When is a Hysterectomy necessary?
A hysterectomy is the surgical removal of a woman’s uterus. It is considered an essential procedure for life threatening diseases such as cancer of the ovaries, cervix, uterus and fallopian tubes. In Australia, 90% of hysterectomies are performed for non life threatening conditions, such as uterine fibroids, endometriosis, heavy periods, uterine prolapse, and abnormal uterine bleeding.
Alternative treatment options
If you’re thinking about having the procedure for a non life threatening condition, you may wish to consider the alternatives first. A hysterectomy is a major operation with a long recovery time and is only performed after other, less invasive treatments have been tried. The vast majority of non-cancerous conditions may be successfully treated with other options
Medications – injections may shrink the fibroids but can cause menopausal-type side effects. If this is the case, a prescription-only morning pill can be tried instead.
Myomectomy – surgery to remove the fibroids but keep the uterus intact.
Uterine artery embolization – this procedure cuts off the blood supply to the fibroids and shrinks them. Not suitable for women who wish to conceive.
Contraceptive pill or Mirena coil
Medications taken during periods
Endometrial ablation which treats the lining of the uterus
Laparoscopic surgery should be considered first, for diagnosis and to remove the endometriotic tissue, followed by medication to suppress the redevelopment of the endometriosis.
If a woman would like to have more children, the uterus can be surgically suspended, or she can use a pessary — a device that holds the uterus in place. Pelvic floor exercises can also help restore muscle tone, and lifestyle changes such as weight loss and avoiding heavy lifting can help.
Things to consider
If you have a hysterectomy, in addition to having your uterus removed, you may also have to decide whether to have your cervix or ovaries removed. Your decision will usually be based on your personal feelings, medical history and any recommendations your doctor may have. Dr Arun urges women who are considering a hysterectomy to ask a lot of questions, especially if they want children or aren’t sure yet.
“A hysterectomy is permanent — you can never have a child after the procedure.”
For further enquiries, please contact
Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG
Waikiki Specialist Centre
221 Wilmott Drive, Waikiki
Phone 9550 0300
Fax 9592 9830