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Demystifying Hysterectomy Part III: Risks and Benefits

Posted May 17 2010 12:00am

Having a hysterectomy means that you will no longer have the ability to bear children.  It also means you should no longer experience menstrual bleeding (although you may experience other cyclic changes depending upon whether you still have ovaries).  Hysterectomy alone (ie without removal of or damage to the ovaries) does not result in menopause.  However, hormonal changes after hysterectomy are possible. 

Many women are concerned that removal of the uterus will adversely affect their sexual functioning and satisfaction.  There are no studies demonstrating that hysterectomy (with or without removal of the cervix) has a negative effect on patients’ sex lives.  Neither the uterus nor cervix itself contributes to vaginal lubrication or orgasmic response. Most patients’ male partners can not detect the presence or absence of a uterus or cervix and among those who can, few feel that it impacts their experience during intercourse.  Therefore, the best predictor of sexual satisfaction and functioning after hysterectomy is your sexual satisfaction and functioning prior to surgery.

You should discuss these concerns with your gynecologist before considering any kind of surgery to remove all or part of your uterus.

Complications from hysterectomy are uncommon but can be serious.  Although it is impossible to predict or list every possible problem, these infrequent complications may include infection, bleeding, thromboembolic events (blood clots), injury to adjacent organs, bladder or bowel dysfunction, nerve injury, postoperative pain, and anesthesia complications.  You should talk to your doctor about the possible complications of any treatment you consider undergoing.

Hysterectomy is permanent.  Even when performed via minimally invasive techniques, it is still a major surgery. 

Other options for managing certain gynecologic conditions may be appropriate.  These options may include expectant management (watchful waiting), therapy with hormonal or other types of medication, the use of interventional radiology (uterine artery embolization), targeted ultrasound ablation, or other fertility-sparing surgical procedures (myomectomy, ablation of endometrium or endometriosis).

The choice of whether hysterectomy is the right option for you depends on a number of factors.  Talk to your doctor about your condition and all of your options when considering hysterectomy as part of a treatment plan.

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