You may need a hysterectomy to treat:
- Gynecologic cancer. If you have a gynecologic cancer — such as cancer of the uterus or cervix — a hysterectomy may be your best treatment option. Depending on the specific cancer you have and how advanced it is, your other options might include radiation or chemotherapy.
- Fibroids. A hysterectomy is the only certain, permanent solution for fibroids — benign uterine tumors that often cause persistent bleeding, anemia, pelvic pain or bladder pressure. Nonsurgical treatments of fibroids are a possibility, depending on your discomfort level and tumor size. Many women with fibroids have minimal symptoms and require no treatment.
- Endometriosis. In endometriosis, the tissue lining the inside of your uterus (endometrium) grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs. When medication or conservative surgery doesn't improve endometriosis, you might need a hysterectomy along with removal of your ovaries and fallopian tubes (bilateral salpingo-oophorectomy).
- Uterine prolapse. Descent of the uterus into your vagina can happen when supporting ligaments and tissues weaken. Uterine prolapse can lead to urinary incontinence, pelvic pressure or difficulty with bowel movements. A hysterectomy may be necessary to treat these conditions.
- Abnormal vaginal bleeding. If your periods are heavy, irregular or prolonged each cycle, a hysterectomy may bring relief when the bleeding can't be controlled by other methods.
- Chronic pelvic pain. Occasionally, surgery is a necessary last resort for women who experience chronic pelvic pain that clearly arises in the uterus. However, a hysterectomy provides no relief from many forms of pelvic pain, and an unnecessary hysterectomy may create new problems. Seek careful evaluation before proceeding with such major surgery.
A hysterectomy ends your ability to become pregnant. If you think you might want to become pregnant, ask your doctor about alternatives to this surgery. In the case of cancer, a hysterectomy might be the only option. But for other conditions — including fibroids, endometriosis and uterine prolapse — you may be able to try less invasive treatments first.
During hysterectomy surgery, your surgeon might also perform a related procedure that removes both of your ovaries and your fallopian tubes (bilateral salpingo-oophorectomy). You and your doctor should discuss ahead of time whether you need this procedure, which results in what's known as surgical menopause.
With surgical menopause, menopause symptoms often begin suddenly for women after having the procedure done. Depending on how much these symptoms affect your quality of life, you may need short-term treatment with hormones.
Aug. 15, 2017
- Walters M. Choosing a route of hysterectomy for benign disease. http://www.uptodate.com/home. Accessed Dec. 4, 2015.
- Hysterectomy. First consult. https://www.clinicalkey.com. Accessed Dec. 4, 2015.
- Hysterectomy fact sheet. U.S. Department of Health and Human Services Office on Women's Health. http://womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. Accessed Dec. 4, 2015.
- Baggish MS. Robotic surgery in gynecology. Atlas of Pelvic Anatomy and Gynecologic Surgery. 4th ed. Saunders Elsevier. Philadelphia, Pa: Elsevier; 2016. http://www.clinicalkey.com. Accessed Dec. 4, 2015.
- Stovall T, et al. Abdominal hysterectomy. http://www.uptodate.com/home. Accessed Dec. 4, 2015.
- Bakkum-Gamez J (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 14, 2015.
- Frequently asked questions. Special procedures FAQ008. Hysterectomy. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq008.pdf?dmc=1&ts=20121106T1337303494. Accessed Dec. 4, 2015.
- The rise and rise of robotic hysterectomy. BMJ. 2013;346:f1116.
- Cook AJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Sept. 24, 2015.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 10, 2015.