In this Article

• What is a hysterectomy?
• How common is hysterectomy?
• Why is a hysterectomy performed?
• What tests or treatments are performed prior to a hysterectomy?
• How is a hysterectomy performed?
• What are the types of hysterectomies
• Total abdominal hysterectomy
• Vaginal hysterectomy
• Laparoscopy-assisted vaginal hysterectomy
• Supracervical hysterectomy
• Laparoscopic supra cervical hysterectomy
• Radical hysterectomy
• Oophorectomy and salpingo-oophorectomy (removal of the ovaries and/or Fallopian tubes)
• What are complications of a hysterectomy?
• What are the alternatives to a hysterectomy?
• Should women who have had a hysterectomy continue to have PAP smears?
• Patient Discussions: Hysterectomy - Describe Your Experience
• Hysterectomy Index

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 usually 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 make a firm 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.

Hysterectomy - Describe Your Experience

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Suggested Reading by Our Doctors

• Pap Smear - Read about Pap smear, a test to screen for cervical cancer, and precancerous changes in the cervix. Risk factors for abnormal Pap include HPV, smoking medicaitons, and a weakened immune system.
• Ovarian Cancer - Get information on ovarian cancer symptoms, diagnosis, tests, staging, research, surgery and risk factors. Treatment options include surgery, chemotherapy and radiation.
• Endometrial Ablation - Read about endometrial ablation, a procedure performed to treat abnormal bleeding of the uterus. During the procedure the lining tissues of the uterus are destroyed.

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