Hysterectomy is the most commonly performed major surgical procedure in the non-pregnant woman. Approximately 600,000 hysterectomies are performed yearly in the U.S. Exactly what is done during hysterectomy and what are the consequences? This article will review this commonly discussed but less understood surgical procedure.

In order to understand the procedure it is first important to understand the female anatomy. The uterus is located in the pelvic cavity, sitting between the bladder and rectum. The bladder sits directly on top and is loosely attached to the lower anterior segment of the uterus. The ureters which carries urine from the kidneys to the bladder, course alongside and under the lateral edges of the uterus and cervix. Posterior to the uterus is the rectosigmoid (distal end of colon as it exits body to become anus). There isn’t a direct attachment of these two organs; they merely rest side by side. The uterus ends in the cervix which is the distal and exterior portion of the uterus that sits in the birth canal. The fallopian tube branches off the top of the uterus to drape over the ovaries and they exist as separate but loosely attached structures.

The ovaries produces the eggs, the fallopian tubes allows transport of the egg into the uterine cavity. The sperm and egg meet in the fallopian tube where fertilization occurs. The fertilized egg starts to replicate in the fallopian tube, travels into the uterus and implants in the endometrium (lining of the uterus). The reproductive organs have clear cut functions. The ovaries produce the oocyte or egg and also produce hormones which include estrogen, progesterone and testosterone. The fallopian tube allows for fertilization and transport to the uterus. The uterus is the incubator for the developing fetus and the cervix is the door that keeps the developing fetus in place and allows for delivery when it is time for birth.

A hysterectomy is the surgical removal of the uterus. Sometimes the entire uterus is removed while sometimes the cervix is left in place. The ovaries and tubes can be removed at the time of a hysterectomy or separately. Removal of an ovary is described as an oophorectomy and removal of a fallopian tube is a salpingectomy. There are a myriad of reasons why the different procedures are performed. Once the uterus is removed a woman can no longer carry a pregnancy. If both ovaries are removed then a woman cannot produce a fetus and the absence of the fallopian tubes makes normal fertilization impossible.
Since this is one of the most commonly performed surgeries in women, we all know someone who has had or is considering the procedure. If a hysterectomy has been recommended to you then make sure you understand exactly what will be removed and why. Be clear on the reasons for the surgery and other options to address your problems. This will avoid any regret about the decision to have surgery and better help you to accept any potential adverse outcomes that may occur. The risk of complications is low but it certainly doesn’t feel that way to the person affected. Be an advocate for yourself so you can have an ideal outcome.

I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!