Hysterectomy is the surgical removal of the uterus. It is done to
treat certain gynecological conditions, including childbirth complications;
cancer; and fibroids, endometriosis, or uterine bleeding that hasn't responded
to other treatments.
A total (complete) hysterectomy is removal
of the uterus and cervix. A subtotal (also called
partial or supracervical)
hysterectomy is the surgical removal of the uterus, leaving the cervix in
place.
A radical hysterectomy is done for some
cancers. It is the removal of the uterus, cervix, ovaries, structures that
support the uterus, and sometimes the lymph nodes.
The uterus can be removed through:
- An incision in the vagina (vaginal
hysterectomy).
- A small incision [usually about
2 in. (5 cm) long] just at or
above the pubic hairline (mini-laparotomy, or "mini-lap").
- A large
incision made in the lower abdomen (abdominal hysterectomy).
- Laparoscopy, which is less invasive than other methods. In this
procedure, a special viewing instrument (laparoscope) is inserted through a
small incision. The uterus can then be removed through a small abdominal
incision or a vaginal incision (laparoscopic assisted vaginal hysterectomy).
The ovaries may be removed along with the uterus. The decision
about whether to remove or leave the ovaries is based on a woman's wishes and health
issues.