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Why it's done
By Mayo Clinic staffVaginal hysterectomy treats many different gynecologic problems, including:
- Fibroids. Many hysterectomies are done to permanently treat fibroids — benign tumors in your uterus that can cause persistent bleeding, anemia, pelvic pain, pain during intercourse and bladder pressure. If you have large fibroids, you may need an abdominal hysterectomy.
- Endometriosis. Endometriosis occurs when the tissue lining your uterus (endometrium) grows outside of the uterus, involving the ovaries, fallopian tubes or other organs. Most women with endometriosis have an abdominal hysterectomy, but sometimes a vaginal hysterectomy is possible.
- Gynecologic cancer. If you have cancer of the uterus, cervix, endometrium or ovaries, your doctor may recommend a hysterectomy to treat it. Most of the time, an abdominal hysterectomy is done during treatment for ovarian cancer, but sometimes vaginal hysterectomy may be appropriate for women with cervical cancer or endometrial cancer.
- Uterine prolapse. When pelvic supporting tissues and ligaments get stretched out or weak, the uterus can descend or sag into the vagina, causing urinary incontinence, pelvic pressure or difficulty with bowel movements. Removing the uterus with hysterectomy and repairing pelvic relaxation may relieve those symptoms.
- Abnormal vaginal bleeding. When medication or a less invasive surgical procedure doesn't control irregular, heavy or very long periods, hysterectomy can solve the problem.
- Chronic pelvic pain. If you have chronic pelvic pain clearly caused by a uterine condition, hysterectomy may help, but only as a last resort. Chronic pelvic pain can have several causes, so an accurate diagnosis of the cause is critical before having a hysterectomy for pelvic pain.
For most of these conditions — with the possible exception of cancer — hysterectomy is just one of several treatment options. You may not even need to consider hysterectomy unless medications and less invasive gynecologic procedures have failed.
You cannot get pregnant after you've had a hysterectomy. If you're less than completely sure you're ready to give up your fertility, explore other treatments.
- About hysterectomy: Surgical removal of the uterus, or womb. American College of Surgeons. http://www.facs.org/public_info/operation/hysterectomy.pdf. Accessed May 10, 2010.
- Falcone T, et al. Overview of hysterectomy. http://www.uptodate.com/home/index.html. Accessed May 10, 2010.
- Hysterectomy. The National Women's Health Information Center. http://womenshealth.gov/faq/hysterectomy.cfm. Accessed May 10, 2010.
- Stovall TG, et al. Vaginal hysterectomy. http://www.uptodate.com/home/index.html. Accessed May 10, 2010.
- Hysterectomy. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp008.cfm. Accessed May 10, 2010.
- Cain J, et al. Gynecology. In: Brunicardi FC, et al. Schwartz's Principles of Surgery. 9th ed. New York, N.Y.; McGraw-Hill Medical; 2010. http://www.accessmedicine.com/content.aspx?aid=5025391. Accessed May 10, 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=2391554. Accessed May 10, 2010.
- Lyons T. Laparoscopic approach to hysterectomy. http://www.uptodate.com/home/index.html. Accessed May 10, 2010.
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