Why Would I Need a Hysterectomy?
Hysterectomy is the second-most-common surgery for women — behind only C-sections. Each year, 600,000 women undergo this procedure, which removes the uterus and cervix.
Past and current health conditions that may lead to a hysterectomy
- Uterine fibroids – Benign tumors located in the uterus, fibroids affect approximately 30 to 40 percent of women during their lifetime. If medication or other treatments fail, the woman may choose a hysterectomy.
- Abnormal, irregular, heavy or painful periods
- Pelvic pain
- Pain during intercourse
“We typically see women in their 40s and 50s having hysterectomies as that is when bleeding abnormalities usually appear,” said Molly Uhing, MD, Avera OB/GYN, “but we see women as young as their 30s all the way to their 70s needing this procedure due to health concerns.” Hysterectomy is only considered a last-resort measure if a woman is of child-bearing age and still wants to have children.
The health issues that typically lead to hysterectomies rest in your DNA, and while there’s no surefire way to prevent the awakening of your genetics, you can take steps to improve your odds. Maintaining a healthy weight may help control bleeding as well as prevent cancers. If you do experience heavy periods, using hormone therapies or other minimally invasive office procedures early on can lessen the likelihood of a future hysterectomy.
“While hysterectomy is still the second most common surgery for women, the need for them among women is actually decreasing because we are finding and addressing those health issues before we get to that point,” explained Uhing.
There are three ways the procedure is typically carried out. In the vast majority of cases, hysterectomy is a minimally invasive procedure:
- Trans-vaginal: The uterus and cervix are removed through the vagina. Cost effective and minimally invasive with less than 1 percent complication rate, this is the gold standard of hysterectomies.
- Laparoscopic: In this procedure, the surgeon uses either laparoscopic instruments or robotic arms to remove the uterus and cervix through small incisions made in the abdomen. Sometimes the incision is made through the belly button, resulting in virtually no scar afterwards. A 1 percent complication rate and shorter recovery make this another ideal option for patients.
- Open surgery: Much like a C-section, an open surgical hysterectomy involves an incision along the lower abdomen. This option is extremely rare as it requires a longer recovery and poses a 20 percent complication rate.
“If you need a hysterectomy, know your options,” said Uhing. “Ask if you’re a candidate for robotic surgery or another minimally invasive procedure that carries low risk.”
Unfortunately, Uhing has found that many women try avoiding the hysterectomy they so desperately need in fear of losing their sex drive or hormones and starting menopause early.
This isn’t true. “Female hormones are primarily produced from the ovaries, which are rarely removed at the same time as a hysterectomy,” explained Uhing. A hysterectomy in addition to a bilateral salpingo oophorectomy removes the uterus, cervix, ovaries and fallopian tubes. “Because the hormones that come from the ovaries are so important to a woman’s long-term health, the only time we consider removing them is if there’s a specific problem with the ovaries or if there’s a personal or family history of cancer.”
Unless you have a more invasive surgery, hysterectomy can be an outpatient procedure. In most cases, you’ll go home the same day. For the more common trans-vaginal and laparoscopic procedures, you’ll take pain medications for three to five days, be back to work within two weeks and follow a lifting restriction of no more than 10 pounds for about six weeks.
Hysterectomies often resolve heavy bleeding and pelvic pain. While it can be hard to grasp that you’re losing a major organ, advanced options lessen pain and recovery time, and in most cases help you feel better than before.