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Hysterectomy Indications

By Dr Ananya Mandal, MD

Hysterectomy or surgical removal of the womb is a common operation carried out to treat conditions of the female reproductive system.

In some cases, it may be necessary to remove the cervix, fallopian tubes, ovaries or other surrounding structures, as well as the womb. Hysterectomy is a major procedure that is associated with both risk and benefits. The procedure can cause hormonal imbalance and affect a woman’s overall health. Hysterectomy is therefore usually only recommended in cases where reproductive conditions cannot be treated in any alternative way.

Some of the conditions this procedure may be used to resolve are described below.

Fibroids

Fibroids are benign tumors found growing in or around the uterus. The tumors, which vary in size, are made up of muscle and fibrous tissue and can cause painful, heavy periods; persistent pelvic pain; the need to urinate frequently; constipation and discomfort during sex. If a woman does not wish to have children, hysterectomy is considered as a treatment for the growths.

Endometriosis

Endometriosis is the growth of uterine tissue outside of the womb such as in the ovary, bladder, fallopian tube or rectum. If these growths become trapped, they can cause inflammation, pain, irregular periods and even infertility. A hysterectomy can be used to remove this tissue and may be considered in cases where less invasive methods have failed and the woman no longer wishes to have children.

Adenomyosis

Here, the tissue that lines the womb begins to grow within the muscle wall of the womb. This can cause severely painful periods. In peri-menopausal or menopausal women, hysterectomy may be a treatment option where all other alternatives have failed.

Heavy periods

Some women lose a significant amount of blood when they are menstruating, which can cause stomach cramps and pain. The heavy bleeding may be caused by fibroids, but usually no cause can be identified. In cases where the woman’s life is severely impacted by the bleeding, she no longer wants children and all other therapies have failed, physicians may consider hysterectomy as an option for treating the heavy bleeding.

Vaginal prolapse

A prolapsed uterus, which often occurs as a result of childbirth is caused by tissues and ligaments that usually support the womb becoming weak, meaning the structure falls from its usual position. Some examples of symptoms that may occur include back pain, a sensation that something is falling from the vagina, urinary incontinence and problems having sex. In cases where the supporting tissues are severely weakened and the woman does not wish to have children, a hysterectomy may be considered as a treatment option.

Cancer

A hysterectomy may be advised when cancer is affecting any of the following structures, especially if the cancer has reached an advanced stage.

  • Cervix
  • Ovaries
  • Fallopian tubes
  • Womb

Pelvic inflammatory disease

This condition occurs due to bacterial infection of the female reproductive system. In the early stages, it can be treated with antibiotics. However, if the infection spreads, it can lead to long-term damage and pain. In these cases, a hysterectomy may be considered.

Reviewed by , BSc

Further Reading

Last Updated: Oct 16, 2014

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