Hysterectomy

What is a hysterectomy?

A hysterectomy is when a woman's uterus is removed.

The uterus can be removed in 3 different ways:

  • laparoscopic hysterectomy
    • small keyhole incisions (5-10mm) are used to place instruments and a camera inside the abdomen, then the procedure is performed watching the camera view on a monitor
  • abdominal hysterectomy
    • an incision is made on the lower abdomen
  • vaginal hysterectomy
    • the whole procedure is performed through the vagina

When is a hysterectomy performed?

For many women an operation to remove their uterus becomes a necessary next step. This may be because methods to stop heavy bleeding are not successful, side effects of medications are intolerable, fibroids are problematic or endometriosis is severe enough that a more permanent solution is determined.

How is it the procedure performed?

At Aceso Health, the vast majority of hysterectomies are performed using a laparoscopic approach. This is an advanced procedure requiring advanced laparoscopic skills and intensive training.

A laparoscopic hysterectomy holds many advantages over other methods. Recovery is much faster, hospital stay is shorter hospital, less pain, and there is a more rapid return to family life, work and exercise.

On most occasions a woman’s ovaries are retained, meaning she does not go through the menopause as the ovaries still produce hormones (estrogen and progesterone).

In women having a hysterectomy we advise removal of the fallopian tubes. Once the uterus is removed the tubes are have no function. The main reason for removal is that clinical studies show a reduction in the risk of ovarian cancer when the tubes are removed at hysterectomy.

How we can help

The doctors at Aceso Health will evaluate the issues; discuss all options and work together to make an evidence and experience-based plan. We aim to work with our patients to determine the most appropriate course of action.

Further reading

Aceso blog

Further information

Symptoms

Bleeding between periods

This is quite common, and if you experience just a single episode you need not be overly concerned. Common causes are oral contraceptives and other hormonal therapies. Persistent bleeding may be caused by genital tract infections, polyps within the uterus or cervix, or possibly cervical cancer. Find out more

Heavy periods

Typically women may menstruate (bleed) for 2-5 days, and lose around 30-40ml of blood. Abnormally heavy bleeding is when: your periods last longer than 7 days; the volume is more than 80ml; there is flooding or clotting; you are anaemic. Find out more

Infertility

As many as 1 in 6 couples in New Zealand have difficulty falling pregnant. Some causes of infertility in men are issues with sperm quantity and quality. Causes of infertility in women include problems with ovulation, endometriosis, tubal blockage, and issues with egg numbers or quality. Find out more

Irregular or unscheduled bleeding

There are a number of causes of irregular bleeding, and our investigations will depend a bit on your age and fertility plans. Common causes can include endometriosis, infection, instability of the lining of the womb, ovarian cysts, perimenopause, polycystic ovarian syndrome, polyps, and early pregnancy. Find out more

Painful bowel movements

Painful bowel movements (dyschezia) are extremely common. Causes include constipation, anal fissures and irritable bowel syndrome. If you have severe endometriosis, you may suffer from dyschezia during your period. You may also have extremely painful periods and pain with deep intercourse. Find out more

Painful periods

The medical term for painful periods is dysmenorrhoea. You may describe it as pain, discomfort or cramps around the time of menstruation. There are 2 types of dysmenorrhoea: primary and secondary. Find out more

Persistent pelvic pain

If you have pain on and off for more than 6 months we call it 'persistent pelvic pain'. There are a number of conditions that can be involved, and sometimes more than one will be present. In some cases the cause is obvious, such as an ovarian cyst, or a urinary tract infection, but in other women the cause is elusive. Find out more

Postmenopausal bleeding

Any bleeding in the menopause is abnormal and needs to be investigated. It is most often caused by fragile tissues (vagina, endometrium) due to lack of estrogen production. Endometrial hyperplasia and cancer may be the cause in 5-10% of cases, and if promptly attended to, treatment is highly successful. Find out more

Urinary incontinence

There are a number of different types of urinary incontinence, but the main two are 'stress' and 'urge' incontinence. An estimated 1 in 4 women are affected. There are a number of strategies that can help, and for some women there are simple surgical procedures with an excellent chance of success. Find out more

Conditions

Adenomyosis

Adenomyosis is similar to endometriosis. It occurs when the inside lining of the uterus (endometrium) is found within the muscular wall of the uterus. This may cause the uterus to become enlarged. Adenomyosis may be patchy, or severe, causing a severely enlarged uterus. Find out more

Endometriosis

Endometriosis is a common disorder that affects many women in New Zealand. It occurs when endometrial tissue, which should only be found in the uterus, also grows outside the uterus, such as on ovaries or the bowel. This can be very painful and is why women with endometriosis usually have pain around the same time as their period. Find out more

Hyperplasia and uterine cancer

Endometrial hyperplasia occurs when the inside lining of the uterus (the endometrium) starts to behave abnormally. Whilst not cancer, endometrial hyperplasia is a potential 'pre-cancer'. Risk factors include being over 35, obesity, cigarette smoking and polycystic ovarian syndrome. Find out more

Prolapse

Prolapse occurs when the walls of the vagina lose support. This can cause the organs and spaces around the vagina to bulge downwards. The symptoms or complaints that an individual might have in this situation vary widely. Find out more