A hysterectomy is a major surgery that involves removing at least the uterus, but sometimes more. It may be an open surgery, where the doctor makes a large incision in the abdomen, or done vaginally, which leaves no visible scarring. Other minimally invasive alternatives involve the use of a laparoscope, a small tube with a camera on the end, which is inserted through a very small incision on the abdomen, allowing the doctor to see what’s going on inside, but with less severe risks. All of these decisions are dependent upon the reason for the hysterectomy, which are many.
Tumors
Uterine fibroids are tumors that develop on the uterus. They are thankfully noncancerous but can still cause problems. It is not uncommon to have fibroids, and many time they require no treatment because they cause no trouble. However, they can cause bleeding, anemia, abdominal pain, painful sex, and pressure on the bladder. Fibroids are one of the most common reasons for hysterectomies.
Endometriosis
Endometriosis is the second most common reason for a hysterectomy. The endometrium, or uterine lining, sometimes begins to grow outside of it and onto the surrounding organs. This results in infertility and scarring, along with painful periods and and abnormal bleeding. Other alternatives may be attempted, but when these don’t work, a hysterectomy is necessary, along with a salpingo-oophorectomy, a procedure in which one or both of the fallopian tubes and ovaries are removed.
Uterine Prolapse
Prolapse essentially means to fall. When the ligaments and tissue that keep the uterus up where it’s supposed to be get strained, worn, or otherwise affected (menopause, pregnancy, and even obesity are common causes), they may lose their ability to keep the uterus in place. The uterus then prolapses, and it begins to press on other organs—specifically the bladder, which can cause incontinence. However, it may also cause constipation and abdominal pressure or pain. While there are alternatives to dealing with uterine prolapse (such as vaginal mesh implants), these may not be successful or may (in the case of mesh implants) cause more harm than help. A hysterectomy provides very thorough relief from these symptoms. However, since it means becoming pregnant is no longer an option, younger women may opt for something else first.
Cancer
Many forms of gynecological cancer may require a hysterectomy. The endometrium (lining of the uterus), cervix, or ovaries can all develop cancer. While chemotherapy or radiation are somtimes a viable alternative, the operation is often the surest way to keep the cancer from spreading to surrounding organs.
Pain and Bleeding
Sometimes chronic pelvic pain may occur that nothing else can solve. Additionally, some women experience periods that are constant or heavy and cannot be controlled through other methods. When the risks start to get too high, or the pain becomes too much to bear, a hysterectomy may be the best option for relieving these symptoms. In all cases, but especially that of chronic pelvic pain, a hysterectomy may not always be the best option, which means it is important to explore all of your options before deciding on such an irreversible choice.
