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By Dr. Matt Siedhoff
Learn answers to important questions and concerns related to this
Most people donít look
forward to having surgery, but for a variety of reasons hysterectomies in
particular can be viewed negatively. This is completely understandable ó the
procedure is a final statement on the ability to carry a pregnancy, and the
uterus is an organ that makes someone uniquely female. Misconceptions about the
procedure can lead to fear of what otherwise might be a good treatment option.
Hysterectomies arenít always the right choice, but itís important to separate
fact from fiction when it comes to this important medical procedure for women.
Here are some of the misconceptions and realities of the procedure:
Iím going to be out of
commission for six weeks after my hysterectomy
you have a large abdominal incision, called a laparotomy, for your hysterectomy,
thatís probably true. But now, most hysterectomies can be performed in a minimally invasive
fashion ó using tiny abdominal incisions with laparoscopic surgery or with no
outside incisions at all in the case of vaginal hysterectomy. If you are
considering hysterectomy, make sure you seek out someone who specializes in this
surgery and can offer a minimally invasive option even for complex cases.
Minimally invasive surgery reduces the risk of a number of complications and has
a recovery time of about two weeks for most women.
Canít you just remove the
Fibroids are very common
benign tumors of the uterus and one of the most frequent reasons women have
hysterectomies. Removing fibroids and reconstructing the uterus is called a
myomectomy and is the right surgical choice for women wishing to preserve
fertility. Sometimes myomectomy can be a much more complicated operation, so if
future fertility isnít a concern, a hysterectomy may be a better choice.
Why do women have
Setting aside cancerous
conditions, the most common reasons women undergo hysterectomies include:
Fibroids (benign tumors which
can grow quite large and cause pain or heavy bleeding)
Abnormal bleeding that canít
be controlled in other ways
Prolapse (when the uterus
sags downward into the vagina)
I donít want to go through
The age a woman will begin
menopause is not significantly impacted by having a hysterectomy. Menopause is
determined by the function of the ovaries, which are often retained when a woman
has a hysterectomy and hasnít undergone menopause already. If the ovaries do
need to be removed, most of the time a woman can replace the hormones the
ovaries make to avoid the negative effects of early menopause.
My sex life is going to
worsen if I have a hysterectomy
Good research shows that, on
average, sexual function actually improves after hysterectomy, probably because
the surgery is addressing a problem that is interfering with sexual health.
However, if the ovaries are removed and no hormone replacement is given, that
could negatively impact sexuality.
Wonít my bladder fall down if
I have a hysterectomy?
Prolapse ó when structures
such as the uterus, bladder or rectum sag down into the vagina ó can happen
whether a woman has had a hysterectomy or not. Factors such as family history
and having delivered children vaginally have a much bigger impact on whether a
woman will experience prolapse in the future.
Opinions about hysterectomy
can easily be spread by casual story-telling and personal experiences. Although
that information can be important, itís also important to remember every
situation is different. When making the decision about whether or not to have a
hysterectomy, find a doctor who specializes in gynecologic surgery and can offer
you a full range of treatment options. You will be able to make an informed
decision about what treatment is best for you.
Matthew Siedhoff, M.D., is a
gynecologic surgeon on faculty at Cedars-Sinai in Los Angeles, CA, specializing
in urogyn and pelvic recon surgery. He is a graduate
of Stanford Medical School and completed his residency at New York University
School of Medicine. He also received his Masterís degree from University of