A total hysterectomy is a surgical procedure that involves the removal of both the uterus and the cervix. The uterus is also known as the womb. This procedure is a common treatment for various conditions affecting the female reproductive organs.
What a Total Hysterectomy Entails
A total hysterectomy involves the surgical removal of the entire uterus and the cervix. The uterus is the hollow, pear-shaped organ where a fetus develops during pregnancy, and the cervix is the lower, narrow part of the uterus that connects to the vagina.
While a total hysterectomy refers specifically to the removal of the uterus and cervix, other reproductive organs, such as the ovaries and fallopian tubes, may also be removed during the same surgical session. When both ovaries and fallopian tubes are removed, the procedure is called a bilateral salpingo-oophorectomy. This additional procedure is often performed concurrently with a hysterectomy but is not inherently part of the definition of a total hysterectomy. The decision to remove these additional organs depends on the specific medical condition, the individual’s age, and other health factors.
Clarifying Hysterectomy Types
Hysterectomies are categorized based on which parts of the reproductive system are removed. A supracervical or partial hysterectomy involves removing only the upper part of the uterus, leaving the cervix intact. This procedure is sometimes chosen when treating non-cancerous conditions like fibroids or endometriosis.
In contrast, a radical hysterectomy is a more extensive operation, typically performed for certain cancers, such as cervical cancer. This procedure removes the uterus, cervix, the upper part of the vagina, and surrounding tissues, including ligaments and sometimes lymph nodes. This broader removal aims to eliminate any potential spread of cancer cells.
Reasons for the Procedure
A total hysterectomy is often recommended to treat various gynecological conditions when less invasive treatments have not been successful. Common reasons include uterine fibroids, which are non-cancerous growths in the uterine wall that cause heavy bleeding, pain, or pressure. Endometriosis, where tissue similar to the uterine lining grows outside the uterus, and adenomyosis, where this tissue grows into the uterine wall, can also necessitate a hysterectomy if symptoms are severe.
Uterine prolapse, which occurs when the uterus descends into the vaginal canal due to weakened pelvic floor muscles, is another condition that can be resolved with a hysterectomy. Persistent abnormal uterine bleeding that cannot be managed by other methods may also lead to the recommendation of a total hysterectomy. The surgery is also a treatment option for gynecological cancers, including cancers of the uterus, cervix, and ovaries, or for precancerous conditions.
Post-Procedure Considerations
After a total hysterectomy, several physiological changes occur due to the removal of the uterus and cervix. These include the cessation of menstruation and the permanent loss of the ability to carry a pregnancy.
If the ovaries are also removed during the procedure (bilateral salpingo-oophorectomy), individuals will experience surgical menopause immediately, regardless of their age. This rapid onset of menopause can lead to symptoms such as hot flashes, vaginal dryness, and mood swings due to the sudden drop in hormone levels. If the ovaries are left intact, they typically continue to produce hormones, potentially delaying or mitigating menopausal symptoms, though some hormonal changes may still occur. The body’s internal organs will also shift slightly to fill the space where the uterus once was.