Gynecology refers to the surgical specialty dealing with health of the female reproductive system (uterus, vagina and ovaries).
Procedures performed include (but are not limited to):
A hysterectomy is a surgical procedure where the uterus is removed through an incision in the abdomen. As part of the hysterectomy, the fallopian tubes and cervix may also be removed. A total hysterectomy is removal of the entire uterus and the cervix. A radical hysterectomy is the removal of the uterus, the tissue on both sides of the cervix, and the upper part of the vagina. A hysterectomy may be done through an abdominal incision (abdominal hysterectomy), a vaginal incision (vaginal hysterectomy), or through laparoscopic incisions (small incisions on the abdomen -- laparoscopic hysterectomy). Your provider will help you decide which type of hysterectomy is best for you. It will depend on your medical history and the reason for your surgery.
Why the procedure Is performed
There are many reasons a woman may need a hysterectomy. But, there may be ways to treat your condition that do not require this major surgery. Your condition may be helped with less invasive surgery. Talk with your doctor about your treatment options.
After having their uterus removed, many women will notice changes both in their body and in how they feel about themselves. Talk with your doctor, your family, and your friends about these possible changes before you have surgery.
Hysterectomy may be recommended for:
- Tumors in the uterus, like uterine fibroids
- Cancer of the uterus, most often endometrial cancer
- of the cervix or a precancerous condition of the cervix called cervical dysplasia
- Cancer of the ovary
- Endometriosis, when your pain is severe and other treatments have not helped
- Severe, long-term (chronic) vaginal bleeding that cannot be controlled by medicines
- Prolapse of the uterus. A prolapsed uterus slips down into the vagina.
- Adenomyosis. This condition occurs when the tissue that lines the uterus grows inside the walls of the uterus.
- Chronic pelvic pain
- Complications during childbirth, like bleeding that cannot be controlled
Complete recovery may take two weeks to two months. Recovery from a vaginal or laparoscopic hysterectomy is faster than recovery from an abdominal hysterectomy. It may also be less painful. Average recovery times are:
- Abdominal hysterectomy -- 4-6 weeks.
- Vaginal hysterectomy -- 3-4 weeks.
If your ovaries are also removed and you have not gone through menopause yet, this surgery will cause menopause. Your doctor may recommend estrogen replacement therapy.
Some women worry that their sexual function will decrease after their uterus is removed. Sexual function after a hysterectomy depends mostly on what sexual function was like before the surgery.
Ovary Removal Surgery (Oophorectomy)
Ovary removal surgery, is the surgical removal of one or both ovaries. The surgery is performed to remove ovaries affected by cancer, to remove the source of estrogen that may stimulate some cancers, to remove large ovarian cysts, and to treat endometriosis.
What are the reasons to have an oophorectomy?
About 10% of women who have a hysterectomy also have a condition or disease that may increase the need for an oophorectomy. These conditions or diseases include:
- Heredity (inherited) diseases: Women who have certain abnormal genes (known as BRCA1 and BRCA2) have an increased risk for developing ovarian cancer before age 70. These women often develop cancer around age 45, which is about 20 years earlier than women who do not have these genes. If your mother or sister has had ovarian cancer, or you know that you have an abnormal BRCA gene, you may consider having your ovaries removed. You will not be able to become pregnant after having this surgery. And your risk for developing ovarian cancer will drop to nearly zero. Your breast cancer risk will also be lower. Talk to your doctor to decide if this choice is right for you.
- Breast cancer: Hormones produced by the ovaries increase the risk of breast cancer. Oophorectomy may reduce the risk of breast or ovarian cancer in women who have the abnormal genes BRCA1 or BRCA2. Oophorectomy is sometimes recommended to treat breast cancer, because it eliminates the hormones produced by the ovaries.
- Suspected disease: When a premenopausal woman is scheduled to have one ovary removed during the surgical removal of the uterus (hysterectomy) because disease is suspected, removal of both ovaries may be recommended if disease is found.