Hysterectomy
Hysterectomy refers to the removal of the uterus. It can be necessary for many medical conditions including uterine fibroids, severe endometriosis, abnormal vaginal bleeding leading to severe anemia, chronic pelvic pain, pelvic prolapse, and pre-malignant and malignant conditions of the uterus. It is the definitive treatment for uterine fibroids, endometrial polyps, and dysfunctional uterine bleeding. It is reserved for occasions when symptoms are not alleviated with less invasive attempts at treatment.
A total hysterectomy defines removal of the uterus and the cervix. The cervix is the opening to the uterus. A supracervical hysterectomy is the removal of the uterus with the preservation of the cervix. A supracervical hysterectomy is performed when there is a concern about the safety of removal of the cervix. It may also be performed out of patient concern of post-hysterectomy sexual function and pelvic support. The benefit to pelvic support and sexual function is theoretical.
When the ovaries are removed in addition to the uterus , the procedure is called a bilateral salpino-oopherectomy and total hysterectomy. This is done when there is an ovarian mass or occasionally when a menopausal woman is having a hysterectomy.
Hysterectomy can be performed by removing the uterus through the abdomen laparoscopically or through an abominal incision. In either of these methods the lower portion of the uterus, the cervix, can preserved – this is a supracervical hysterectomy. Hysterectomy can also be accomplished by removing the uterus through the vagina. The vaginal hysterectomy involves no abdominal incisions, is a very safe procedure, and is associated with a shorter recovery period than abdominal procedures. Laparsocopy can be used to assist with vaginal hysterectomy in some occasions.