Hysterectomy, the removal of a woman's uterus, is one of the most common surgical procedures performed on women in this country. Nearly 40% of women in the United States will have a hysterectomy during the course of their lifetimes. Hysterectomies are frequently performed for fibroids, abnormal bleeding, endometriosis, cancerous or pre-cancerous conditions, or pelvic organ prolapse.
The decision to have a hysterectomy should not be undertaken lightly. Often the decision is made only after trying a number of different treatments to correct the underlying problem. Sometimes a hysterectomy is the only reasonable option to treat a medical condition. As physicians, we are very mindful of individual attitudes about hysterectomy and try to help you reach the best decision for you at your stage of life.
Women frequently ask about the necessity of taking out ovaries or fallopian tubes at the time of hysterectomy. In general, we recommend that women under 40 keep their ovaries, women over 45 have their ovaries taken out, and that women whose ages are in-between make the decision for themselves. The reason for this is to reduce the risk of ovarian cancer. While fewer than 2 women in 300 will get ovarian cancer, it is difficult to detect, rapidly growing cancer that is difficult to cure. Recent research has indicated that fallopian tubes may actually hold reservoirs of pre-cancerous cells. If true it would mean that we should encourage women to have their tubes removed but not their ovaries. We are keeping a close eye on this research to see how it will affect the way we counsel patients.
Women also need to decide whether to remove their cervix at the same time they have their uterus removed. This will depend on your individual circumstance and should be discussed with your physician.
Hysterectomies can be performed as open abdominal procedures, vaginal procedures, or laparoscopic procedures either with or without the use of the Da Vinci robot. With recent advances in surgical techniques, we are able to perform over 90% of our hysterectomies laparoscopically, enabling our patients to have less pain, shorter hospital stays, and quicker recoveries.