What hysterectomy surgical options are available?

To perform a hysterectomy, the surgeon reaches your internal reproductive organs either through an incision in your lower abdomen, through laparoscopic (keyhole) surgery via small abdominal incisions or vaginally. Hysterectomy is performed under general anaesthetic. The surgeon first cuts the ligaments that keep the uterus suspended in your abdomen, then the supporting structures (pedicles) that attach the uterus to neighboring internal organs, and finally ties off the arteries that supply the uterus with blood.


Your hysterectomy surgical options depend on the amount of time and facilities available, the extent of your disease, the size of your uterus, and the skill of your surgeon.

If your uterus is enlarged it may require a large abdominal incision for removal. Your incision will most likely extend vertically between your pubic bone and your navel to enable the obstetrician to see the internal organs well and to provide adequate room to manipulate the instruments. The scar will be immediately visible because of the size. Abdominal incisions are more painful than vaginal incisions, so your hospital stay will be extended. Most hysterectomies (75%) are performed abdominally.

If your hysterectomy is a planned (elective) operation, as most are, then you have more choices. If your uterus is not greatly enlarged, you may be a candidate for removal:

Your surgeon may remove:


Who requires a hysterectomy?

The incidence of hysterectomy depends on where you live. Hysterectomy is most prevalent in the U.S.A., especially in the Midwest and South among African-American women. Every year, over 550,000 American women have hysterectomies. It is the second most prevalent form of female surgery. Fifty-five percent of hysterectomies are performed on young women between the ages of 35 and 49. One-third of American women experience hysterectomy by the age of 60. The high rate of American hysterectomy has been questioned by foreign observers, who estimate 30% of American hysterectomies are unnecessary.

In recent years, the total number of hysterectomies is decreasing, but more American women under the age of 40 are hysterectomized. For some, it is for prevention of ovarian and uterine cancer due to genetic predisposition. For most, removal of the uterus is the recommended option by physicians because conventional pharmaceutical drug treatments do not adequately treat uterine fibroids, heavy menstrual bleeding and/or endometriosis.



Understand more on Hysterectomy:

What is Hysterectomy & why is it performed?

Hysterectomy preparation & aftercare

Hysterectomy side effects

What is natural progesterone?

Progesterone treatment and side effects

The information in this article has been taken with permission from the official Lawley booklet on Understanding Hysterectomy.