical, ovarian or endometrial cancer.
• Chronic pelvic conditions: Including pelvic pain or pelvic inflammatory disease, a hysterectomy may eliminate these conditions.
• Endometriosis: With this condition, cells from the lining of the uterus, or endometrium, grow outside of the uterus or on other organs in the pelvic cavity. This causes chronic pelvic pain, pain during sex, and prolonged or heavy bleeding and treatment may include a hysterectomy.
• Fibroid tumors: A hysterectomy may be necessary to remove these noncancerous tumors.
• Uterine prolapse: When the uterus drops, or prolapses, down into the vagina, a hysterectomy may be necessary.