What is a hysterecomy?
Hysterectomy is one of the most common surgical procedures performed in the United States with 1 in 9 women participating. It is defined as the surgical removal of the uterus (not ovaries). The purpose of the uterus is to grow and protect a baby so once a patient is finished with childbearing the purpose of the uterus becomes limited.
It is a common misconception that a hysterectomy includes removal of the ovaries. Fortunately, this is not the case and most patients are able to maintain their ovaries and as such their hormones. There are very clear benefits to maintaining ovarian function in younger women including lower rates of osteoporosis, heart attack and strokes.
Do I need a hysterectomy?
The most common reasons or indications for hysterectomy are fibroids, abnormal menstrual bleeding and pain. Up until a few years ago, the most often employed route of removing the uterus was through a “open” approach through a large incision in the lower abdomen (similar to a C-section scar). Over the last decade, this route of hysterectomy has thankfully become less common with the introduction of minimally invasive surgical techniques such as robotic-assisted laparoscopy. Most patients go home from the hospital the same day as their surgery if the surgeon is able to complete the surgery without the large incision. In the hands of an experienced robotic surgeon, very complicated hysterectomies can be completed through three separate 8-millimeter incisions in the lower abdomen.
It is important to note that hysterectomy is not the only treatment for the conditions listed above, though if a patient has failed the other options or is unable or unwilling to attempt them, hysterectomy remains as the only “definitive management option.” For example, if a patient has heavy periods and they undergo a hysterectomy we can guarantee that their bleeding will no longer bother them following surgery. If they choose another option such as an endometrial ablation, they may experience a recurrence of their symptoms as time goes by.
What are the risks of a hysterectomy?
However, hysterectomy is not without risk and even with minimally invasive techniques, it is still a major surgery with potential for complications. One of the most feared complications of hysterectomy is injury to the Ureters – the tubes that carry urine from the kidneys to the bladder. The ureters run very closely to the uterine arteries and if they are injured the kidneys could potentially be irreversibly damaged.
In the hands of a well-trained, high-volume surgeon, the robot has the potential to improve outcomes and may mitigate risk associated with large “open” incisions. Inquiring about the various routes of hysterectomy and their inherent risks is an essential part of the planning process when considering this surgery as well as the particular surgeon in which to place your trust.
Damen Hershberger, MD, is an obstetrician and gynecologist with Heartland Women’s Group.
For more information or to schedule an appointment, please call 316.858.7100 or visit www.heartlandwomensgroup.com.
