What is a hysterectomy?
is an operation to remove a woman's uterus (womb). The uterus is where
a baby grows when a woman is pregnant. Sometimes the fallopian tubes,
ovaries, and cervix are removed at the same time the uterus is removed.
These organs are located in a woman's lower abdomen (see image on the right).
The cervix is the lower end of the uterus. The ovaries are organs
that produce eggs and hormones. The fallopian tubes carry eggs from
the ovaries to the uterus. There are several
types of hysterectomy:
- A complete
or total hysterectomy removes the cervix as well as the uterus.
This is the most common type of hysterectomy.
- A partial
or subtotal hysterectomy (also called a supracervical hysterectomy)
removes the upper part of the uterus and leaves the cervix in
- A radical
hysterectomy removes the uterus, the cervix, the upper part of
the vagina, and supporting tissues. This is done in some cases
(Mouse over the labels above for a description/definition)
common are hysterectomies?
Hysterectomy is the second most common major surgery among women
in the United States. (The most common major surgery that women
have is cesarean section delivery.) Each year, more than 600,000
hysterectomies are done. About one third of women in the United
States have had a hysterectomy by age 60.
is a hysterectomy performed?
Hysterectomies are done through a cut in the abdomen (abdominal
hysterectomy) or the vagina (vaginal hysterectomy). Sometimes an
instrument called a laparoscope is used to help see inside the abdomen.
The type of surgery that is done depends on the reason for the surgery.
Abdominal hysterectomies are more common than vaginal hysterectomies
and usually require a longer recovery time.
do women have hysterectomies? Do alternatives exist?
Hysterectomies are most often done for the following reasons:
- Uterine fibroids.
Fibroids are common, benign (noncancerous) tumors that grow in
the muscle of the uterus. More hysterectomies are done because
of fibroids than any other problem of the uterus. Fibroids often
cause no symptoms and need no treatment, and they usually shrink
after menopause. But sometimes fibroids cause heavy bleeding or
alternatives to hysterectomy to treat fibroids, which may be
especially important for younger women who hope to have children.
Sometimes fibroids are treated with medicine or other treatments
designed to shrink the fibroids. But, this is only temporary
- when the medicine is stopped, the fibroids will grow again.
A type of surgery to remove only the fibroids without removing
the uterus is called a myomectomy. A relatively new procedure
to shrink fibroids is called uterine artery embolization. It
involves placing small plastic particles in the blood vessels
feeding the fibroids.
- Endometriosis. This is another benign condition that affects the uterus. Endometriosis
is the second leading reason for hysterectomies. It is most common
in women in their thirties and forties, especially in women who
have never been pregnant. It occurs when endometrial tissue (the
inside lining of the uterus) begins to grow on the outside of
the uterus and on nearby organs. This condition may cause painful
menstrual periods, abnormal vaginal bleeding, and sometimes loss
of fertility (ability to get pregnant). Endometriosis is usually
not a problem for women after menopause.
endometriosis are often treated with hormones and medicines
that lower their levels of estrogen. Surgery to remove the patches
of endometrial tissue causing the symptoms may be done using
a laparascope or through a larger cut in the abdomen (laparatomy).
A hysterectomy is generally not done unless other treatment
prolapse. This is a benign condition in which the uterus moves
from its usual place down into the vagina. Uterine prolapse is
due to weak and stretched pelvic ligaments and tissues. Other
organs such as the bladder can also be affected. Childbirth, obesity,
and loss of estrogen after menopause may contribute to this problem.
Uterine prolapse accounts for about 16 percent of hysterectomies.
may include estrogen therapy, exercises to strengthen pelvic
floor muscles, or use of a pessary, a plastic ring inserted
into the vagina to help support the uterus. In more severe cases,
surgery can restore the sagging organs to their normal location
and repair the supporting tissues. Sometimes a hysterectomy
may be done if the prolapse is causing severe problems.
- Cancers affecting
the pelvic organs account for only about ten percent of all hysterectomies.
Endometrial cancer (cancer of the lining of the uterus), uterine
sarcoma, cervical cancer (cancer of the cervix), and cancer of the
ovaries or fallopian tubes often require hysterectomy. Depending
on the type and extent of the cancer, other kinds of treatment such
as radiation or hormonal therapy may be used as well.
- Other reasons why hysterectomies are done include chronic pelvic
pain, heavy bleeding during or between periods, and chronic pelvic
is Laparoscopic Supracervical Hysterectomy?
An alternative to the Abdominal Hysterectomy is a new and innovative
procedure and is performed in patients which would normally require
an abdominal hysterectomy. With the help of slender laparoscopic
cameras and instruments this state of the art procedure is possible.
With this procedure the cervix will be preserved; therefore, it
is important to make sure that the cervix is not or has not been
diseased. With the preservation of the cervix and the connective
tissue around it, the integrity of the pelvic support structures
will be preserved and there will be less likelihood of prolapse
or relaxation of the structures.
hysterectomy surgery is performed under general anesthesia. An instrument
is initially placed in the uterus through the vagina which will
allow us to move the uterus around for better visualization. With
the help of the specialized instruments, the abdominal cavity is
filled with CO2 gas, which is safe for the patients.
the supracervical hysterectomy cameras and instruments are introduced
into the abdominal cavity. With the help of sharp and blunt dissection
and specific coagulation instruments, the tissues will be released
from their blood supply. Once the major uterine blood supplies have
been cut off, the uterus will be separated from the cervical stump.
The cervical opening will be coagulated, to avoid future bleeding.
are placed on and around the cervical stump to improve the support
structures of the pelvis and avoid future prolapse. Thereafter,
the uterus with or without the tubes and ovaries will be extracted
through the small incisions via an instrument which allows the doctors
to morcellate or cut up the tissues in small pieces. All the tissues
will be evaluated by pathology doctors to rule out abnormalities.
will leave the hospital the next day and are able to return to work
and normal activity within 1-2 weeks.
Florida Hospital Celebration Health, Laparoscopic Supracervical
Hysterectomy offers patients many high-tech advantages including
the empowerment of rapid recovery.
For more information,
or to schedule an appointment, please call Florida Hospital Celebration
Health's Women's Center for Pelvic Health at 407-303-4190.