When Should I Consider a Hysterectomy?

When medication and non-invasive treatment can’t resolve a uterine condition that’s causing debilitating pain or life-threatening conditions, a hysterectomy may be appropriate. A hysterectomy involves the surgical removal of the uterus. It can also include removal of your cervix, fallopian tubes, and ovaries. Considered major surgery, hysterectomies rank as the second most common surgery among women in the United States, with almost 500,000 procedures performed annually. 

In addition to physical changes, a hysterectomy has life-changing consequences. The procedure results in an inability to have children. It can cause symptoms of menopause, vaginal dryness, and an increased risk for conditions such as heart disease and bone loss. 

You’ll feel comfortable considering a hysterectomy while under the care of an expert gynecologist. Obstetrician/gynecologist Darin Swainston, MD, FACOG, has extensive experience performing hysterectomies. At his practice in Las Vegas, Nevada, Dr. Swainston specializes in single-site umbilical hysterectomy. This innovative technique uses robotic-assisted surgery to remove the uterus and other structures through a small incision in your belly button.

Depending on your symptoms, removal of your uterus and other organs may be the appropriate treatment for any of the following conditions.

Endometriosis

Endometriosis occurs when uterine tissue, or endometrium, grows outside your uterus. This creates deposits in areas such as your ovaries, fallopian tubes, bowel, rectum, or bladder. The cells in this uterine tissue grow and bleed every month in alignment with your menstrual cycle. As these cells break down, the process can cause inflammation and irritation in nearby non-uterine tissue. 

Symptoms of endometriosis include intense cramps and debilitating pain in the organs where endometrium grow. The condition can also cause periods that last longer than normal and produce heavy bleeding. During your period, you may experience intense lower back pain and leg pain that limits your ability to move or walk. Severe migraines, nausea, constipation, diarrhea, and allergy flare-ups may also occur.

A hysterectomy can reduce the incidence of endometriosis with the removal of the uterus as well as the endometrium deposited outside the uterus.  

Endometrial hyperplasia

Endometrial hyperplasia occurs when your body produces too much estrogen without producing an adequate supply of progesterone. During your menstrual cycle, estrogen promotes cell growth while progesterone regulates how often cells shed. When these hormones become imbalanced, estrogen produces too many cells which accumulate and the lining of your uterus becomes too thick.

Symptoms of endometrial hyperplasia include periods that occur last longer than normal and fewer than 21 days apart, creating a cycle of almost constant bleeding. You may also experience bleeding between periods, heavy menstrual bleeding, or missed periods. If you’re post-menopausal, you may have uterine bleeding even without having your period. 

Left untreated, atypical and complex forms of endometrial hyperplasia can lead to cancer. In these cases, a hysterectomy can provide life-saving treatment. 

Uterine fibroids

Uterine fibroids occur as noncancerous muscular tumors in your uterus, on its wall, or its surface. Uterine tumors typically appear during childbearing years. Symptoms can include painful periods, heavy bleeding between periods, pelvic pressure, difficulty voiding, or frequent urination. You may notice visible distortion of your abdomen or uterus if you have large fibroids. 

Fibroids can increase your risk of infertility or miscarriages because they change the structure of your uterus. Appropriate treatment varies with the severity of your condition. Hysterectomy provides the only definitive cure for fibroids. 

Uterine prolapse

Uterine prolapse occurs when the muscles and ligaments on your pelvic floor become so stretched or weakened that they can’t support your uterus in its proper position. As a result, your uterus slips down into your vagina. 

Symptoms include pelvic pressure or feeling like you’re sitting on a ball. As your uterus slips lower, you’re more likely to experience a sensation of having something protruding from your vagina. This pressure can make it difficult to sit or walk normally. Uterine prolapse can also cause lower back pain, difficulty voiding and urinating, and painful sex.

When the uterus sags into the vagina but doesn’t protrude, special devices or exercises can strengthen muscles to correct the condition. However, your cervix or entire uterus can drop and protrude outside your vagina in advanced uterine prolapse, making a hysterectomy appropriate. 

Cancer

If you have cancer of the uterus, cervix, fallopian tubes, or ovaries, a hysterectomy may help you survive these life-threatening diseases. Symptoms of these cancers can include:

• Post-menopausal vaginal bleeding
• Heavy-irregular periods
• Foul-smelling vaginal discharge
• Painful urination and/or intercourse
• Enlarged abdomen
• Leg, back, and lower abdominal pain

Uterine pain, irregular heavy bleeding, or any serious uterine condition requires prompt treatment. Schedule an appointment online or call our office to arrange a consultation today.