Why it's done

Vaginal hysterectomy treats many different gynecologic problems, including:

  • Fibroids. Many hysterectomies are done to permanently treat fibroids — benign tumors in your uterus that can cause persistent bleeding, anemia, pelvic pain, pain during intercourse and bladder pressure.

    If you have large fibroids, you may need an abdominal hysterectomy — surgery that removes your uterus through an incision in your lower abdomen.

  • Endometriosis. Endometriosis occurs when the tissue lining your uterus (endometrium) grows outside of the uterus, involving the ovaries, fallopian tubes or other organs.

    Most women with endometriosis have an abdominal hysterectomy, but sometimes a vaginal hysterectomy is possible.

  • Gynecologic cancer. If you have cancer of the uterus, cervix, endometrium or ovaries, your doctor may recommend a hysterectomy to treat it.

    Most of the time, an abdominal hysterectomy is done during treatment for ovarian cancer, but sometimes vaginal hysterectomy may be appropriate for women with cervical cancer or endometrial cancer.

  • Uterine prolapse. When pelvic supporting tissues and ligaments get stretched out or weak, the uterus can lower or sag into the vagina, causing urinary incontinence, pelvic pressure or difficulty with bowel movements. Removing the uterus with hysterectomy and repairing pelvic relaxation may relieve those symptoms.
  • Abnormal vaginal bleeding. When medication or a less invasive surgical procedure doesn't control irregular, heavy or very long periods, hysterectomy can solve the problem.
  • Chronic pelvic pain. If you have chronic pelvic pain clearly caused by a uterine condition, hysterectomy may help, but only as a last resort.

    Chronic pelvic pain can have several causes, so an accurate diagnosis of the cause is critical before having a hysterectomy for pelvic pain.

For most of these conditions — with the possible exception of cancer — hysterectomy is just one of several treatment options. You may not even need to consider hysterectomy if your doctor recommends hormonal medications or other less invasive gynecologic procedures that are successful in managing your symptoms.

You cannot become pregnant after you've had a hysterectomy. If you're less than completely sure that you're ready to give up your fertility, explore other treatments.

Dec. 11, 2015
References
  1. Walters MD. Choosing a route of hysterectomy for benign disease. http://www.uptodate.com/home. Accessed Sept. 5, 2015.
  2. Hysterectomy fact sheet. U.S. Department of Health and Human Services Office on Women's Health. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html. Accessed Sept. 5, 2015.
  3. Stovall TG, et al. Vaginal hysterectomy. http://www.uptodate.com/home. Accessed Sept. 5, 2015.
  4. Frequently asked questions. Special procedures FAQ008. Hysterectomy. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Hysterectomy. Accessed Sept. 11, 2015.
  5. Darwish M, et al. Psychological outcomes after hysterectomy for benign conditions: A systematic review and meta-analysis. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2014;174:5.
  6. Hoffman BL, et al. Surgeries for benign gynecologic conditions. In: Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed Sept. 11, 2015.
  7. Einarsson JI, et al. Laparoscopic hysterectomy. http://www.uptodate.com/home. Accessed Sept. 11, 2015.
  8. Cook AJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. July 17, 2015.