Partial Hysterectomy

A hysterectomy is a surgical procedure in which the surgeon removes part or all of a woman\’s reproductive organs – uterus, cervix, fallopian tubes and ovaries. A total hysterectomy remove all of these, a radical hysterectomy also remove the fallopian tubes, top portion of the vagina and lymph nodes. In contrast a partial hysterectomy usually only removes the uterus.

Both a full and radical hysterectomy are often used for disease processes which may invade or take over all or part of the reproductive system, such as cancer or endometriosis. A partial hysterectomy is often used in the treatment of fibroids and other conditions which cause severe and uncontrollable vaginal bleeding.

A partial hysterectomy can be performed either vaginally or abdominally. This means that the uterus can be removed through the vagina in instances where it is small enough to do so. However, the most common method it is an abdominal approach which is done much like a C-section. The uterus is detached from its blood supply and the ligaments which support it and then removed from the body.

Using an abdominal approach the surgeon is able to visualize the other reproductive organs and determine whether or not there is need for others to be removed. However, there is a more significant recovery time when the procedure is done abdominally and not vaginally and there will be a significant incision that will leave a visible scar.

Unfortunately, it is impossible for a vaginal hysterectomy to remove large fibroids. The physician also finds it diffficult to visualize an approach and will often use a laparoscope in order to visualize the abdominal cavity during surgery. Anesthesia is often general for either a vaginal approach for an abdominal incision.

A hysterectomy is the second most common operations performed in the United States today. Approximately 556,000 of them are done annually and by age 60, one out of every three American women will have one. Unfortunately, researchers also estimate that at least 30% of them are also unnecessary. Despite the high numbers only 10% of hysterectomies are performed to treat cancer of the cervix, uterus or ovaries. The most frequent reason is the removal of fibroids tumors which accounts for 30% of the reason a hysterectomy is performed.

Another 20% of the time a hysterectomy is performed for the treatment of endometriosis. This is a condition that occurs when the cells which lined the uterus begin growing outside of the uterus. The remainder of the hysterectomies are done for heavy or abnormal bleeding and to treat a prolapsed uterus, pelvic inflammatory disease or a potentially precancerous condition.

Even though a partial hysterectomy will spare the ovaries, in other words the surgeon leaves the ovaries in place, the blood flow to these organs will gradually stop. Therefore the women will still experience side effects from hormonal changes and menopause. The consequences will include hot flashes, headaches, weight gain, urinary tract problems, decreased sex drive, irritability and osteoporosis. Other symptoms, which women reported, included depression, mood swings, dizziness and nervousness, fatigue, hair loss, headaches and heart palpitations. Women also reported symptoms that they had not experienced prior to surgery, including insomnia, joint pain, memory lapses, vaginal dryness and painful intercourse

Women who undergo a partial hysterectomy are also at risk for side effects following surgery related to the surgery itself. These can include bowel or bladder injuries or infection to those organs, adhesion, infections along the incision line, hemorrhaging and reactions to the anesthesia. Because this surgery has been done numbers of times across the United States, more surgeons are well-versed and experienced in the procedure. Hysterectomies are now relatively safe operations, although it remains a major surgery that continues to carry risks.

Although there is some concern by researchers for the number of hysterectomies which are performed, and the 30% which they believe are unnecessary. Results from the Maine Woman\’s Health Study revealed that 71% of the women who had had a hysterectomy to correct symptoms reported feeling better mentally, physically and sexually after the operation.

A partial hysterectomy is a permanent and irreversible surgery that may bring about unwanted side effects. More and more physicians recommend that unless there is a life-threatening condition the woman may consider other treatment options.

(1) Obstetrics and Gynecology: The Maine Women\’s Health Study

RESOURCES

WomensHealth.gov: Hysterectomy Fact Sheet

MayoClinic.com: Abdominal Hysterectomy