10 Surprising Facts about Hysterectomy

Over 500,000 women in the United States have a hysterectomy each year, but there is still a lot that people do not know about the operation. Even women having the surgery sometimes come out of it to find that it was not what they thought it was. Do you know how many organs are removed during a hysterectomy? Do you know why women have a hysterectomy? Get your surprised face ready—here are ten surprising facts that you may not know about hysterectomy:

1. Hysterectomy is the second-most common surgery performed on reproductive-age women.

The only surgery performed more frequently is cesarean section. 1 in 3 women in the United States will have a hysterectomy by the age of 60. Over 22 million women have had a hysterectomy. According to ACOG, there are about 500,000 inpatient hysterectomies performed each year in the United States—down from over 600,000 in 1980 (a).

Because this surgery is so common, it is important to know your facts and, more importantly, your options. If a doctor suggests a hysterectomy, make sure you get a second opinion from a specialist in your particular diagnosis. In today’s techonologically advancing medical environment, there is a good chance that there is an alternative treatment option.

2. By definition, a hysterectomy is the removal of only one organ—the uterus.

Women often describe their surgery as a “complete hysterectomy,” believing that this includes their ovaries and fallopian tubes, too. Not so. Because a hysterectomy is the surgical removal of the uterus (aka womb)—a complete hysterectomy refers only to the removal of the complete uterus. A partial hysterectomy means that only the top part of the uterus (the fundus) is removed, leaving the cervix in place at the top of the vagina. The removal of the whole uterus, both tubes, and both ovaries that many confuse as a “total hysterectomy” is actually called a total hysterectomy with bilateral salpingo and oophorectomy.

If you are scheduled for a hysterectomy, be sure you talk to your doctor/surgeon before your surgery about what is being removed during your surgery. You don’t want any surprises in your surgical report.

3. Many women can choose to keep their ovaries.

Many women feel like they should remove their ovaries when they have their hysterectomy, but this is not always the best plan. If there is no family history of ovarian cancer, breast cancer, or other ovarian disease, women do have the option of retaining their ovaries. According to CDC data, over half of the women who had a hysterectomy between 1994 and 1999 had a bilateral oophorectomy, most of which were performed on women with benign diagnoses (b).

The estrogen produced by the ovaries is vital for overall health. So while removing ovaries can reduce the risks of ovarian and breast cancer, keeping the ovaries can help prevent many other diseases and health conditions such as heart disease, lung cancer, dementia, osteoporosis, sexual dysfunction, and death. Before making any decisions about removing or keeping ovaries, talk carefully with your doctor about the pros and cons of either decision. Be open, honest, and thorough about your personal and family medical history in order for the doctor to make the most informed recommendation.

Comparing stats from 2004 to 2013, HysterSisters.com reports these changes from 169,000 member responses:

255% increase in laparoscopic hysterectomy
52% decrease in abdominal hysterectomy
35% increase in “keeping ovaries during hysterectomy”

4. Many women can choose to keep their cervix.

At HysterSisters.com, statistics show that about 18 percent of women who have a hysterectomy choose to keep their cervix, removing only the upper portion of the uterus—known as a partial or supra-cervical hysterectomy (c). Because there is no vaginal cuff, retaining the cervix can make for an easier, quicker recovery with less risk of infection. Some believe that the cervix could also help maintain the pelvic floor and sexual satisfaction. On the downside, keeping the cervix could also mean “mini” periods, the risk of cervical cancer, and further surgery.

5. Hysterectomy technology is behind the times.

Despite how frequently hysterectomies are performed, many women today are still having the same hysterectomy their mothers and grandmothers had—with an open abdominal incision. While the rest of the medical community has adopted minimally invasive options, and most women are eligible for minimally invasive hysterectomy, nationwide statistics indicate that about 60 percent of all hysterectomies are open incision (d). HysterSisters.com, however, reports less than 30 percent of women receiving open incision hysterectomy—opting for either a vaginal or laparoscopic procedure (c). Since the introduction of the daVinci robot in 2008, the number of laparoscopic hysterectomies alone has grown from 14 percent in 2004 to nearly 53 percent in 2013.

Not all surgeons offer minimally invasive surgery. If you are scheduled for an abdominal hysterectomy, you might ask if you are a candidate for laparoscopic surgery. It could be that you are eligible, but that particular surgeon does not have the option available. If that is the case, you could consider finding another surgeon who can perform the less invasive surgery type.

6. Hysterectomy can be done as an outpatient procedure.

According to ACOG, 18 percent of all US hysterectomies in 2005 were performed as same-day, outpatient procedures (meaning the patient can go home within 23 hours of surgery) (a).
This percentage is raising rapidly for laparoscopic and vaginal hysterectomies; in some hospitals as high as 80 percent of all laparoscopic and vaginal hysterectomies are considered outpatient surgeries (e). Be sure to ask your doctor when you will be able to go home after your surgery. Depending on your diagnosis and contingent on surgery going smoothly, you could get to go home within 23 hours.

7. A hysterectomy does not cure endometriosis.

Contrary to common belief, endometriosis does not depend on the uterus to survive. If implants are left behind on other organs after the uterus is removed, endometriosis can continue to spread. The best treatment for endometriosis is the the careful excision of all endometrial implants, but even so, there is no permanent solution. Still, endometriosis remains as one of the top reasons for hysterectomy (a).

Women are strongly recommended to see an endometriosis specialist before they consider having a hysterectomy. If there is not a specialist available in your area, and you are able to travel, it can definitely pay off to see a specialist who practices excision and/or other alternatives to hysterectomy for endometriosis.

8. Many women grieve the loss of their womb after a hysterectomy.

Many women who prematurely lose the ability to have long-desired children, feel a great deal of grief at the loss of their womb. But even women who have had children, even if those children are grown, sometimes find themselves grieving over the loss of the womb that carried those children. Here are some sentiments from HysterSisters members:

“I’m feeling depressed for losing my ability to have children, empty because I have no other children in my life, and guilty for not giving my mom the grandchildren she always wanted.”

“I am absolutely heartbroken at the thought that I will never have children. How can I get beyond the thought of losing these ‘children of my heart’?”

“Ever since I heard I had to have a hysterectomy, I feel like a part of me is isolated in a world of fear and nobody can reach me. Why is this so hard?”

“I have a wonderful thirteen-year-old son that I thank God for, but I have wanted another child since he was two. Everybody keeps saying, ‘just be grateful for the one you have.’ I am, but I still have days where I just sit and think ‘what if?'”

9. Hysterectomy is the most-invasive treatment for uterine fibroids.

Myomectomy, uterine embolization, MRI-guided focused ultrasound surgery (MRgFUS), myolysis, and ablation are all less-invasive treatment options for uterine fibroids. In mild cases, no treatments are necessary. These alternative treatments have brought down the number of hysterectomies for fibroids from 44 percent in 2000, to 33 percent in 2008 (a).

Before you schedule a hysterectomy for fibroids, be sure you have explored some of these other options. If your doctor does not provide them, don’t be shy about seeking out a doctor who does.

10. Most hysterectomies are elective.

It is estimated that up to 90 percent of hysterectomies may be unnecessary (f). There are several life-threatening conditions that do make it necessary (e.g. aggressive cancers, birth complications, infections, unmanageable bleeding), but most women have a hysterectomy for issues that have other, less invasive treatments. Fibroids, endometriosis, prolapse, and even some non-invasive cancers can be treated without removing the uterus. To avoid an unnecessary hysterectomy, HysterSisters strongly recommends getting a second opinion before making a final decision.

For such a common surgery, many of these basic facts go either unnoticed or misunderstood. As a patient advocacy group, HysterSisters aims to provide accurate, useful information so that women facing gynecological issues can make informed decisions for their health now and in the future.

(a) American Congress of Obstetricians and Gynecologists: 2011 Women’s Health Stats and Facts
(b) CDC—Hysterectomy Surveillance
(c) HysterSisters Hysterectomy Trends
(d) Nationwide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches.
(e) Outpatient laparoscopic hysterectomy reported to be safe
(f) National Women’s Health Network—Hysterectomy in the United States: Facts and Figures

Republished by permission from HysterSisters.com

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