Gynaecology Services - Hysterectomy
Sub Total Hysterectomy
This involves removing the uterus, leaving the cervix. The ovaries are retained. This was performed more frequently in the past than it is now. However current opinions favours removal of the cervix as retaining it serves no purpose except to leave a potential cancer site in the body
This is the term used when the uterus, including the cervix is removed. The ovaries are retained.
Hysterectomy & Bilateral Salpingo-Oophorectomy
This is the term used when the uterus, ovaries and fallopian tubes are removed. This operation is performed when there is disease of the ovary, for example, endometriosis.
Women who have not reached menopause should be aware that this type of surgery will bring on an early menopause. Hormone Replacement Therapy will be discussed with you by your Doctor.
This is the term used when the uterus, upper part of the vagina, ovaries, pelvic ligaments and lymph nodes are removed. This is usually performed in the case of cancer of the cervix, which can spread sideways into these ligaments and nodes.
Note: Sometimes the ovaries are retained.
Will you keep your Ovaries?
Before the operation discuss with your Doctor whether your ovaries will or will not be removed, and the reasons for this decision.
The ovaries continue to produce the female hormones estrogen and progesterone after the uterus has been surgically removed. Healthy ovaries play an important role in a woman’s health and well being. They can affect many physical functions such as co-ordination, temperature regulation, fluid retention, mood changes and the ability to concentrate. They also help maintain skin texture and vaginal lubrication.
If both of the ovaries are removed in a pre-menopausal woman, she will experience a surgically induced menopause. Even a small piece of ovary can maintain normal hormonal activity.
If your hysterectomy is indicated because of cancer it is likely that your ovaries will be removed. This eliminates any risk of ovarian cancer in the future.
A post-menopausal woman having a hysterectomy will routinely have her ovaries removed because, as a natural consequence of menopause, they no longer function.
The ovaries may also be removed if your surgery is performed for endometriosis as ovarian function does affect this disease.
If your ovaries are not removed you will continue to ovulate (produce and release ova or eggs). The ova are released and absorbed back into your body. You will not have any more periods and you will not be able to conceive a child. However, if you have had problems with pre-menstrual syndrome, having a hysterectomy won’t automatically solve that problem.
This operation destroys the lining of the uterus (the endometrium) and is most commonly used as an alternative to hysterectomy for women with non-cancerous bleeding disorders.
A general anaesthetic is required for this procedure. Removal of the endometrium is carried out with a cutting loop, a roller ball or a laser. It is a less invasive procedure than a hysterectomy with the following advantages:
· No surgical wound
· The uterus and ovaries are retained
· Day surgery procedure
· Faster recovery time
Endometrial ablation can only be used for women who do not wish to remain fertile. It is not advisable that a woman becomes pregnant after this procedure. After endometrium ablation more than half of the women have no periods, while some have much lighter bleeding than before. Only a small proportion of women continue to have bleeding as heavy as it was before surgery. For those women a second operation may be required.
Acknowledgements & Source
The information in this page has been drawn from a variety of sources, primarily the following books:
Sandra Coney and Lynn Potter (Heinemann Reed 1990)
Hysterectomy Information Package
Southern Canterbury Women’s Wellness Centre
Staff at Christchurch Women's Hospital
So You're Having a Hysterectomy
Megan Gressor (Gore & Osment Publications)
Some illustrations by Marisa Swanink
Cervical Cancer: A book for Every Woman.