For information about Gynaecology, laparoscopy, hysterectomy, Gynaecologists

​​​​​Hysterectomy

Hysterectomy is the surgical removal of the uterus, usually for benign disease (such as heavy menstrual bleeding) or malignant disease (such as uterine/endometrial cancer or ovarian cancer). Hysterectomy may be total (removing the "body" of the uterus - see diagrams below - and cervix, the "neck" of the uterus) or subtotal (removal of the uterine body while leaving the cervix intact; also called "supracervical"). The ovaries and fallopian tubes may also be removed or conserved. There may be benefits to this.

 

It is a commonly performed gynecological surgical procedure. However, the number of hysterectomies performed in the UK is falling, because of safe, alternative methods of treating benign gynaecological diseases (such as tablet forms of treatment, use of the hormone-releasing intrauterine device Mirena, and safer forms of endometrial ablation i.e. destruction of the lining of the womb). As a result, fewer gynaecologists routinely perform the procedure. Because the development of "keyhole" techniques requires technical expertise and regular practice, even fewer gynaecologists routinely perform "keyhole" or laparoscopic hysterectomy as part of their standard surgical practice.

 

Hysterectomy is considered when other forms of treatment for benign diseases have been unsuccesful. This includes treatment of heavy periods, certain types of chronic pelvic pain, severe endometriosis and prolapse of the womb/vagina. It may also be recomended for treatment of some "fibroids". In these cases it is only an option if your family is complete.Some helpful links regarding hysterectomy are included as follow (including National Institute for Health & Care Excellence, or NICE, guidance).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hysterectomy may also be recommended for treatment of female or gynaecological cancers. This includes some cervical cancers; uterine or endometrial cancers; ovarian or fallopian tube cancers.

In selected cases, surgery to prevent inherited cancers may be recommended (prophylactic risk-reducing surgery) as the only proven method of reducing cancer risk in susceptible individuals. These types of cancers are rare and surgery should only be performed following advice from a specialised Cancer Genetics Centre team (follow link) and recognised Gynaecological Cancer specialist. (Please note that screening has not been proven to prevent or reduce the risk of either inherited or non-inherited ovarian/fallopian tube cancers; however the majority of cervical cancers are prevented by attending for your scheduled "smear" test). For fallopian tube and ovarian cancer (related to BRCA1 & BRCA2 gene faults) the procedure BSO (Bilateral Salpingo-oophorectomy) may be advised; HNPCC is a very rare inherited condition; one feature is an increased risk of uterine/endometrial cancer. Hysterectomy may be recommended to prevent this developing.