Hysterectomy is one of the commonest type of surgery done in women. In this surgery the uterus and cervix are removed. There are many diseases for which hysterectomy may be done. Some of the common disorders which necessitate hysterectomy include:
Hysterectomy is usually considered only after all other treatment approaches have been tried without success.
Fibroids: This is the most common disease for which hysterectomy is done. Fibroid is a benign (non-cancerous) tumour which grows in the muscle of the uterus. In many women fibroids are small and cause minor symptoms –these fibroids do not need treatment. In some cases it may grow big in size and may be associated with heavy bleeding and pain. Fibroids can be treated with medications or surgery. Recent advances in treatment of fibroids include uterine artery embolisation, which blocks the blood supply to the tumours.
Interruption of blood supply causes the fibroids to shrink over time this relieves symptoms such as pain and heavy bleeding. Fibroids mostly shrink in size after menopause. If medications or procedures to remove the fibroids are not effective, hysterectomy may be needed to cure fibroids. Indications of need for hysterectomy for fibroids include big size (usually greater than the size of an eight month pregnancy), pressure or pain due to the fibroids, and/or bleeding severe enough to produce anaemia.
Prolapse of the uterus: In women with prolapse, the uterus slides from its normal position (in the pelvis) into the vaginal canal and may even come out of the vagina. It may cause urinary and bowel problems, or difficulty with bowel movements and pelvic pressure.
Cancer of the uterus, ovary, cervix, or endometrium: Hysterectomy may be done for cancers of female genital tract (such as cancer of the uterus, ovary, cervix, or endometrium). Endometrium is the tissue that lines the insides of the uterus. In women with early stage cancer, hysterectomy may be the best option.
Endometriosis: It is a painful disorder which occurs when normal endometrial tissue (tissue that normally lines the inside of your uterus) grows outside the uterus. Women with severe endometriosis, may be recommended hysterectomy. The ovaries are also removed as hysterectomy alone is not effective (oestrogen is produced by the ovaries and if they are not removed, it can stimulate any remaining ectopic endometrial tissue and cause pain to persist).
Abnormal vaginal bleeding: There are many causes of abnormal vaginal bleeding (such as changes in hormone levels, infection, cancer, or fibroids)—treatment depends on the cause. Bleeding may be controlled with medications. Women who do not respond to medications may need hysterectomy.
Adenomyosis: In this condition, the endometrium (tissue that lines the inside of uterus) grows inside the walls of the uterus. It can cause severe pain and bleeding. If other treatments fail to improve symptoms, hysterectomy may be required for cure.
Chronic pelvic pain: In some women chronic pelvic pain may come from the uterus. If medications and other treatments fail to improve the symptoms, hysterectomy may be done as a last resort.
Following caesarean delivery: In rare cases the uterus may bleed profusely after caesarean delivery. Hysterectomy may be done to control bleeding if other methods fail to control bleeding.
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