Do I Need A Hysterectomy?

Submitted by Dr S. Patel on 16 September 2017

Thousands of Indian women undergo hysterectomy, or removal of the uterus, every year, even though most of these cases can be avoided. Dr Shital Raval enumerates some surgical and non-surgical options available that should be considered before opting for hysterectomy.

Hysterectomy is a surgery that entails partial or complete removal of the uterus in women. In America alone, more than half a million women have a hysterectomy every year. Is it a necessary surgical option? Or are there alternatives that you can condider for various medical conditions?

Some claim that 90% of the hysterectomies are unnecessary and can be avoided. In certain cases, especially cancer, elective hysterectomy is recommended and essential. Hysterectomy can be total (removal of entire uterus and cervix) or partial (ovaries and cervix are left whole). If the ovaries and fallopian tubes are also removed, it is referred to as Bilateral salpingo-oopherectomy or BSO.

When is hysterectomy necessary?

In women with cervical cancer, uterine cancer or ovarian cancer
Excessive or sudden uterine hemorrhage
Severe uterine infection

When is hysterectomy necessary only as a final option?

Uterine fibroids
Endometriosis
Uterine prolapse
Abnormal vaginal bleeding
Adenomysosis (abnormal endometrium growth)
Uterine polyps

In many of these cases, hysterectomy can be avoided and other alternatives should be offered to the patient. Non-surgical options are available and should be considered before opting for hysterectomy. This also helps preserve fertility and prevents complications related to a hysterectomy like early menopause, difficulty in urinating and weakened pelvic muscles.

Be sure to check with your doctor and get a second opinion as a hysterectomy is a permanent procedure. With advancement of medical research, there are increasing number of options now. So spend time to evaluate the options before making any final decisions.

Alternative treatment options for various conditions:

CONDITION	TREATMENT CHOICES
Uterine Fibroids	Medication Myomectomy(removal of fibroids only) Uterine artery embolization (shrinking of fibroids by cutting off blood supply)
Endometriosis	Hormonal contraceptives pills Endoscopic removal of scar tissue followed by medication
Uterine Prolapse	Pessary (device to hold uterus in place) Surgical suspension of uterus Pelvic floor exercises Weight loss Avoiding heavy lifting
Vaginal bleeding	IUD insertion Birth control pills Weight loss in overweight patients Exercises Endometrial ablation
Adenomysosis	Pain medication Birth control pills IUD insertion Uterine artery embolization
Polyps	Surgical removal D&C with hysterectoscopy

So take the time to understand the options available to you and seek a second opinion if need be.

#BeAware #BeEmpowered

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