Hysterectomy

  • Medical Author:

    Dr. Suzanne Trupin is a Clinical Professor of Obstetrics and Gynecology at the University Of Illinois College Of Medicine at Urbana-Champaign. She graduated from Stanford University and completed her medical training at New York Medical in Valhalla, New York. She received her residency training at the University of Southern California Women's Hospital in Los Angeles, California. She is Board-Certified by the American Board of Obstetrics and Gynecology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What tests or treatments are performed prior to a hysterectomy?

A woman must have a pelvic examination, Pap smear, and a diagnosis prior to proceeding with a hysterectomy. Prior to having a hysterectomy for pelvic pain, women might undergo more limited (less extensive) exploratory surgery procedures (such as laparoscopy) to rule out other causes of pain. Prior to having a hysterectomy for abnormal uterine bleeding, women require some type of sampling of the lining of the uterus (biopsy of the endometrium) to rule out cancer or pre-cancer of the uterus. This procedure is called endometrial sampling. Also, pelvic ultrasounds and/or pelvic computerized tomography (CT) tests can be done to confirm a diagnosis. In a woman with pelvic pain or bleeding, a trial of medication treatment is often given before a hysterectomy is considered.

Therefore, a premenopausal (still having regular menstrual periods) woman whose uterine fibroids are causing bleeding but no pain is generally first offered medical therapy with hormones. Non-hormonal treatments are also available, such as tranexamic acid and more moderate surgical procedures, such as ablations (removal of the lining of the uterus). If she still has significant bleeding that causes major impairment to her daily life, or the bleeding continues to cause anemia (low red blood cell count due to blood loss), and she has no abnormality on endometrial sampling, she may be considered for a hysterectomy.

A postmenopausal woman (whose menstrual periods have ceased permanently) who has no abnormalities in the samples of her uterus (endometrial sampling) and still has persistent abnormal bleeding after trying hormone therapy, may be considered for a hysterectomy. Several dose adjustments or different types of hormones may be required to decide on the optimal medical treatment for an individual woman.

Medically Reviewed by a Doctor on 5/4/2015

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