Reasons for a Hysterectomy
According to the American College of OB/GYNs, a woman may have a hysterectomy for reasons that include:
- Long-term (chronic) pelvic pain
- Severe, long-term vaginal bleeding that is not controlled with other treatments
- Severe endometriosis that does not get better with other treatments
- Uncontrolled bleeding during childbirth
- Slipping of the uterus into the vagina (uterine prolapse)
- Tumors in the uterus, such as uterine fibroids
- Adenomyosis, which causes heavy, painful periods
- Cancer of the uterus, most often endometrial cancer
- Cancer of the cervix or changes in the cervix called cervical dysplasia that may lead to cancer
- Cancer of the ovary
What Is Removed during a Hysterectomy?
During a hysterectomy, the surgeon may remove the entire uterus or just part of it. The fallopian tubes and ovaries may also be removed. Your doctor will help you decide which type of hysterectomy is best. The choice often depends on your medical history and reason for the surgery.
Surgical Techniques for Hysterectomies
Surgeons use different approaches for hysterectomy, depending on the surgeon’s experience, the reason for the hysterectomy and a woman's overall health. Generally, there are two approaches to surgery — a traditional open surgery or surgery using a minimally invasive procedure.
- Vaginal hysterectomy. The uterus is removed through the vagina with no abdominal incision.
- Abdominal hysterectomy. The uterus is removed through an incision in your lower abdomen. The opening in your abdomen gives the surgeon a clear view of your pelvic organs.
Minimally Invasive Options
Abdominal hysterectomies are performed using a minimally invasive technique, meaning they require only a few small incisions in the abdomen. A robot-assisted laparoscopic hysterectomy is performed with the help of a machine controlled by the surgeon.