There are several types of procedure. The most common are:
- Radical hysterectomy - the removal of the uterus, fallopian tubes, tissues on both sides of the cervix (parametrium), ovaries and the upper part of the vagina and the attached pelvic ligaments and lymph nodes.
- Hysterectomy with bilateral salpingo-oophorectomy - the removal of the uterus, fallopian tubes and ovaries.
- Total hysterectomy - the removal of the entire uterus and the cervix; the ovaries remain.
Sometimes the type of hysterectomy you need will be clear-cut, based on your diagnosis. For instance, if you have cancer a radical hysterectomy may be your only option. But in many cases you may have some choice, particularly about whether your ovaries are removed.
In pre-menopausal women, removing the ovaries causes instantaneous (or surgical) menopause, which some women may find a difficult or unwanted side-effect. However, some gynaecologists will recommend this option because it eliminates the chance of developing ovarian cancer in the future.
You need to have a clear understanding of the advantages and disadvantages of this option as it has major implications in your life. For the majority of women (except those who have cancer or an emergency hysterectomy after childbirth), a hysterectomy is rarely urgent, so you can take your time deciding what’s right for you.
In terms of the procedure, there are three ways a hysterectomy can be performed:
- Abdominal hysterectomy (through an incision in the lower abdomen)
- Vaginal hysterectomy (through the vagina)
- Laparoscopic hysterectomy (“keyhole surgery” through small incisions in the abdomen)
The method used depends on a number of factors, including the reason for the operation, the extent of surgery required, a woman’s anatomy (including weight and previous pelvic surgery), and the surgeon’s expertise and choice.