A hysterectomy is a procedure for removal of the uterus. This procedure is usually recommended as a last resort for the treatment of a number of conditions. Removal of the uterus does not cause any reduction in the body’s functionality, apart from the part that the woman can no longer carry a pregnancy, but if her ovaries are functioning properly, she has the option of having a baby with her own eggs through a surrogate mother.
However, if the ovaries are also removed when the uterus is being removed (a surgery called oophorectomy), women who are not yet menopausal will automatically become menopausal, due to the absence of female hormones which are produced by the ovaries.
The reasons for having a hysterectomy done are as follows:
- Uterine fibroids – This is the definitive treatment for fibroids, and a hysterectomy can be offered to a woman with fibroids who has completed child bearing, has symptomatic fibroids (heavy, painful periods, abdominal swelling, frequent urination, e.t.c), and is not yet menopausal.
- Cancer of the uterus, ovaries, or cervix – This is the most suitable treatment option for many gynaecological cancers, in order to minimise the risk of the cancer spreading. In some cases (depending on the age of the woman, the type of cancer and the stage of the cancer), the tubes and the ovaries may also be removed at the same time. This is called a bilateral salpingo-oophorectomy.
- Abnormal vaginal bleeding – Hysterectomy provides a permanent solution to irregular and heavy menstrual periods, for which treatment with medications has failed.
- Endometriosis and Adenomyosis – Sometimes these conditions can persist even after conservative surgical procedures and the use of medications. A hysterectomy with bilateral salpingo-oophorectomy can be done.
- Uterine prolapse – This occurs when the pelvic ligaments which hold up the uterus become weak, and the uterus begins to ‘drop’. It is usually associated with increasing age, and symptoms include a feeling of pressure in the pelvis, difficulty in holding urine (incontinence), and difficulty in moving your bowel. A hysterectomy can be done to provide permanent relief.