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Hysterectomy

What is a hysterectomy?

A hysterectomy is an operation to remove a woman's uterus, or womb. If you have this done, it means you can't get pregnant any more, or have biological children.

A hysterectomy is a major operation with significant recovery time. It's usually only recommended if there are no other treatment alternatives. For some women, the operation brings relief from symptoms like painful periods or fibroids, but for others, it can be a shock, both emotionally and physically.

How common is hysterectomy?

Hysterectomy is a common procedure in the UK with up to 1 in 5 women having it done by the time they're 55. It's become less common in recent years because of improved treatment alternatives.

What are the types of hysterectomies?

The type of hysterectomy you have will depend on why you need to have the operation. It also depends on how much of the rest of your surrounding reproductive system may need to be removed.

Total hysterectomy – removes the womb as well as the cervix, or neck of the womb. This is usually a preferred choice as it reduces the risk of cervical cancer developing later.

Subtotal hysterectomy – removes the womb but leaves the cervix intact. This operation is less common, but may be done if a woman wants to keep as much of her body intact as possible. Your doctor will discuss the risks involved with you.

Total hysterectomy with bilateral salpingo-oophorectomy – removes the cervix, fallopian tubes and the ovaries along with the womb. According to National Institute for Health and Care Excellence (NICE) guidelines, ovaries should only be removed when the woman is at serious risk of health problems. Some women may opt to have this operation as a 'risk-reducing' surgery if her genetic family history means she's at greater risk of developing breast or ovarian cancer.

Radical hysterectomy – removes the womb and all surrounding tissues, including the ovaries, fallopian tubes, lymph glands, fatty tissues and part of the vagina. This type of operation is also known as Wertheim's hysterectomy and is usually done to treat cancer, when radiotherapy, chemotherapy or other treatments can't be used or aren't working.

Why is a hysterectomy done?

A hysterectomy may be carried out for a number of reasons. They include:

Heavy or painful periods – Some women naturally experience pain and lose a lot of blood during their monthly periods. Fibroids may be the cause, or there may be no obvious cause. A hysterectomy may be carried out if pain and heavy bleeding is severely disrupting your daily life, and as long as a woman doesn't want to have children.

Fibroids - are non-cancerous, fibrous growths that form in and around the womb. They're sometimes called myomas, or leiomyomas. As well as heavy, painful periods, they can cause pelvic or back pain, and discomfort during sex. They can also trigger constipation, or a frequent urge to go to the loo. Fibroids are common, with around 1 in 3 women developing them at some point in their life. Rarely, complications with fibroids can cause pregnancy problems and affect your fertility. If you have persistent, severe pain or bleeding, and you don't want more children, your doctor may recommend a hysterectomy.

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