Hysterectomy is the second most frequent major surgery performed on women in the United States, with about half a million procedures performed each year. For instance, in 1995, approximately 590,000 women in this country underwent the procedure. One in three women will have a hysterectomy by age 60. Annual costs associated with this surgery exceed $5 billion, and there are wide variations in rates of hysterectomy in different parts of the country.
The procedure is performed for a variety of diseases, and, particularly, for cancer of the uterus or ovary. Most women who undergo hysterectomy are between the ages of 35 and 54, with the highest age-specific rate for women 35 to 44 years of age.
Fibroids account for approximately one third of hysterectomies.
Endometriosis accounts for 18% of surgeries.
Cancer of the uterus, the ovaries, or the cervix
Very heavy or irregular bleeding
Stress incontinence (involuntary loss of urine)
Chronic pelvic pain, severe pelvic infection
Emergency heavy bleeding from the uterus after delivery or during surgery
Hysterectomy is the surgical removal of the uterus. It ends menstruation and the ability to become pregnant. Depending on the patient's specific condition, the surgery may also involve removal of other organs and tissue in addition to the uterus. Here are the different procedures:
Total hysterectomy: removal of the uterus, including the cervix
Subtotal hysterectomy: removal of the uterus, leaving the cervix, ovaries, and fallopian tubes in place
Total hysterectomy with bilateral salpingo-oophorectomy: removal of the uterus, cervix, ovaries, and fallopian tubes
Laparoscopic hysterectomy: Hysterectomy is carried out using a laparoscope instead of a large incision.
Vaginal hysterectomy: The uterus is removed through the vagina.
Effects of anesthesia
Damage to nearby organs: bowel or rectum, bladder or ureter
Hemorrhage (bleeding) that may require a blood transfusion
Wound infection, urinary tract infection, bowel obstruction
Incontinence or urinary retention requiring the continued use of a catheter
Vaginal pain, fistula (abnormal passage) between the vagina and bladder or rectum