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Hysterectomy: What you need to know

Posted at 11:39 AM, Jul 18, 2018

In the Midlife, Menopause and Sexual Health facility, the topic of hysterectomy often comes up. While it's a scary topic, it can help women suffering from symptoms like heavy bleeding or pelvis pain.

Nationally recognized menopause specialist Dr. Diana Bitner from Spectrum Health, talks about the different types of hysterectomies and how they can help relieve horrible symptoms.

Dr. Bitner says in order to understand a hysterectomy, women need to visualize the uterus like a balloon in the pelvis. It can expand when it holds a baby, or can expand with fibroids-benign uterine tumors. The cervix is the opening of the uterus, and the fallopian tubes come off each corner at the top of the uterus. The ovaries are outside the uterus and attached to the side of the pelvis and loosely also to the uterus.

There are different types of hysterectomy, named for what is actually removed:

  • Total Hysterectomy:  Removal of the uterus and cervix, and a sub-total or supra cervical means the cervix is left and just the uterus is removed.
  • Partial Hysterectormy: When the ovaries and tubes are removed, it is named a “hysterectomy with removal of ovaries and tubes, or bilateral (both sides) salpingo(tube) oophrectomy(ovaries).
  • Radical Hysterectomy: Done for cancer, and includes the top of the vagina as well as all the connective tissues out to the wall of the pelvis and sometimes lymph nodes as well.

Knowing what a hysterectomy is can be helpful, but why is a more important question. It is the most common female surgery done in the US and should not be taken lightly. It can be expensive, certainly has some risks, and for the correct reasons, can drastically improve the quality of life for a woman. Hysterectomies can be done for many reasons when other options have been tried and fail.

Here are possible reasons why a woman would need to get a hysterectomy:

  • Uterine fibroids (benign tumors)-due to bleeding or ‘bulk symptoms’ pressure or pain
  • Uterine prolapse-sliding out of the uterus
  • Cancer of the uterus or cervix or ovaries
  • Endometriosis
  • Chronic pelvic pain
  • Adenomyosis

There are several types of hysterectomy:

There are different ways to get to the uterus in a hysterectomy. The left is more invasive, whereas the right is a less-invasive.

  • Open surgery hysterectomy: involves a large scar, less common now, requires more time in hospital and longer recovery.
  • Vaginal hysterectomy: removed through the vagina, cervix and uterus, possible the tubes and ovaries as well.
  • Laparoscopic hysterectomy: using straight instruments through 2-4 small openings in the belly wall.
  • Robot-assisted Laparoscopic: using instruments with wrist movement ends attached to a robot and operated by the surgeon next to the bedside, for more complicated procedures, saves an open surgery from having to be performed

With or without removal of ovaries and tubes: removal of the ovaries before menopause can result in early menopause and this should always be questioned. Premature menopause has risks of early heart disease and sudden and dramatic symptoms if not treated with post-surgery hormone medication. Sometimes ovary removal is necessary for cancer treatment or severe endometriosis, and it is important to be prepared.

Dr. Bitner's office is located at 3800 Lake Michigan Drive Northwest, Suite A. To schedule an appointment with her, call (616)-267-8225.

All information was provided by Dr. Diana Bitner, her blog. Read more.