Six Conditions that May Warrant Hysterectomy

Certain symptoms that arise from uterine pathology can become severe and debilitating. Chronic pain, abnormal bleeding, anemia and bowel or bladder dysfunction are common in women suffering from severe uterine pathology, like fibroids, polyps or adenomyosis. Many times there are minor office or outpatient procedures to remedy the condition, but if these treatments fail, removing the uterus can solve the problem, eliminating pain and bleeding. 

At Physicians for Women — Melius, Schurr & Cardwell in Madison, Wisconsin, our team of OB-GYN specialists can help determine if a hysterectomy is an option you should consider.

Types of hysterectomies 

Hysterectomies are more common than you might think; they’re the second-most common surgery performed by OB-GYNs after Cesarean section delivery. Hysterectomy is a generalized term. Several modifications of the surgery exist. The type of hysterectomy chosen takes into account your health and past medical and surgical histories in order to accomplish the removal of your uterus as safely as possible.

A Total hysterectomy involves removing the entire uterus and the cervix. Supracervical hysterectomy only removes the upper part of the uterus, leaving the cervix intact. Abdominal, vaginal, laparoscopic and robotic are all different surgical approaches to a total hysterectomy. A supracervical hysterectomy, which is often selected as a way to preserve the supportive system of the pelvic floor, can be approached abdominally, laparoscopically or robotically. Sometimes removal of the fallopian tubes and ovaries (called a bilateral salpingo-oophorectomy) is needed as well, as a part of the hysterectomy surgery..

All of our Board-Certified OB-GYNs at Physicians for Women counsel their patients extensively on their surgical treatment options, including the type and surgical approach to hysterectomy, if recommended. We also discuss the surgical risks of each option.

Six GYN Conditions that may warrant Hysterectomy 

A hysterectomy is a major surgical procedure. It is performed in the hospital Operating Suite with an Anesthesiologist providing general anesthesia and one, sometimes two, of our OB-GYNs operating together, to perform the surgery. By removing the uterus, the procedure addresses many uterine conditions that often result in a restoration of your health, allowing you more freedom, and occasionally even saving your life in situations where cancer, profound anemia or infection is a present. Here are six of the most common conditions that may warrant hysterectomy: 

1. Endometriosis- a condition that can only truly be diagnosed by visualization of the pelvis. Ultrasound and clinical exams can be suggestive but are not diagnostic.Endometrial cells adhere to surfaces within the pelvis and grow to cause pain, scarring and bleeding. If the endometriosis invades into the walls of the uterus, it’s called adenomyosis and can only be diagnosed and often treated by uterine removal, or hysterectomy.
2.  Abnormal uterine bleeding (AUB) - heavy periods or protracted irregular bleeding which can result in anemia, transfusions, extreme fatigue, shortness of breath and potential cardiac compromise.
3. Pelvic support problems (uterine and vaginal wall prolapse), which cause symptoms such as stress urinary incontinence and pelvic pain, painful intercourse or present with a noticeable bulge at the opening to the vagina (introitus). This condition is more common in post-menopausal women and in women who have had multiple vaginal births.
4. Chronic pelvic pain- sometimes caused by endometriosis, adhesions or past  pelvic inflammatory disease (PID)
5. Uterine fibroids - benign smooth muscle tumors involving the uterine myometrium. The condition is common; about 1in 3 women will have at least one fibroid.They can be small and innocuous or large, elicit heavy menstrual bleeding and compression of other pelvic structures, like your bladder and intestines. Sometimes small fibroids are problematic if they protrude into the uterine cavity as they tend to be vascular and bring about heavy bleeding.
6. Cancer - endometrial and ovarian cancers are managed with hysterectomy and may also warrant lymph node sampling and directed biopsies. Hysterectomies for cancer are typically performed by a GYN Oncologist.

If you’ve questions about these conditions and need more information about hysterectomy.  Call our office 608-218-4835, or book an appointment online with one of our OB-GYNs.