Hysterectomy should i keep my cervix

Losing both ovaries means these hormones are also lost abruptly, a condition known as surgical menopause. This sudden loss of female hormones can cause stronger symptoms of menopause, including hot flashes and loss of sex drive. The emotional trauma of hysterectomy may take much longer to heal than the physical effects. If you have a hysterectomy that removes your ovaries, then you should talk about the pros and cons of estrogen therapy with your doctor, Streicher says.

After the ovaries are removed, estrogen therapy can help relieve uncomfortable symptoms of menopause. However, oral hormone therapy carries increased risks of stroke, blood clots like deep vein thrombosis , and heart disease, which you should also discuss with your doctor.

Depending on the condition you are facing, you may be able to keep your uterus intact. Alternatives are out there for about 90 percent of hysterectomies surgeons do, according to Streicher in her book The Essential Guide to Hysterectomy.

Fibroids, for example, may be treated using a nonsurgical procedure called uterine artery embolization that cuts off the fibroids' blood supply. Another option is myomectomy, which removes fibroids but spares the uterus.

For heavy bleeding, an ablation procedure — which freezes or burns the uterine lining — may be a treatment option. Before scheduling a hysterectomy, have a discussion with your doctor about the alternative treatments for your condition. Ask your doctor about minimally invasive surgery, also called laparoscopic or robotic-assisted hysterectomy. This newer type of surgery requires general anesthesia but only uses tiny incisions, causes less blood loss, and comes with shorter hospital stays.

Laparoscopic surgery is used about 45 percent of the time now for hysterectomy, according to Streicher. Table I Characteristics of patients and the procedure. Open in a separate window. Technique of subtotal hysterectomy The patient is placed in a lithotomy position and bladder catheterization is performed.

Photo 1. Photo 2. Photo 3. Delivering the uterine body with myoma from the peritoneal cavity. Photo 4. Photo 5. Photo 6. Photo 7. Results The blood loss and the duration of the surgery were acceptable and did not differ from other vaginal surgeries usually performed in our ward.

Discussion A large meta-analysis of 34 studies that included women, concerning benefits and disadvantages of abdominal, vaginal and laparoscopic hysterectomy, was published in by Nieboer et al. Conclusions It is important to remember that the decision whether to remove or retain the cervix belongs to the patient.

References 1. The evaluate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. Thomas B, Magos A. Subtotal hysterectomy and myomectomy — vaginally. Richardson EH. A simplified technique for abdominal panhysterectomy.

Surg Gynecol Obstet. Total versus subtotal hysterectomy: a survey of gynecologists. Obstet Gynecol. Urodynamic evaluation of lower urinary tract function in relation to total hysterectomy.

Surgical approach to hysterectomy for benign gynecological disease. Cochrane Database Syst Rev. Hysterectomy: indications, alternatives and predictors. Am Fam Physician. Electrosurgery of cervical changes and its place in cervical cancer prophylaxis.

Ginekol Pol. Quality of life and surgical outcome after total laparoscopic hysterectomy versus total abdominal hysterectomy for benign disease: a randomized, controlled trial. J Minim Invasive Gynecol. Identifying the indications for laparoscopically assisted vaginal hysterectomy: a prospective, randomized comparison with abdominal hysterectomy in patients with symptomatic uterine fibroids.

Total laparoscopic hysterectomy compared with abdominal hysterectomy in the presence of a large uterus. J Am Assoc Gynecol Laparosc. Clinical indications for hysterectomy route: patient characteristics or physician preference? Am J Obstet Gynecol. Challenging generally accepted contraindications to vaginal hysterectomy. Supravaginal uterine amputation vs. Effects on libido and orgasm.

News Corp is a global, diversified media and information services company focused on creating and distributing authoritative and engaging content and other products and services. Dow Jones. By Laura Johannes. To Read the Full Story. Subscribe Sign In. Total hysterectomy with bilateral salpingo-oophorectomy A total hysterectomy with bilateral salpingo-oophorectomy is a hysterectomy that also involves removing: the fallopian tubes salpingectomy the ovaries oophorectomy The National Institute for Health and Care Excellence NICE recommends that the ovaries should only be removed if there's a significant risk of further problems — for example, if there's a family history of ovarian cancer.

Your surgeon can discuss the pros and cons of removing your ovaries with you. Radical hysterectomy A radical hysterectomy is usually carried out to remove and treat cancer when other treatments, such as chemotherapy and radiotherapy , are not suitable or have not worked. During the procedure, the body of your womb and cervix is removed, along with: your fallopian tubes part of your vagina ovaries lymph glands fatty tissue Performing a hysterectomy There are 3 ways a hysterectomy can be performed.

These are: laparoscopic hysterectomy vaginal hysterectomy abdominal hysterectomy Laparoscopic hysterectomy Laparoscopic surgery is also known as keyhole surgery. Laparoscopic hysterectomies are usually carried out under general anaesthetic. Vaginal hysterectomy During a vaginal hysterectomy, the womb and cervix are removed through an incision that's made in the top of the vagina. A vaginal hysterectomy can either be carried out using: general anaesthetic — where you'll be unconscious during the procedure local anaesthetic — where you'll be awake, but will not feel any pain spinal anaesthetic — where you'll be numb from the waist down A vaginal hysterectomy is usually preferred over an abdominal hysterectomy as it's less invasive and involves a shorter stay in hospital.

Abdominal hysterectomy During an abdominal hysterectomy, an incision will be made in your tummy abdomen. It may also be recommended if your ovaries need to be removed.

Getting ready If you need to have a hysterectomy, it's important to be as fit and healthy as possible. As soon as you know you're going to have a hysterectomy: stop smoking eat a healthy, balanced diet exercise regularly lose weight if you're overweight You may need to have a pre-assessment appointment a few days before your operation.