Gynecology - Hysterectomy


If your doctor suggests hysterectomy as an option in management of your problem, first “Be Not Afraid”.

There are many preconceived ideas, myths, old wives tales and fears regarding hysterectomy.  Please remember the truth lies somewhere between fact and fiction.  Please voice your concerns to your physician as communication is of primary importance in making an informed decision.  The website HysterSisters offers support and answers many hysterectomy questions.

A Hysterectomy can mean many things.  It can be performed through an abdominal incision, it can be performed via a vaginal approach or it can be performed laparoscopically or with the assistance of a robot (da Vinci).  It can include removal of one or both ovaries or may not include removal of ovaries at all.  Only a portion of the uterus may be removed as in supra-cervical hysterectomy or the entire uterus may be removed which we refer to as a total hysterectomy.  A total hysterectomy does not imply removal of the ovaries but the total removal of the uterus.

If you have a hysterectomy that implies removal of the uterus only, you will continue to have a menstrual cycle, but no menstrual bleeding. If you have retained one or both ovaries, they continue their normal cyclic production of hormones. (Menstrual bleeding comes from the uterine response to those ovarian hormones).   You will be able to conceive a child if you retain ovarian function through insemination procedures, but will have to find a surrogate to carry that pregnancy for you.  If both ovaries are removed, you will no longer have a menstrual cycle, you will no longer have eggs available for potential pregnancy and menopause begins immediately. Menopause does not begin however, if you take an estrogen replacement as your body is unable to tell the difference between an estrogen molecule produced from the ovary and that absorbed into your system from estrogen replacement.  Additional procedures may also be performed at the time of your hysterectomy. Frequently, bladder procedures for incontinence and suspension procedures for prolapse are required at the time of hysterectomy.

From the above discussion you may see that choosing a hysterectomy can be quite complicated.  Again, it is of utmost importance to communicate with your physician in order to voice your concerns, have appropriate expectations and full knowledge in your decision making. for more information. 


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