Hysterectomy - Not a "One Size Fits All" Procedure

Have you been deal­ing with pelvic pain for too long? Is heavy, fre­quent, or irreg­u­lar uter­ine bleed­ing dis­rupt­ing your life? Have you avoid­ed pur­su­ing oth­er options because noth­ing has worked so far? 

If so, a hys­terec­to­my – a surgery to remove the uterus and cervix – may be rec­om­mend­ed by a gynecologist.

When med­ica­tions or hor­mon­al ther­a­pies have failed to help con­di­tions such as endometrio­sis, uter­ine fibroids, or PCOS, it may be time to con­sid­er a hysterectomy.

Have you avoid­ed con­sid­er­ing a hys­terec­to­my because you are wor­ried about the pain and recov­ery that may come with surgery? You may be sur­prised to know that much has changed over recent years when it comes to the way hys­terec­tomies are performed. 

In the past, many patients requir­ing a hys­terec­to­my did not have many options oth­er than surgery that required large inci­sions. Now, patients have sev­er­al surgery options includ­ing many types of min­i­mal­ly inva­sive hysterectomies.

Min­i­mal­ly Inva­sive Hys­terec­to­my – What is it and what are the dif­fer­ent types?

Min­i­mal­ly inva­sive surgery has been a rapid­ly grow­ing area of med­ical research and improve­ment, and hys­terec­to­my has been no excep­tion. A min­i­mal­ly inva­sive hys­terec­to­my is any hys­terec­to­my that does NOT require a large inci­sion on the abdomen or stom­ach, to remove the uterus. There are sev­er­al types of min­i­mal­ly inva­sive hysterectomies:

  • Vagi­nal Hys­terec­to­my – It may sound odd, but the uterus can be removed through the vagi­na. A vagi­nal hys­terec­to­my is asso­ci­at­ed with the least amount of pain and has the low­est com­pli­ca­tion rates. 
  • Laparo­scop­ic Hys­terec­to­my – This uses three to four very small inci­sions in the abdomen that are less than one cen­time­ter (or less then about half of an inch) in size to remove the uterus.
  • Robot­ic Assist­ed Laparo­scop­ic Hys­terec­to­my – The assis­tance of the DaVin­ci Robot allows for the abil­i­ty to per­form more com­pli­cat­ed hys­terec­tomies through laparo­scop­ic inci­sions. Before the inven­tion of robot­ic sur­gi­cal devices, these hys­terec­tomies were per­formed through large incisions.

Min­i­mal­ly inva­sive surg­eries are asso­ci­at­ed with short­er recov­ery times, less pain and low­er risks of com­pli­ca­tions than surg­eries that use large incisions.

Hys­terec­to­my Facts — True and False

You may be inter­est­ed to know that a hys­terec­to­my is actu­al­ly one of the most com­mon­ly per­formed surg­eries in the Unit­ed States. Despite this, there are still many ques­tions and some mis­con­cep­tions about what to expect when plan­ning for a hysterectomy.

True or False: A hys­terec­to­my will cause me to go into menopause.

False. A hys­terec­to­my most com­mon­ly involves remov­ing the uterus along with the cervix and some­times the fal­lop­i­an tubes. While remov­ing the uterus means bleed­ing with men­stru­al cycles will stop, these struc­tures do not pro­duce hor­mones and have no impact on when a patient enters menopause. The ovaries are com­plete­ly sep­a­rate organs from the uterus and are often left in place when a hys­terec­to­my is per­formed. This allows patients to main­tain their own nat­ur­al hor­mones which are known to sup­port both heart health and bone health.

True or False: I will not be able to get preg­nant if I have a hysterectomy.

True. After a hys­terec­to­my, it is impos­si­ble to get preg­nant. It is impor­tant to make sure you have con­sid­ered fam­i­ly plan­ning before under­go­ing a hysterectomy. 

True or False: It will take me a long time to recov­er from surgery and require a long hospitalization.

False. Patients who have min­i­mal­ly inva­sive hys­terec­tomies are dis­charged from the hos­pi­tal either on the day of surgery or the day fol­low­ing surgery. Near­ly all recov­ery can occur in the com­fort of your own home.

True or False: I will have some con­trol over my own recov­ery from surgery.

True. By focus­ing on con­trol­ling oth­er med­ical issues before and after surgery, recov­ery can be expe­dit­ed, and the risk of com­pli­ca­tions relat­ed to surgery can be sig­nif­i­cant­ly decreased.

Plan­ning for Surgery – What to Expect

Cer­tain steps may be rec­om­mend­ed by your Duly Health and Care gyne­col­o­gist to plan for your surgery. 

If you have not yet tried non-inva­sive treat­ment options such as med­ica­tions, these will be rec­om­mend­ed. Non-inva­sive treat­ments will work for many patients and help them avoid risks of surgery entire­ly. Many insur­ance com­pa­nies will not cov­er the expense of surgery until at least one non-inva­sive treat­ment has been tried. Oth­er diag­nos­tic test­ing may also be rec­om­mend­ed which may include blood work and/​or imag­ing pro­ce­dures, such as a pelvic ultrasound.

If surgery is the best option for you, your gyne­col­o­gist will work with you to per­son­al­ize your treat­ment and deter­mine the best type of hys­terec­to­my for you. Your doc­tor will con­sid­er your med­ical and sur­gi­cal his­to­ry, phys­i­cal exam and results of diag­nos­tic test­ing. This is all to ensure that surgery is safe and the best treat­ment option for you.

Your gyne­col­o­gist may ask you to see your pri­ma­ry care physi­cian to make sure any oth­er med­ical con­di­tions are being treat­ed and you are phys­i­cal­ly ready for surgery. 

And final­ly, your Gyne­col­o­gist will review the spe­cif­ic risks and ben­e­fits of your surgery and make sure you both agree on the plan.

Are you ready to find out what your options are?

Decid­ing it is time to treat a long-stand­ing issue with surgery is a big deal. At Duly Health and Care, our gyne­col­o­gists are ready to help you with every step in mak­ing this deci­sion and will work with you to deter­mine the best treat­ment plan. 

Sched­ule an appoint­ment with a Duly Gyne­col­o­gist today!

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  • I value the importance of practicing evidence based medicine and feel patients should be well informed of all treatment options before making shared decisions regarding their medical care. I believe communication and mutual understanding are critical in providing the best possible outcomes for my patients.