Hysterectomy
For many women an operation to remove their uterus becomes a necessary next step. This may be because methods to stop heavy bleeding are not successful, side effects of medications are intolerable, fibroids are problematic or endometriosis is severe enough that a more permanent solution is determined.
Overview
A hysterectomy is when a woman’s uterus is removed.
The uterus can be removed in 3 different ways:
laparoscopic hysterectomy: small keyhole incisions (5-10mm) are used to place instruments and a camera inside the abdomen, then the procedure is performed watching the camera view on a monitor
abdominal hysterectomy: an incision is made on the lower abdomen
vaginal hysterectomy: the whole procedure is performed through the vagina
When & why
When is a hysterectomy performed?
For many women, an operation to remove their uterus becomes a necessary next step. This may be because methods to stop heavy bleeding are not successful, side effects of medications are intolerable, fibroids are problematic or endometriosis is severe enough that a more permanent solution is determined.
How
At Central Gynaecology, the vast majority of hysterectomies are performed using a laparoscopic approach. This is an advanced procedure requiring advanced laparoscopic skills and intensive training.
A laparoscopic hysterectomy holds many advantages over other methods. Recovery is much faster, the hospital stay is shorter, less pain, and there is a more rapid return to family life, work, and exercise.
On most occasions a woman’s ovaries are retained, meaning she does not go through menopause as the ovaries still produce hormones (estrogen and progesterone).
In women having a hysterectomy, we advise removal of the fallopian tubes. Once the uterus is removed the tubes have no function. The main reason for removal is that clinical studies show a reduction in the risk of ovarian cancer when the tubes are removed at hysterectomy.
We can help
What should I expect after a Hysterectomy?
The doctors at Central Gynaecology will evaluate the issues; discuss all options and work together to make evidence and an experience-based plan. We aim to work with our patients to determine the most appropriate course of action.
Further reading
Related symptoms
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Commonly caused by hormone therapies, including oral contraceptives. Persistent bleeding may be due to genital tract infections, polyps, or cervical cancer.
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High volume, long-lasting periods with flooding, clotting or anaemia. Causes can include fibroids, polyps, hyperplasia, PCOS, infection, or endometriosis.
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Women may have problems with tubal blockage, endometriosis, ovulation, egg numbers or quality. Men may have issues with sperm quantity or quality.
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Causes include endometriosis, infection, instability of the lining of the womb, ovarian cysts, perimenopause, PCOS, polyps, and early pregnancy.
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Causes include constipation, anal fissures, IBS and severe endometriosis. Extremely painful periods and pain with deep intercourse may also occur.
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Pain, discomfort or cramps around the time of menstruation. Can be due to prostaglandin production, or caused by endometriosis or adenomyosis.
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Defined as pelvic pain lasting more than 6 months. Causes can include ovarian cysts and urinary tract infections, but can be elusive and hard to diagnose.
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This needs to be investigated. Often due to fragile vaginal or endometrial tissue caused by lack of estrogen. Hyperplasia and cancer may be the cause in 5-10% of cases.
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The two main types are ‘stress’ and ‘urge’ incontinence. Caused by giving birth and overactive bladder, respectively. Can also be caused by infection or prolapse.
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Periods that last more than 7 days. Causes include fibroids, polyps, hyperplasia or cancer of the uterus, PCOS, genital tract infection, and endometriosis.
Related conditions
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Adenomyosis occurs when the inside lining of the uterus is found within the muscular wall of the uterus, enlarging it.
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When endometrial tissue, which should only be found in the uterus, also grows outside the uterus, causing severe pain.
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Hyperplasia occurs when the inside lining of the uterus starts to behave abnormally and is a potential ‘pre-cancer’.
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Occurs when the walls of the vagina lose support, causing organs and spaces around the vagina to bulge downwards.