OB/GYN Dr Sushma Tomar Explains What You Need To Know About Having Your Uterus Removed

Fibroids, endometriosis, chronic PID or severe period pain, the reason for a hysterectomy can vary depending on your age, health status and several other factors. The mere fact that if a woman has a hysterectomy, she will no longer have menstrual periods or be able to have a child, and will not need to use contraception scares most people. And this results in misinformation and delayed medical attention. So why is a hysterectomy done, what are the risk factors and how is it related to cancer?

1. What is a hysterectomy?

Hysterectomy is the surgical removal of the uterus for any pathology, chronic pain and infections. Depending on the pathology, the uterus and adjacent structures such as fallopian tubes, ovaries, and lymph nodes are removed. There are different types of hysterectomy, and it depends on the extent of removal. – Total Hysterectomy: Removal of the entire uterus – Subtotal Hysterectomy: Removal of body of the uterus, leaving behind Uterus mouth or Cervix – Pan Hysterectomy: Removal of the uterus, both fallopian tubes and ovaries – Extended Hysterectomy: Removal of the cuff of the vagina with pan hysterectomy

2. What are some reasons your doctor may be recommending a hysterectomy?

There are different indications of hysterectomy based on non-malignant and malignant factors. Non-Malignant indications are: – Early and heavy bleeding (Dysfunctional Uterine Bleeding) – Fibroid uterus – Tubo ovarian mass – Endometriosis and Adenomyosis – Carcinoma in situ – Endometrial hyperplasia – Prolapse Uterus – Chronic pelvic pain

3. What happens to your body when you have a hysterectomy?

When only the uterus is removed, there are no significant changes observed in the body. If both the ovaries are removed, then the patient develops menopausal symptoms. Hormonal Replacement Therapy is considered when both ovaries are removed. Post-surgery, a patient may experience Urinary Tract Infection, vaginal bleeding, and constipation. In the long run, they may experience itching, vaginal discomfort, pain during sexual intercourse, anxiety and mood swings.

4. What are some alternatives to a hysterectomy?

The alternative depends on the indication of hysterectomy. If the size of the uterus is normal with profuse bleeding, one can consider Hysteroscopy Dilatation, Curettage, and Histopathology to rule out cancer. A hormone-loaded Cu T can be inserted in Uterus. One can also undergo medical hormone treatment. In the case of malignancy, depending on the stage, chemotherapy and radiation can be considered. Even a smaller size fibroid which is asymptomatic can be treated.