Hysterectomy

By: Red Hot Mamas

Published: May 26, 2010

The word hysterectomy comes from the Greek word “hystero” which means “womb.” The first hysterectomy was performed more than 16 centuries ago by a Greek physician named Soranus. As a result of the high mortality rate (90%) at that time, a hysterectomy was only performed if life threatening gynecological conditions were involved. Today, only about 10 % of hysterectomies are performed because of life threatening conditions. The other 90% are performed electively.

Approximately 600,000 hysterectomies are performed each year in the United States. In fact, it is the second most commonly performed surgery and it is estimated there will be 824,000 hysterectomies performed in 2005. More than 18 million American women in the have had a hysterectomy. The average age of a woman undergoing hysterectomy is 42.7 years. And, more than one out of every three women over age 60 has had one.

The rate of hysterectomy varies with different regions of the United States. The South has the highest rates of this procedure (6.8 per 1,000 women) and the Northeast the lowest (3.9). The average annual rates were 5.5 in the Midwest and 4.9 in the West. The high rates in the South are due to an increased number of younger women (ages 15 – 44) undergoing this operation. Hysterectomy is also performed more on African-American women than on Caucasian women.

Hysterectomy is major surgery. Many women are confused about what is removed and how this event may affect the rest of their lives. Much of the confusion surrounding hysterectomy has to do with the terminology describing the operation. To help you understand the vocabulary of hysterectomy it is important to understand the many different types of hysterectomy which include:

Hysterectomy or simple hysterectomy:
Involves the removal of the uterus and sometimes the Fallopian tubes. The hormone producing ovaries are left intact.
Total hysterectomy:
Refers to the removal of the uterus and cervix. The ovaries are left intact.
Total Abdominal Hysterectomy (TAH):
The hysterectomy is performed through an incision in the abdomen.
Total Vaginal Hysterectomy (TVH):
The hysterectomy is performed through an incision in the vagina.
Laparoscopically Assisted Vaginal Hysterectomy (LAVH):
A telescope (laparoscope) is used through several Band-Aid incisions in the abdomen to complete part of the operation and the uterus is removed through an incision in the vagina.
Subtotal or partial hysterectomy:
The removal of the uterus above the cervix. The cervix and ovaries are left intact.
Oophorectomy (or ovariectomy):
The removal of one ovary. If you are perimenopausal when this surgical procedure is performed, the ovary that has been left intact will continue to produce estrogen and progesterone which regulates your menstrual cycle. Reproduction is still possible. A woman will not experience menopause until her natural time when one ovary is left in place.
Salpingo-oopherectomy:
The removal of a fallopian tube and ovary on one side. If one ovary is left intact, the woman will not experience menopause until her natural time.
Bilateral oophorectomy:
The removal of both ovaries. If this procedure is performed before you experience natural menopause, you will have “surgical menopause” meaning you will go into menopause immediately.
Bilateral salpingo-oopherectomy:
The removal of both ovaries and Fallopian tubes. If this procedure is performed before the woman has experienced natural menopause, she will experience surgical menopause.
Hysterectomy with bilateral salpingo-oophorectomy:
Refers to the removal of the uterus, both ovaries, and both Fallopian tubes. Most women refer to this as a total or complete hysterectomy. When this procedure is performed, surgical menopause results.

Hysterectomy is indicated in the following situations:

The occurrence of invasive cervical or endometrial cancer; massive hemorrhage; uterine rupture; of severe uncontrollable infection. Elective hysterectomy may be performed for a variety of other reasons such as dysfunctional/abnormal bleeding; endometriosis, fibroids; chronic pelvic pain, genital prolapse (pelvic relaxation) and endometrial hyperplasia (premalignant changes in the uterine lining).

It is always best to get a second opinion about the decision to undergo a hysterectomy. After obtaining the second opinion, you probably will return to your first physician. It is during this visit you should gain more information about the specific reason/condition you and what caused the problem; what diagnostic tests are needed; whether treatment or surgery is necessary; what are the compendium of surgical methods for hysterectomy; what are the alternatives; discuss the risks associated with this treatment and/or surgery; and possible medications which may be recommended. If there is an important reason to perform the hysterectomy and if your partner is supportive of the operation, there will likely be no loss of sexual pleasure after the operation. Sexual problems may occur if you are not clear why you are having the procedure and if your partner does not understand why it is happening, what the procedure really is, or is not supportive.

My personal hysterectomy experience is one of the primary reasons I founded PRIME PLUS/Red Hot Mamas® and the reason why I write this article for you today. However, this is just a primer on hysterectomy. It is important to communicate with your physician, your partner and family members. I also recommend attending a local Red Hot Mamas meeting which are offered through hospitals and physician group practices across the USA. The programs are supportive and the healthcare professionals associated with Red Hot Mamas will give you helpful advice and a multitude of information. Also visit the following websites: www.hersfoundation.com, www.hystersisters.com, www.ourgyn.com, and www.menopause.org.

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