It’s Not Your Mother’s Hysterectomy

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Double board-certified physician in OB/GYN and Maternal-Fetal Medicine Dr. Kecia Gaither offers tips on understanding hysterectomy surgery today

Dr. Kecia Gaither

With the advent of refined diagnostics and minimally invasive procedures, today’s hysterectomy is not your mother’s hysterectomy.

Years ago it was commonplace for women reaching middle age to undergo hysterectomy as a matter of course for “female problems,” and the surgery itself typically involved a large incision and a long recovery. But with the advent of refined diagnostics and minimally invasive procedures, today’s hysterectomy is not your mother’s hysterectomy, says perinatal consultant and women’s health expert Kecia Gaither, MD.

First performed in England in 1843, hysterectomy is still the most common non-pregnancy-related major surgery done on American women. A surgical procedure that removes the uterus and cervix – and for some conditions, also the ovaries and fallopian tubes – about 600,000 hysterectomies are performed each year in the United States, according to the U.S. Centers for Disease Control and Prevention.

“At one time, women and their doctors considered hysterectomy a ‘cure’ for almost everything that might affect a woman in her 40s or 50s – not only heavy periods and other so-called ‘women’s ailments,’ but even fatigue and depression,” explains Dr. Gaither.

“But we’ve left those days behind,” she adds. “Not only don’t we prescribe hysterectomy for any random women’s problem, but if you and your doctor decide a hysterectomy is the right approach for you, you can benefit from huge strides made in medicine since your mother’s hysterectomy.”

Modern reasons for hysterectomy
What are the most common reasons for a hysterectomy in this day and age? Dr. Gaither says they include:

  • Fibroids, benign tumors in the uterus that can increase in size and number during the reproductive years, often causing bleeding and discomfort
  • Genital prolapse, significant weakening of the muscles and ligaments supporting the uterus, causing vaginal pressure, urine leakage, low back pain and other problems
  • Cancer of the reproductive organs, including the uterus, cervix or ovaries

Not all cases of these conditions require hysterectomy, Dr. Gaither notes. “Surgery may be the best option, depending on levels of pain, discomfort, bleeding and/or the condition’s overall health threat to a patient. Often there’s a better option than hysterectomy, but it’s useful to have in our arsenal if other treatments aren’t appropriate or effective.”

Types of hysterectomy procedures
Hysterectomy surgery today can be performed in several different ways, depending on the condition it’s treating and the surgeon and woman’s preferences. What are the options?

  • Traditional “open” surgery (Laparotomy) -- using a long horizontal incision along the woman’s pelvis.
  • Vaginal hysterectomy, which removes the uterus and cervix through the vagina.
  • A combination of laparoscopic (small incisions made into the abdomen, via a laparoscope, to cut the ligaments holding the uterus in the pelvis) and vaginal techniques to perform the hysterectomy (the freed uterus is then moved vaginally).

“Your mother’s hysterectomy didn’t give her the options that today’s hysterectomy does,” says Dr. Gaither. “Surgical advances have enabled us to perform most hysterectomies today through a few tiny incisions, translating to less pain, shorter hospital stays and shorter recovery times for you.”

Kecia Gaither, MD, MPH, FACOG, a perinatal consultant and women’s health expert, is a double board-certified physician in OB/GYN and Maternal-Fetal Medicine in New York City. http://www.keciagaither.com

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