Medical term:

Hysterectomy

Definition

Hysterectomy is the surgical removal of the uterus. In a total hysterectomy, the uterus and cervix are removed. In some cases, the fallopian tubes and ovaries are removed along with the uterus (called hysterectomy with bilateral salpingo-oophorectomy). In a subtotal hysterectomy, only the uterus is removed. In a radical hysterectomy, the uterus, cervix, ovaries, oviducts, lymph nodes, and lymph channels are removed. The type of hysterectomy performed depends on the reason for the procedure. In all cases, menstruation stops and a woman loses the ability to bear children.

Purpose

Hysterectomy is the second most common operation performed in the United States. About 556,000 of these surgeries are done annually. By age 60, approximately one out of every three American women will have had a hysterectomy. Yet it's estimated that 30 percent of hysterectomies are unnecessary.

About 10% of hysterectomies are performed to treat cancer of the cervix, ovaries, or uterus. Women with cancer in one or more of these organs almost always have the organ(s) removed as one part of their cancer treatment.

The most frequent reason for hysterectomy in the United States is to remove fibroid tumors, accounting for 30% of these surgeries. Fibroid tumors are noncancerous (benign) growths in the uterus, which can cause pelvic and low back pain and heavy or lengthy menstrual periods. They occur in 30-40% of women over age 40, and are three times more likely to be present in African-American women than in Caucasian women. Fibroids do not need to be removed unless they are causing symptoms that interfere with a woman's normal activities.

Treatment of endometriosis is the reason for 20% of hysterectomies. The endometrium is the lining of the uterus. Endometriosis is a condition that occurs when the cells from the endometrium begin growing outside the uterus. The outlying endometrial cells respond to the hormones that control the menstrual cycle, bleeding each month the way the lining of the uterus does. This causes irritation of the surrounding tissue, leading to pain and scarring.

Another 20% percent of hysterectomies are done because of heavy or abnormal vaginal bleeding that can not be linked to any specific cause and cannot be controlled by other means. The remaining 20% of hysterectomies are performed to treat prolapsed uterus, pelvic inflammatory disease, and endometrial hyperplasia, a potentially precancerous condition.

Alternatives

There are several alternatives to hysterectomy today. They include:

Embolization

Uterine artery embolization is not a surgical procedure. Instead, interventional radiologists put a catherter into the artery that leads to the uterus and inject polyvinyl alcohol particles right where the artery leads to the blood vessels that nourish the fibroids. By killing off those blood vessels, the fibroids have no more blood supply, and they die off. Severe cramping and pain after the procedure is common, but serious complications are less than 5 percent and it may protect fertility.

Myomectomy

A myomectomy is a surgery used to remove fibroids, thus avoiding a hysterectomy. Hysteroscopic myomectomy, in which a surgical "telescope," or laparascope, is inserted into the uterus through the vagina can be done on an outpatient basis. If there are large fibroids, however, an abdominal incision is required. Then women typically are hospitalized for two to three days, and require up to six weeks recovery. However, laparascopic myomectomies are also being done more often. They only require three small incisions in the abdomen, and have a much shorter hospitalization and recovery time.

Once the fibroids have been removed, the surgeon must repair the wall of the uterus to eliminate future bleeding or infection.

Endometrial ablation

In this surgical procedure, recommended for women with small fibroids, the entire lining of the uterus is removed. Women are no longer fertile, however. The uterine cavity is filled with fluid and a hysteroscopy, or telescope, inserted to provide a clear view of the uterus. Then the uterus is destroyed using a laser beam or electric voltage. The procedure is typically done under anesthesia, although women can go home the same day as the surgery. Another, newer procedure involves using a balloon, which is filled with superheated liquid and inflated until it fills the uterus. The liquid kills the lining, and after 8 minutes the balloon is removed.

Endometrial resection

Like endometrial ablation, the uterine lining is also destroyed during this procedure, only instead of a laser, an electrosurgical wire loop is used.

Total hysterectomy

A total hysterectomy, sometimes called a simple hysterectomy, removes the entire uterus and the cervix. The ovaries are not removed and continue to secrete hormones. Total hysterectomies are always performed in the case of uterine and cervical cancer. This is the most common kind of hysterectomy.

Sometimes, in addition to a total hysterectomy a procedure called a bilateral salpingo-oophorectomy is performed. This surgery removes the ovaries and the fallopian tubes. Removal of the ovaries eliminates the main source of the hormone estrogen, so menopause occurs immediately. Removal of the ovaries and fallopian tubes is performed in about one-third of hysterectomy operations, often to reduce the risk of ovarian cancer.

Subtotal hysterectomy

If the reason for the hysterectomy is to remove uterine fibroids, treat abnormal bleeding, or relieve pelvic pain, it may be possible to remove only the uterus and leave the cervix. This procedure, called a subtotal hysterectomy (or partial hysterectomy), removes the least amount of tissue. The opening to the cervix is left in place. Some women feel that leaving the cervix intact aids in their achieving sexual satisfaction. This procedure, which used to be rare, is now performed more frequently when requested.

Subtotal hysterectomy is easier to perform than a total hysterectomy, but leaves a woman at risk for cervical cancer. She will still need to get yearly pap smears.

Radical hysterectomy

Radical hysterectomies are performed on women with cervical cancer or endometrial cancer that has spread to the cervix. A radical hysterectomy removes the uterus, cervix, top part of the vagina, ovaries, fallopian tubes, lymph nodes, lymph channels, and tissue in the pelvic cavity that surrounds the cervix. This type of hysterectomy removes the most tissue and requires the longest hospital stay and longer recovery period.

Precautions

The frequency with which hysterectomies are performed in the United States has been questioned in recent years. It has been suggested that a large number of hysterectomies are performed unnecessarily. The United States has the highest rate of hysterectomies (number of hysterectomies per thousand women) of any country in the world. Also, the frequency of this surgery varies across different regions of the United States. Rates are highest in the South and Midwest, and are higher for African American women. In recent years, although the number of hysterectomies

Three types of hysterectomies: subtotal, total, and total with salpingo-oophorectomy.

(Illustration by Electronic Illustrators Group.)

performed has declined, the number of hysterectomies performed on younger women in their 30s and 40s is increasing, and 55 percent of all hysterectomies are performed on women 35 to 49.

Women for whom a hysterectomy is recommended should discuss possible alternatives with their doctor and consider getting a second opinion, since this is major surgery with life-changing implications. Alternative treatments exist for many conditions. Whether these alternatives are appropriate for any individual woman is a decision she and her doctor should make together.

As in all major surgery, the health of the patient affects the risk of the operation. Women who have chronic heart or lung diseases, diabetes, or irondeficiency anemia may not be good candidates for this operation. Heavy smoking, obesity, use of steroid drugs, and use of illicit drugs add to the surgical risk.

Description

There are two ways that hysterectomies can be performed. The choice of method depends on the type of hysterectomy, the doctor's experience, and the reason for the hysterectomy.

Abdominal hysterectomy

About 75% of hysterectomies performed in the United States are abdominal hysterectomies. The surgeon makes a four to six inch incision either horizontally across the pubic hair line from hip bone to hip bone or vertically from navel to pubic bone. Horizontal incisions leave a less noticeable scar, but vertical incisions give the surgeon a better view of the abdominal cavity. The blood vessels, fallopian tubes, and ligaments are cut away from the uterus, which is lifted out.

Abdominal hysterectomies take from one to three hours. The hospital stay is three to five days, and it takes four to eight weeks to return to normal activities.

The advantages of an abdominal hysterectomy are that the uterus can be removed even if a woman has internal scarring (adhesions) from previous surgery or her fibroids are large. The surgeon has a good view of the abdominal cavity and more room to work. Also, surgeons have the most experience with this type of hysterectomy. The abdominal incision is more painful than with vaginal hysterectomy and the recovery period is longer.

Vaginal hysterectomy

With a vaginal hysterectomy, the surgeon makes an incision near the top of the vagina. The surgeon then reaches through this incision to cut and tie off the ligaments, blood vessels, and fallopian tubes. Once the uterus is cut free, it is removed through the vagina. The operation takes one to two hours. The hospital stay is usually one to three days, and return to normal activities takes about four weeks.

The advantages of this procedure are that it leaves no visible scar and is less painful. The disadvantage is that it is more difficult for the surgeon to see the uterus and surrounding tissue. This makes complications more common. Large fibroids cannot be removed using this technique. It is very difficult to remove the ovaries during a vaginal hysterectomy, so this approach may not be possible if the ovaries are involved.

Vaginal hysterectomy can also be performed using a laparoscopic technique. With this surgery, a tube containing a tiny camera is inserted through an incision in the navel. This allows the surgeon to see the uterus on a video monitor. The surgeon then inserts two slender instruments through small incisions in the abdomen and uses them to cut and tie off the blood vessels, fallopian tubes, and ligaments. When the uterus is detached, it is removed though a small incision at the top of the vagina.

This technique, called laparoscopic-assisted vaginal hysterectomy, allows surgeons to perform a vaginal hysterectomy that might be too difficult otherwise. The hospital stay is usually only one day. Recovery time is about two weeks. The disadvantage is that this operation is relatively new and requires great skill by the surgeon.

Any vaginal hysterectomy may have to be converted to an abdominal hysterectomy during surgery if complications develop.

Preparation

Before surgery the doctor will order blood and urine tests. The woman may also meet with the anesthesiologist to evaluate any special conditions that might affect the administration of anesthesia. On the evening before the operation, the woman should eat a light dinner and then avoid eating or drinking anything.

Aftercare

After surgery a woman will feel pain. The degree of discomfort varies, and is generally greatest in abdominal hysterectomies because of the incision. Hospital stays vary from about two days (laparoscopic-assisted vaginal hysterectomy) to five or six days (abdominal hysterectomy with bilateral salpingo-oophorectomy). During the hospital stay, the doctor will probably order more blood tests.

Return to normal activities such as driving and working takes anywhere from two to eight weeks, again depending on the type of surgery. Some women have emotional changes following a hysterectomy. Women who have had their ovaries removed will probably start taking hormone replacement therapy.

Risks

Hysterectomy is a relatively safe operation, although like all major surgery it carries risks. These include unanticipated reaction to anesthesia, internal bleeding, blood clots, damage to other organs such as the bladder, and post-surgery infection. The risk of death is about one in every 1,000 (1/1,000) women having the operation.

Other complications sometimes reported after a hysterectomy include changes in sex drive, weight gain, constipation, and pelvic pain. Hot flashes and other symptoms of menopause can occur if the ovaries are removed. Women who have both ovaries removed and who do not take estrogen replacement therapy run an increased risk for heart disease and osteoporosis (a condition that causes bones to be brittle). Women with a history of psychological and emotional problems before the hysterectomy are more likely to experience psychological difficulties after the operation.

Normal results

Although there is some concern that hysterectomies may be performed unnecessarily, there are many conditions for which the operation improves a woman's quality of life. In the Maine Woman's Health Study, 71% of women who had hysterectomies to correct moderate or severe painful symptoms reported feeling better mentally, physically, and sexually after the operation.

Key terms

Cervix — The lower part of the uterus extending into the vagina.

Fallopian tubes — Slender tubes that carry eggs (ova) from the ovaries to the uterus.

Lymph nodes — Small, compact structures lying along the channels that carry lymph, a yellowish fluid. Lymph nodes produce white blood cells (lymphocytes), which are important in forming antibodies that fight disease.

Prolapsed uterus — A uterus that has slipped out of place, sometimes protruding down through the vagina.

Resources

Organizations

American Cancer Society. (800) 227-2345. http://www.cancer.org.

National Cancer Institute. (800) 4-CANCER. http://www.nci.nih.gov.

Other

Parker, William H. "A Gynecologist's Second Opinion." http://www.gynsecondopinion.com.

hysterectomy

[his″tĕ-rek´to-me]

surgical removal of the uterus. Within the past decade this has become a common major surgery in the United States. Controversy continues over whether many hysterectomies are really necessary. In making the decision for hysterectomy, patients often seek a second medical opinion and are encouraged to discuss options with health care givers and family members. Clinical indications for hysterectomy include pelvic relaxation; pain associated with congestion, endometriosis, or chronic pelvic inflammatory disease; fibroid tumors; recurrent ovarian cysts; excessive and debilitating bleeding; and cervical, ovarian, and uterine malignancies, premalignancy, and other high-risk conditions.

Potential Complications. Whether the surgery is vaginal or abdominal will affect the location of the surgical site and incidence of complications. In general, abdominal incisions are made horizontally and low in the abdomen just above the symphysis. The vaginal route usually is chosen when a patient is obese, when abdominal scarring from previous surgery is present, and for removal of a prolapsed uterus or one in which stage 0 cancer is localized in the cervix.

Incisions made above and around the cervix in vaginal hysterectomy heal more rapidly than do abdominal incisions, and intestinal complications such as ileus are less likely. However, vaginal hysterectomy patients have a higher incidence of postoperative bleeding and infections, especially of the urinary tract.

Patient Care. Two major areas of concern in the care of patients having a hysterectomy are psychosocial implications and physical care during the perioperative period.

Psychosocial Implications. The psychosocial impact of removal of the uterus is a major concern of professional caregivers. Patients may be misinformed about basic anatomical and physiological features of the female reproductive tract and the functions of the uterus, fallopian tubes, and ovaries, or they may not know the effects of the contemplated surgery and are anxious about how it might influence their roles as women.

There should be sufficient time to determine what the patient knows, to answer her questions, and to dispel any misinformation she might have. Preoperative teaching does not necessarily mean that it is done the night before surgery. In fact, at that time the patient may be preoccupied with anxieties about major surgery and fears about pain and perhaps death. In that state of mind she would probably be unable to assimilate most factual information presented to her. At this point relieving the patient's anxiety is a top priority.

A patient's ability to adjust to the loss of a reproductive organ will be influenced by her sense of self as a woman, her age and previous socialization in regard to the roles of women, and the attitudes and expectations of her spouse, family and friends. Negative or positive attitudes can arise from her beliefs about how the surgery will affect her sexual expression and function and her vocational and avocational involvement and enjoyment of life. If the woman has experienced long-term pain and discomfort or has no desire to have more children, she may be favorably disposed toward the surgery. However, she may feel a profound sense of loss and purpose in her life. Negative attitudes toward the hysterectomy can have serious and adverse psychologic effects months or even years after the surgery.

Physical Care After Surgery. Measures such as coughing, turning, deep breathing, and early ambulation to avoid circulatory and respiratory stasis are appropriate whether the hysterectomy is abdominal or vaginal.

Bleeding is a potential danger because of the abundant vascularity of the female pelvis. Dressings and perineal pads are checked regularly every two to four hours, or more often as indicated. The patient who has had vaginal surgery usually has a vaginal packing with a drain attached to the distal end. Some vaginal bleeding and oozing of serosanguineous fluid can be expected, but if there is frank bleeding of more than a light menstrual flow, or if the patient is passing clots around the pack, there is cause for concern. Heavy bleeding, a rapidly distended abdomen, referred shoulder pain, and change in vital signs are signs of an emergency that requires a return to the operating room to find and stop the source of blood loss.

Patients with an abdominal incision are monitored and dressings checked for excessive bleeding. If there is evidence of increasingly larger deposits of blood on the dressing, reinforcement of the dressing and notification of the surgeon are indicated.

The urinary output and characteristics of the urine are observed for signs of urinary tract infection. If the patient has an indwelling catheter, special catheter care is necessary. A poorly draining catheter or one that is totally blocked can lead to bladder distention and abdominal pressure. To avoid additional pressure on the abdomen and sutures, the patient is positioned on her side or back with her knees slightly flexed. High Fowler's position is contraindicated and there should be no pillows or break in the bed to produce pressure behind the knees.

Prior to discharge from the hospital the patient is given instructions in self-care; these should be written so that the patient can refer to them at home if necessary. They should include information about surgical menopause and estrogen therapy if the ovaries were removed; restrictions on douching and sexual intercourse; prevention of constipation; care of the incision; and reportable symptoms such as redness, swelling, pain, or drainage at the operative site and elevation of body temperature. Abdominal cramps and changes in bowel habits also should be reported to the professional caregiver.

The patient should also have opportunities to discuss personal contacts regarding sexual activity and her new body image. Although this may have been discussed during the preoperative period, she may be more receptive after the surgery is over and she is on the way to recovery. Some hospitals and clinics have support groups for women contemplating or recovering from hysterectomy. These can be a great support to patients and provide them with additional information and a forum for expressing and dealing with their emotional reactions to hysterectomy.

abdominal hysterectomy that performed through the abdominal wall. Called also abdominohysterectomy and laparohysterectomy.

cesarean hysterectomy cesarean section followed by removal of the uterus.

radical hysterectomy hysterectomy with excision of the pelvic lymph nodes and wide lateral excision of parametrial and paravaginal supporting structures.

subtotal hysterectomy that in which the cervix is left in place.

total hysterectomy that in which the uterus and cervix are completely excised.

vaginal hysterectomy that performed through the vagina.

hys·ter·ec·to·my

(his'ter-ek'tŏ-mē),

Removal of the uterus; unless otherwise specified, usually denotes complete removal of the uterus (corpus and cervix).

[hystero- + G. ektomē, excision]

Farlex Partner Medical Dictionary © Farlex 2012

hysterectomy

(hĭs′tə-rĕk′tə-mē)

n. pl. hysterecto·mies

Surgical removal of part or all of the uterus.

hys′ter·ec′to·mize′ (-mīz′) v.

hysterectomy

Gynecology The 2^nd most common–after C sections–operation performed in the US ± 590,000/yr, ±4/1000 ♀/yr; annual cost ± $5 x 109; in developed nations, there is a 6-fold range in frequency of hysterectomy–highest in US, lowest in Sweden, Norway, UK Indications Uterine leiomyomas–30%, dysfunctional uterine bleeding–20%, endometriosis and adenomyosis–20%, genital prolapse–15%, chronic pelvic pain–10%, PID, endometrial hyperplasia, and other malignancy–eg, CIN, endometrial CA, and other indications–eg, massive postpartum hemorrhage, septic endometritis, hormone therapy where estrogen receptors are positive Procedures Total abdominal, total vaginal, laparoscopic vaginal Complications Fever, infection, intra- and post-operative hemorrhage, urinary Sx, early ovary failure, retained ovary syndrome, constipation, fatigue, ↓ sexual interest and function, depression, psychiatric morbidity Mortality 7-20 deaths/105 hysterectomies for cancer, 3-4 deaths/105 for pregnancy-related indications, 0.6-1.1 deaths/105 hysterectomies for other indications Sexology ↑ Frequency, orgasms, sexual desire, ↓ dyspareunia posthysterectomy. See Abdominal hysterectomy, Complete hysterectomy, TAH-BSO, Total abdominal hysterectomy, Vaginal hysterectomy. Cf Laparoscopic vaginal hysterectomy.

hys·ter·ec·to·my

(his'tĕr-ek'tŏ-mē)

Removal of the uterus; unless otherwise specified, usually denotes complete removal of the uterus (corpus and cervix).

[hystero- + G. ektomē, excision]

Medical Dictionary for the Health Professions and Nursing © Farlex 2012

hysterectomy

(his?te-rek'to-me) [ hystero- + -ectomy]

HYSTERECTOMY

HYSTERECTOMY

HYSTERECTOMY

Surgical removal of the uterus. Each year, about 500,000 women undergo hysterectomies. Indications for the surgery include benign or malignant changes in the uterine wall or cavity and cervical abnormalities (including endometrial cancer, cervical cancer, severe dysfunctional bleeding, large or bleeding fibroid tumors (leiomyomas), prolapse of the uterus, intractable postpartum hemorrhage due to placenta accreta or uterine rupture, or severe endometriosis). The approach to excision may be either abdominal or vaginal. The abdominal approach is used most commonly to remove large tumors; when the ovaries and fallopian tubes also will be removed; and when there is need to examine adjacent pelvic structures, such as the regional lymph nodes. Vaginal hysterectomy is appropriate when uterine size is less than that in 12 week gestation; no other abdominal pathology is suspected; and when surgical plans include cystocele, enterocele, or rectocele repair. illustration;

In preparation for abdominal hysterectomy, the patient is placed in the dorsal position. The table is ready to be tipped into the Trendelenburg position. As soon as the incision is made through the peritoneum, the table should be put into the Trendelenburg position. This procedure is the same for all abdominopelvic surgery, as the Trendelenburg position allows the abdominal organs to fall away from the pelvis so that they may be easily packed off and isolated from the surgical field with large pads or a large roll of packing.

Patient care

Preoperative: In general, preparations for an abdominal hysterectomy are similar to protocols for any abdominopelvic surgery (e.g., abdominal skin preparation, insertion of an intravenous line and, depending on surgical protocol, an indwelling urinary catheter). Vaginal irrigation with antibacterial solution also may be ordered. All procedures are explained to the patient, who is provided with anticipatory guidance for the postoperative period. Misconceptions are clarified, informed consent is validated, and the signing of the operative permit is witnessed. The patient may be encouraged to discuss the personal meaning and implications of the procedure, such as permanent inability to bear children; emotional support is given. The gynecologist and nurses should make available opportunities for the patient to ask questions and receive information about sexual concerns and be provided with resources (or a way to access resources), or specialist referrals for further information as desired. Controlled trials that have studied large numbers of women have not shown, in aggregate, any adverse effect of hysterectomy on sexuality (good sexual function is retained or regained; however the nature and quality of sexual response may change) or women's perceptions of their femininity.

Postoperative: Initial status assessments include color; vital signs; airway patency and breath sounds; level of consciousness and discomfort; intravenous intake; and nasogastric and indwelling catheter drainage. During the first few hours, assessments usually are made over lengthening intervals, from every 10 to 15 minutes during the first hour to every 30 minutes to hourly. Intervals and assessment priorities may be altered on the basis of current findings, such as bleeding. Color; vital signs; airway patency and lung sounds; level of consciousness and discomfort; intake and output (including intravenous fluids, nasogastric and indwelling catheter drainage); and abdominal dressings (intact, amount and character of any drainage) are monitored. Additional later assessments include bowel sounds; lower extremity circulation (pedal pulses, leg pain); and wound status (redness, edema, ecchymosis, discharge, and approximation). The patient is encouraged to splint the incision, turn from side to side, use incentive spirometry, deep breathe and cough every 2 hr, and use incentive spirometry. Prescribed intravenous fluids and analgesics are administered. The woman is assisted in self-administering patient-controlled analgesia. Antithromboembolitic devices (pneumatic dressings or elastic stockings) are applied as needed. The patient is encouraged and assisted with early ambulation. The patient is encouraged to splint the incision, turn from side to side, deep breathe and cough every 2 hr, and use incentive spirometry.

If the patient's ovaries have been removed, the reasons for hormone therapy are explained to her. Effective coping strategies related to anticipated radiation and/or chemotherapy are targeted. Desired outcomes include evidence of incisional healing; absence of complications; return of normal GI and bladder function; and understanding of and compliance with the prescribed treatment regimen.

abdominal hysterectomy

The removal of the uterus through an abdominal incision.

Synonym: abdominohysterectomy

cesarean hysterectomy

The surgical removal of the uterus at the time of cesarean section.

pan hysterectomy

Removal of the uterus, fallopian tubes, and ovaries.

radical hysterectomy

The surgical removal of the uterus, tubes, ovaries, adjacent lymph nodes, and part of the vagina.

subtotal hysterectomy

A procedure in which the cervix is left intact after the uterus has been removed. The cervix, which acts as an anchor, and upper vagina are preserved, resulting in better support of the remaining structures. Most women experience less discomfort and faster recovery with this procedure than with a total hysterectomy. Routine pap screening following this procedure is recommended. Any woman with a history of abnormal pap tests or cervical cancer is not a candidate for subtotal hysterectomy. Synonym: supracervical hysterectomy; supravaginal hysterectomy

supracervical hysterectomy

Subtotal hysterectomy.

supravaginal hysterectomy

Subtotal hysterectomy.

total abdominal hysterectomy

Removal of the uterus, including the cervix, through an abdominal incision.

vaginal hysterectomy

The surgical removal of the uterus through the vagina.

hysterectomy

Surgical removal of the womb (uterus). This may be done through the vagina (vaginal hysterectomy) or through an incision in the abdominal wall (abdominal hysterectomy). The operation is performed to treat extensive FIBROIDS, cancer of the womb, ENDOMETRIOSIS, excessive menstruation (MENORRHAGIA), for purposes of sterilization or out of fear of possible later womb cancer. In some affluent countries hysterectomy is grossly over-performed. In California, for instance, almost half of all women undergo hysterectomy.

Patient discussion about hysterectomy

Q. What Is a Hysterectomy? I am 60 year old. My doctor told me I night need to undergo a hysterectomy because I have large fibroids, that most likely not malignant, however they do cause bleeding. What exactly is a hysterectomy?

A. A hysterectomy is an operation to remove a woman's uterus (womb). In some cases, the ovaries and fallopian tubes also are removed. These organs are located in a woman’s lower abdomen. There are several types of hysterectomies:

*Complete or total. Removes the cervix as well as the uterus. (This is the most common type of hysterectomy.)
*Partial or subtotal. Removes the upper part of the uterus and leaves the cervix in place.
*Radical. Removes the uterus, the cervix, the upper part of the vagina, and supporting tissues. (This is done in some cases of cancer.)
Often one or both ovaries and fallopian tubes are removed at the same time a hysterectomy is done. For the full article: http://www.4woman.gov/faq/hysterectomy.htm
Hope this helps.

Q. If I Have a Hysterectomy, Will I Go Through Menopause? I am 40 years old and my Doctor said I have to have a Hysterectomy. Does this mean I will go through an early menopause?

A. Menopause is different for every woman, whether she’s had a hysterectomy or not.
After a partial hysterectomy, you’re likely to experience a normal perimenopause and menopause, but it is hard to know when it’s starting because there are no periods to identify the initial changes. Menopause is defined by the cessation of periods for one full year for a woman with a uterus. The cessation of periods is just one point in a process that can take many years. That process still occurs in women who have no uterus, but who still have their ovaries, since it is the ovaries that make most of our sex hormones.

Q. uterine fibroids. Whats the best way to deal with them? My doctor says hysterectomy? What about my hormones?

A. Yes, drugs that suppress the levels of the female sex hormones (estrogen) are successful for treating uterine fibroids. However, the relief is only temporary and the fibroids recur once the treatment is stopped. In addition, these treatments cause side effects similar to menopause.

Surgery is the definitive treatment, especially for complications such as bleeding or pain, and when there's a suspicion for malignancy.

You may read more here: http://www.nlm.nih.gov/medlineplus/ency/article/000914.htm

More discussions about hysterectomy

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