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Why it's done
By Mayo Clinic staff
Hysterectomy may be needed if you have one of the following conditions:
- Gynecologic cancer. If you have a gynecologic cancer — such as cancer of the uterus or cervix — a hysterectomy may be your best treatment option. Depending on the specific cancer you have and how advanced it is, your other options might include radiation or chemotherapy.
- Fibroids. Hysterectomy is the only certain, permanent solution for fibroids — benign uterine tumors that often cause persistent bleeding, anemia, pelvic pain or bladder pressure. Nonsurgical treatments of fibroids are a possibility, depending on your discomfort level and tumor size. Many women with fibroids have minimal symptoms and require no treatment.
- Endometriosis. In endometriosis, the tissue lining the inside of your uterus (endometrium) grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs. When medication or conservative surgery doesn't improve endometriosis, you might need a hysterectomy along with removal of your ovaries and fallopian tubes (bilateral salpingo-oophorectomy).
- Uterine prolapse. Descent of the uterus into your vagina can happen when the supporting ligaments and tissues weaken. Uterine prolapse can lead to urinary incontinence, pelvic pressure or difficulty with bowel movements. Hysterectomy may be necessary to achieve satisfactory repair of these conditions.
- Persistent vaginal bleeding. If your periods are heavy, irregular or prolonged each cycle, a hysterectomy may bring relief when the bleeding can't be controlled by other methods.
- Chronic pelvic pain. Occasionally, surgery is a necessary last resort for women who experience chronic pelvic pain that clearly arises in the uterus. However, hysterectomy provides no relief from many forms of pelvic pain, and an unnecessary hysterectomy creates new problems. Seek careful evaluation before proceeding with such major surgery.
Hysterectomy ends your ability to become pregnant. If you think you might want to become pregnant, ask your doctor about alternatives to this surgery. In the case of cancer, hysterectomy might be the only option. But other conditions — including fibroids, endometriosis and uterine prolapse — have alternative treatments that you can try first.
During hysterectomy surgery, your surgeon might also perform a related procedure that removes your ovaries and fallopian tubes (bilateral salpingo-oophorectomy). You and your doctor will discuss ahead of time whether you should have this procedure done.
- Stovall TG, et al. Abdominal hysterectomy. http://www.uptodate.com/home/index.html. Accessed Feb. 5, 2010.
- Schorge JO, et al. Surgeries for benign gynecologic conditions. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=3166442. Accessed Feb. 12, 2010.
- Wieslander CK, et al. Therapeutic gynecologic procedures. In: DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology. 10th ed. New York, N.Y.: McGraw-Hill Medical; 2007. http://www.accessmedicine.com/content.aspx?aid=2391387. Accessed Feb. 12, 2010.
- Hysterectomy. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp008.cfm. Accessed Feb. 12, 2010.
- Hysterectomy: Frequently asked questions. National Women's Health Information Center. http://www.womenshealth.gov/faq/hysterectomy.cfm. Accessed Feb. 12, 2010.
- About hysterectomy. American College of Surgeons. http://www.facs.org/public_info/operation/hysterectomy.pdf. Accessed Feb. 12, 2010.
- Baggish MS. Total and subtotal abdominal hysterectomy. Best Practice & Research Clinical Obstetrics & Gynaecology. 2005;19:333.
- Rannestad T. Hysterectomy: Effects on quality of life and psychological aspects. Best Practice & Research Clinical Obstetrics & Gynaecology. 2005;19:419.
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