A hysterectomy is the surgical removal of the uterus. This may be necessary for a number of reasons, as it is the only total treatment for some conditions. It can be confusing and scary for a woman faced with such an enormous decision, when really there isn’t much choice at all. The most important thing is to be informed. Here are five important terms related to this procedure that you should know.
Cervix
To understand how a hysterectomy works, it is necessary to understand the gynocological anatomy of a woman. First, there’s the vagina and vaginal canal. At the top (or end, depending on how you want to look at it) of this resides the cervix. The cervix is a tissue-covered circle of cartilage that looks like an overinflated life saver. The side that faces the vagina is called the ectocervix, and in its center is the external os, which opens to allow things to pass into the uterus from the vagina.
The cervix is better known for what it does during sex. Some women become fearful that sexual pleasure will decrease, because the cervix is often removed along with the uterus. However, there is no scientific evidence for this, and most patients report that there is at the least no change, and sometimes even improvement. This makes sense, since the irritation of the uterus can affect the cervix, especially in conditions such as endometriosis.
Endometrium
The endometrium is the lining of the uterus. Another common reason for hysterectomies is endometriosis, a condition in which this tissue begins to grow outside the uterus and on additional, nearby organs. It may cause pain and bleeding and sometimes leads to infertility; this is another of the most common reasons for a hysterectomy. While there are medications that may treat endometriosis symptomatically, and surgeries specifically to try to remove the extra tissue, a hysterectomy is usually the most thorough option to completely stop the growth of extra tissue.
MIP
This stands for “minimally invasive procedure.” Hysterectomies are often open surgeries, meaning doctors make a five to seven inch long incision in the abdomen, from which to remove the uterus. However, MIPs can be a much safer, much less invasive alternative. A small incision can be made in the vagina, and the uterus removed that way, or an MIP can be performed using a laparoscope.
A laparoscope is a length of small tube with a camera on the tip. A much smaller incision is made, the laparoscope is inserted, and then the necessary tools are used (sometimes also through small incisions, sometimes with robotic assistance). This allows for faster healing, less scarring, and a decreased chance of infection.
Salpingo-Oophorectomy
In some instances, depending on what is being treated, it is necessary for more than just the uterus to come out during a hysterectomy. It is fairly common for at least the cervix, if not the pelvic lymph nodes as well, to be removed. However, when it is necessary for the ovaries and fallopian tubes to come out as well, this is known specifically as a salpingo-oophorectomy.
Fibroid
This is one of the more common reasons for a hysterectomy. Although there are other treatment alternatives, a hysterectomy is the only way to be sure that the fibroids (which are small, benign tumors) are completely removed, down to the root. Sometimes these tumors may not cause any problems at all, but often they result in bleeding, anemia, pain, and pressure in the abdomen.
