The female reproductive system is the remarkable and robust producer of life. Yet, it is fragile and requires constant monitoring and care.

When health problems arise or persist with a uterus and/or ovaries, a hysterectomy may be necessary for a woman’s long-term health.

The second most-common surgery among women in the United States, this procedure basically removes a woman's uterus. The surgeon also may remove fallopian rubes and ovaries – especially if tests indicate possible issues. The procedure ends the woman’s ability to become pregnant.

More than a third of American women older than 60 have undergone the procedure.

Here is some helpful information about hysterectomies:

When It May Be Necessary

Hysterectomies are recommended when certain conditions are diagnosed, such as:

• Uterine fibroids (this is the most common reason for hysterectomy)
• Pelvic support problems (such as Uterine Prolapse)
• Abnormal uterine bleeding
• Chronic pelvic pain
• Gynecologic cancer

Types of Hysterectomies

Most women undergoing this type of procedure have a Total Hysterectomy, when a surgeon removes all of the uterus, including the cervix. The ovaries and the fallopian tubes may or may not be removed.

However, depending on the health issue, the gynecologist might recommend a Subtotal or Supracervical Hysterectomy, where the upper part of the uterus is removed and the cervix remains.

If cancer – especially cervical cancer – is detected in a pre-operation biopsy, doctors usually will perform a Radical Hysterectomy, which removes all of the uterus, cervix, the tissue on both sides of the cervix, and the upper part of the vagina.

Procedure Options

Surgical procedures have advanced dramatically over the years. More than 518,000 hysterectomies are performed each year in the United States. Amazingly, the percent of those procedures done by laparoscopy has increased from 14.3 percent in 2004 to nearly 59 percent today. An astonishing 18 percent are now done as an outpatient.

Surgical options depend on the patient’s pre-surgical diagnosis and overall health. They include:

Vaginal Hysterectomy - The uterus is removed through the vagina. This procedure generally causes fewer complications than the other options. Healing time may be shorter, with a faster return to normal activities. It is recommended as the first choice for hysterectomy when possible. Nationally, about 22 percent of all hysterectomies are performed vaginally.

Abdominal Hysterectomy - The surgeon removes the uterus through an incision in the lower abdomen and has a more a clear path to pelvic organs. The easier access is helpful if the patient has cancer tissue or if the uterus is very large. This procedure has higher risks of infections, bleeding, blood clots or nerve or tissue damage. Patients usually have a longer hospital stay and an extended recovery time. Nationally, about 29 percent of all hysterectomies are performed abdominally.

Laparoscopic Hysterectomy – This procedure requires only a few small incisions in the abdomen. A laparoscope inserted through one of these incisions allows the surgeon to see the pelvic organs. Other surgical instruments are used to remove the uterus in small pieces through the incisions. This surgery results in less pain, has a lower risk of infection, and requires a shorter hospital stay. Though having fewer risks than the other two options, this surgery can take longer in the operating room. Also, there is an increased risk of injury to the urinary tract and other organs. Nationally, about 59 percent of all hysterectomies are performed abdominally.

More Information

An informative resource for women considering or recently having a hysterectomy can be found at HysterSisters.com.

For more information about hysterectomies, you can contact the Johnson Memorial Women’s Health Specialists in Franklin at 317.738.0630 or Whiteland at 317.530.3111.