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Definition

Hysterectomy About 10% of hysterectomies are performed to treat cancer of the cervix, ovaries, or uterus. Women with cancer in one or more of these organs almost always have the organ(s) removed as one part of their cancer treatment.

The most frequent reason for hysterectomy in the United States is to remove fibroid tumors, accounting for 30% of these surgeries. Fibroid tumors are non-cancerous (benign) growths in the uterus, which can cause pelvic and low back pain and heavy or lengthy menstrual periods. They occur in 30-40% of women over age 40, and are three times more likely to be present in African-American women than in Caucasian women. Fibroids do not need to be removed unless they are causing symptoms that interfere with a woman's normal activities.

Treatment of endometriosis is the reason for 20% of hysterectomies. The endometrium is the lining of the uterus. Endometriosis is a condition that occurs when the cells from the endometrium begin growing outside the uterus. The outlying endometrial cells respond to the hormones that control the menstrual cycle, bleeding each month the way the lining of the uterus does. This causes irritation of the surrounding tissue, leading to pain and scarring.

Another 20% percent of hysterectomies are done because of heavy or abnormal vaginal bleeding that can not be linked to any specific cause and cannot be controlled by other means. The remaining 20% of hysterectomies are performed to treat prolapsed uterus, pelvic inflammatory disease, and endometrial hyperplasia, a potentially precancerous condition.

Total hysterectomy

A total hysterectomy, sometimes called a simple hysterectomy, removes the entire uterus and the cervix. The ovaries are not removed and continue to secrete hormones. Total hysterectomies are always performed in the case of uterine and cervical cancer. This is the most common kind of hysterectomy.

Sometimes, in addition to a total hysterectomy a procedure called a bilateral salpingo-oophorectomy is performed. This surgery removes the ovaries and the fallopian tubes. Removal of the ovaries eliminates the main source of the hormone estrogen, so menopause occurs immediately. Removal of the ovaries and fallopian tubes is performed in about one-third of hysterectomy operations, often to reduce the risk of ovarian cancer.