A hysterectomy is a surgery that removes female reproductive organs. For some women, a hysterectomy is the right treatment option to help find lasting relief for several medical conditions.
The Newton-Wellesley OB/GYN team of physicians has many years of experience helping women decide on the best course of treatment, including hysterectomies. With customized treatment plans and two convenient office locations in Newton and Walpole, Massachusetts, the team provides top-quality medical support when you need it.
Reasons to Have a Hysterectomy
The Newton-Wellesley OB/GYN team of physicians perform abdominal, transvaginal, and laparoscopic hysterectomies to treat a range of medical conditions, including:
- Uterine Prolapse
- Chronic Pelvic Pain
- Gynecologic Cancer
- Abnormal Vaginal Bleeding
After a hysterectomy, you no longer have menstrual periods and can’t become pregnant. If you aren’t ready to end your fertility, you should consider other treatments.
Diagnostic Tests Before Hysterectomy
Before you are scheduled for a hysterectomy, your doctor may order some diagnostic tests to check for cancer. These tests include
Pap Smear. This is done to detect the presence of abnormal cervical cells or cervical cancer.
Endometrial Biopsy. This is done to detect abnormal cells in the uterine lining or endometrial cancer.
Pelvic Ultrasound. This is done to show the size of uterine fibroids, endometrial polyps, or ovarian cysts.
Results from these tests will help your surgeon determine the type of hysterectomy you need.
Types of Hysterectomy
The type of hysterectomy you have will depend on numerous factors, including why you’re having a hysterectomy, if there’s a need to explore the upper abdomen, and the size of your uterus.
Partial Hysterectomy. In a partial hysterectomy, your surgeon removes your uterus and leaves the cervix intact.
Supracervical or Subtotal Hysterectomy. In a supracervical hysterectomy, your surgeon removes only the upper part of the uterus, keeping the cervix in place.
Total Hysterectomy. In a total hysterectomy, your surgeon removes the whole uterus and cervix.
Radical Hysterectomy. In a radical hysterectomy, your surgeon removes the whole uterus, tissue on the sides of the uterus, cervix, and the top part of the vagina. This procedure is often done when cancer is present.
Along with a hysterectomy, your surgeon may also remove one or both ovaries (oophorectomy) and fallopian tubes (salpingectomy). If both the ovaries and tubes are removed along with the uterus the procedure is called a hysterectomy and bilateral salpingo-oophorectomy. If you do have your ovaries removed during the procedure, you’ll immediately enter menopause.
Surgical Approaches for Hysterectomy
The best surgical approach for your hysterectomy usually depends on the reason for the hysterectomy and your overall health.
Vaginal Hysterectomy. In a vaginal hysterectomy, your surgeon removes your uterus through your vagina. Your recovery is faster for a vaginal hysterectomy, but it’s only suitable in some instances. If your uterus is enlarged, you’ll have to have an abdominal hysterectomy.
Abdominal Hysterectomy. During an abdominal hysterectomy, your surgeon removes your uterus with an incision in your lower abdomen. A total or a partial hysterectomy can be performed this way.
Surgical Technique for Hysterectomy
There are two surgical techniques for hysterectomy: Traditional or Open Surgery and Minimally Invasive Laparoscopic Surgery. Your doctor will determine the best technique for your procedure based on the reason for your hysterectomy and the results of your diagnostic tests.
Open Surgery. Traditional or open surgery is performed through traditional large incisions (5-7 inches) in the abdomen to remove the uterus and other reproductive organs (if required or recommended by your doctor). Recovery from open surgery may take up to 6 weeks.
Laparoscopic Hysterectomy. At Newton-Wellesley OB/GYN, our physicians can perform hysterectomies laparoscopically using a laparoscope, a slender viewing instrument with a light and camera that they install through small incisions in the abdomen. They use a computer to control the surgical instruments with optimal precision and accuracy to remove pieces of your uterus, one at a time, through the incisions on your abdomen.
Today’s technology allows for quicker, more precise, and more efficient surgeries than ever before. This means less downtime and scarring than with a traditional hysterectomy.
Life After a Hysterectomy
A hysterectomy can help women find permanent relief from a variety of medical conditions, including uterine fibroids, endometriosis, ovarian cysts, abnormal vaginal bleeding, chronic pelvic pain, cancer of the uterus, cervix, or ovaries, and others.
If you had a partial or supracervical (subtotal) hysterectomy, and your cervix remains intact
- You will still be at risk for cervical cancer.
- You will still need regular Pap tests to screen for cervical cancer.
If you have a hysterectomy before menopause and keep your ovaries
- You may experience menopause at a younger than average age.
If you are premenopausal and had your ovaries removed
- You will experience changes in hormone levels and start menopause.
- You may experience vaginal dryness.
- You may develop urinary incontinence.
Many women begin hormone replacement therapy before they leave the hospital to help them adjust to changes in hormone levels.
Genetic Testing FAQs
To help you assess whether you may benefit from hereditary cancer testing, you need to discuss your risk of cancer with your healthcare professional and ask for further evaluation.
Genetic tests are performed on a sample of blood, hair, skin, amniotic fluid (if you are pregnant), or other tissue. The sample is then sent to a lab that specializes in genetic testing. The technicians look for specific changes in chromosomes, DNA, or proteins, depending on the suspected disorder. The lab returns the test results to the doctor who requested the test. It may take several weeks or longer to get the test results.
Under the Affordable Care Act, insurance companies are required to pay for both genetic counseling and breast and gynecological cancer testing (e.g., Hereditary Breast and Ovarian Cancer (HBOC) testing) for women who meet certain criteria. For these patients, insurance companies must cover the entire cost of genetic counseling and breast and gynecological cancer testing with no out-of-pocket costs to the individual.